Tick-borne encephalitis (TBE) is a viral disease endemic in Eurasia. The virus is mainly transmitted to humans via ticks and occasionally via the consumption of unpasteurized milk products. The European Centre for Disease Prevention and Control reported an increase in TBE incidence over the past years in Europe as well as the emergence of the disease in new areas. To better understand this phenomenon, we investigated the drivers of TBE emergence and increase in incidence in humans through an expert knowledge elicitation. We listed 59 possible drivers grouped in eight domains and elicited forty European experts to: (i) allocate a score per driver, (ii) weight this score within each domain, and (iii) weight the different domains and attribute an uncertainty level per domain. An overall weighted score per driver was calculated, and drivers with comparable scores were grouped into three terminal nodes using a regression tree analysis. The drivers with the highest scores were: (i) changes in human behavior/activities; (ii) changes in eating habits or consumer demand; (iii) changes in the landscape; (iv) influence of humidity on the survival and transmission of the pathogen; (v) difficulty to control reservoir(s) and/or vector(s); (vi) influence of temperature on virus survival and transmission; (vii) number of wildlife compartments/groups acting as reservoirs or amplifying hosts; (viii) increase of autochthonous wild mammals; and (ix) number of tick species vectors and their distribution. Our results support researchers in prioritizing studies targeting the most relevant drivers of emergence and increasing TBE incidence.

In this contribution to the longstanding risk theory debate on optimal self‐protection, we aim to enrich the microeconomic modeling of self‐protection, in the wake of Ehrlich and Becker (1972), by exploring the representation of risk perception at the core of the Health Belief Model (HBM), a conceptual framework extremely influential in Public Health studies (Janz and Becker, 1984). In our two‐period model, we highlight the crucial role of risk perception in the individual decision to adopt a preventive behavior toward a generic health risk. We discuss the optimal prevention effort engaged by an agent displaying either imperfect knowledge of the susceptibility (probability of occurrence) or the severity (magnitude of the loss) of a health hazard, or facing uncertainty on these risk components. We assess the impact of risk aversion and prudence on the optimal level of self‐protection, a critical issue in the risk and insurance economic literature, yet often overlooked in HBM studies. Our results pave the way for the design of efficient information instruments to improve health prevention when risk perceptions are biased.

In this perspective paper, we argue that Economics could and should contribute to the development and implementation of the One Health approach currently emerging as a relevant interdisciplinary framework to address present and future infectious diseases. We show how proven tools from Health and Environmental Economics, such as burden evaluation, can be extended to fit the One Health multisectoral perspective. This global health framework could also benefit significantly from Economics to design efficient schemes for prevention and disease control. In return, adapting Economics to the challenges of One Health issues could pave the way for exciting developments in the Economics discipline itself, across many subfields.

Background: Tick-borne encephalitis (TBE) virus is transmitted to humans via tick bites and occasionally via the consumption of unpasteurized milk products. According to the literature, the most important driver of TBE emergence and increase in incidence in humans is changes in human behaviour/activities. Method and principal findings: To compensate for the lack of data, expert opinions were gathered to identify the risk factors for exposure to tick bites linked to twenty-eight human activities (professional or recreational) in forests and to target prevention messages at the populations most at risk. Opinions were elicited from a total of twenty-five European experts. Seven criteria were included in the analysis for each activity: frequency, seasonality, duration of exposure, distance covered, degree of contact with vegetation, speed and average level of protection against tick bites. The activities considered to be the most at risk of exposure to tick bites are, in descending order: three occupational activities (forest monitoring activities, forestry and wood industry activities and scientific and/or analytical activities), five recreational activities and one hunting activity (mushroom picking, spending the night in the forest, hunting, naturalist activities, orienteering, and berry or fruit picking). Conclusions and significance: Prevention messages regarding tick bites could be targeted at people who engage in activities considered in this analysis to be at highest risk of exposure to tick bites.

Le concept de parcours de soins contribue à une meilleure articulation de l’offre de santé sur un territoire. L’analyse des coûts liés à ce parcours (directs/indirects, à la charge du patient/des institutions/de la société…) est fondamentale dans l’élaboration de politiques de santé pour arbitrer entre efficacité sanitaire et viabilité financière. Nous proposons une méthode fondée sur le chemin d’impact et les valeurs tutélaires de la pollution pour intégrer aux coûts d’un parcours le coût environnemental lié aux déplacements. Cette pollution dépend du mode de transport, de la distance, de la densité urbaine et du nombre de déplacements liés à la prise en charge. Nous appliquons cette analyse aux parcours de soins de patientes suivies pour des cancers du sein dans l’ouest francilien et nous mettons en lumière les ordres de grandeur de ces coûts environnementaux liés aux transports, ainsi que les paramètres clés à prendre en compte dans cette évaluation.