

@article {2927,
	title = {Landscape and climatic characteristics associated with human alveolar echinococcosis in {France}, 1982 to 2007},
	journal = {Euro Surveillance: Bulletin Europ{\'e}en Sur Les Maladies Transmissibles = European Communicable Disease Bulletin},
	volume = {20},
	number = {18},
	year = {2015},
	abstract = {Human alveolar echinococcosis (AE) is a severe hepatic disease caused by Echinococcus multilocularis. In France, the definitive and intermediate hosts of E. multilocularis (foxes and rodents, respectively) have a broader geographical distribution than that of human AE. In this two-part study, we describe the link between AE incidence in France between 1982 and 2007 and climatic and landscape characteristics. National-level analysis demonstrated a dramatic increase in AE risk in areas with very cold winters and high annual rainfall levels. Notably, 52\% (207/401) of cases resided in French communes (smallest French administrative level) with a mountain climate. The mountain climate communes displayed a 133-fold (95\% CI: 95-191) increase in AE risk compared with communes in which the majority of the population resides. A case-control study performed in the most affected areas confirmed the link between AE risk and climatic factors. This arm of the study also revealed that populations residing in forest or pasture areas were at high risk of developing AE. We therefore hypothesised that snow-covered ground may facilitate predators to track their prey, thus increasing E. multilocularis biomass in foxes. Such climatic and landscape conditions could lead to an increased risk of developing AE among humans residing in nearby areas.},
	keywords = {Animals, Case-Control Studies, Climate, Disease Outbreaks, Echinococcosis, Echinococcus multilocularis, Foxes, France, Geography, Hepatic, Humans, Incidence, Multivariate Analysis, Population Density, Residence Characteristics, Risk Factors, Seasons},
	issn = {1560-7917},
	author = {Piarroux, M. and Gaudart, J. and Bresson-Hadni, S. and Bardonnet, K. and Faucher, B. and Grenouillet, F. and Knapp, J. and Dumortier, J. and Watelet, J. and Gerard, A. and Beytout, J. and Abergel, A. and Wallon, M. and Vuitton, D. A. and Piarroux, R. and Francechino Network}
}
