Lyme Disease Risks in Europe under Multiple Uncertain Drivers of Change

BACKGROUND: Debates over whether climate change could lead to the amplification of Lyme disease (LD) risk in the future have received much attention. Although recent large-scale disease mapping studies project an overall increase in Lyme disease risk as the climate warms, such conclusions are based on climate-driven models in which other drivers of change, such as land-use/cover and host population distribution, are less considered. OBJECTIVES: The main objectives were to project the likely future ecological risk patterns of LD in Europe under different assumptions about future socioeconomic and climate conditions and to explore similarity and uncertainty in the projected risks. METHODS: An integrative, spatially explicit modeling study of the ecological risk patterns of LD in Europe was conducted by applying recent advances in process-based modeling of tick-borne diseases, species distribution mapping, and scenarios of land-use/cover change. We drove the model with stakeholder-driven, integrated scenarios of plausible future socioeconomic and climate change [the Shared Socioeconomic Pathway (SSPs) combined with the Representative Concentration Pathways (RCPs)]. RESULTS: The model projections suggest that future temperature increases may not always amplify LD risk: Low emissions scenarios (RCP2.6) combined with a sustainability socioeconomic scenario (SSP1) resulted in reduced LD risk. The greatest increase in risk was projected under intermediate (RCP4.5) rather than high-end (RCP8.5) climate change scenarios. Climate and land-use change were projected to have different roles in shaping the future regional dynamics of risk, with climate warming being likely to cause risk expansion in northern Europe and conversion of forest to agriculture being likely to limit risk in southern Europe. CONCLUSIONS: Projected regional differences in LD risk resulted from mixed effects of temperature, land use, and host distributions, suggesting region-specific and cross-sectoral foci for LD risk management policy. The integrated model provides an improved explanatory tool for the system mechanisms of LD pathogen transmission and how pathogen transmission could respond to combined socioeconomic and climate changes. https://doi.org/10.1289/EHP4615