Tick-Borne Diseases in Urban and Periurban Areas: A Blind Spot in Research and Public Health

Tick-borne zoonotic diseases continue to emerge in North America and Europe. Of particular concern are pathogens transmitted by <i>Ixodes</i> ticks, such as <i>Borrelia</i> spp., the causal agents of Lyme disease (Lyme borreliosis). Because <i>Ixodes</i> ticks are adapted to forested habitats with high humidity and depend on wildlife for feeding and movement, research has focused on natural or rural landscapes. Demographic and land-use transitions, however, have created novel ecosystems in urban and periurban areas with high potential for human exposure. We describe post-World War II land processes giving rise to these ecosystems and explore resource-based habitat concepts and top-down community ecology perspectives aimed at predicting tick-borne disease (TBD) risk. We review studies in Europe and North America that demonstrate TBD risk in urban areas and potential drivers for TBD emergence. We identify missed opportunities for data measurements and reporting and propose metrics to quantify landscape connectivity to facilitate future syntheses or meta-analyses.