title: How to Tackle Natural Focal Infections: From Risk Assessment to Vaccination Strategies.
abstract: Natural focal diseases are caused by biological agents associated with specific landscapes. The natural focus of such diseases is defined as any natural ecosystem containing the pathogen's population as an essential component. In such context, the agent circulates independently on human presence, and humans may become accidentally infected through contact with vectors or reservoirs. Some viruses (i.e., tick-borne encephalitis and Congo-Crimean hemorrhagic fever virus) are paradigmatic examples of natural focal diseases. When environmental changes, increase of reservoir/vector populations, demographic pressure, and/or changes in human behavior occur, increased risk of exposure to the pathogen may lead to clusters of cases or even to larger outbreaks. Intervention is often not highly cost-effective, thus only a few examples of large-scale or even targeted vaccination campaigns are reported in the international literature. To develop intervention models, risk assessment through disease mapping is an essential component of the response against these neglected threats and key to the design of prevention strategies, especially when effective vaccines against the disease are available.
authors.affiliation: Department of Veterinary and Food Safety, Istituto Superiore di Sanità, Roma, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Busani
authors.affiliation: Central Research Institute of Epidemiology, Moscow, Russia.
authors.forename: Alexander E
authors.initials: AE
authors.lastname: Platonov
authors.affiliation: Department of Infectious Diseases, Koç University, Istanbul, Turkey.
authors.forename: Onder
authors.initials: O
authors.lastname: Ergonul
authors.affiliation: Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena, 299, Roma, Italy. giovanni.rezza@iss.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rezza
mesh_terms: D004675:Encephalitis, Tick-Borne / Q000453:epidemiology* / Q000517:prevention & control*; D003225:Hemorrhagic Fever Virus, Crimean-Congo; D006479:Hemorrhagic Fever, Crimean / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D017589:Immunization Programs; D018570:Risk Assessment; D014611:Vaccination; D014765:Viral Vaccines / Q000008:administration & dosage / Q000276:immunology*
chemical_list: D014765:Viral Vaccines
keywords: CCHF; Natural Focal Diseases; TBE; Vaccination; Viruses