The growing threat of vector-borne diseases, many of which are climate-sensitive, demands more robust monitoring systems and coordinated response efforts in both endemic and emerging regions. Climate change, expanding mosquito habitats and seasons, and shifting bird migration patterns drive the spread of diseases like West Nile virus (WNV) into new areas.

In response to these challenges, a team of international researchers affiliated with leading European initiatives, including the research projects  IDAlert and E4Warning and the Dutch Pandemic and Disaster Preparedness Center (PDPC), gathered at the Centre for Advanced Studies of Blanes (CEAB-CSIC) to discuss and enhance our understanding of the ecological pathways of WNV circulation and transmission within European wetlands. Their objective was to share and develop more integrated and effective surveillance strategies that bring together data on vectors, avian host dynamics, and their interactions, strengthening early warning capabilities and preparedness in the face of a changing climate and land use transformations.

Wetlands as crucial sentinels: integrated approaches

Wetlands and their peri-urban surroundings are recognized as critical hotspots for the surveillance of vector-borne diseases like WNV. These landscapes represent complex socio-ecological interfaces where natural and human-modified environments converge.

This ecologically rich region, characterized by wetlands and rice fields, provides ideal breeding grounds for mosquitoes and critical habitat for both resident and migratory birds, key components in the WNV transmission cycle. During the summer months, the human population in the area more than doubles due to seasonal tourism, significantly increasing the risk of human exposure to emerging pathogens.

As a result, Aiguamolls serves as a strategic study site for the E4Warning and IDAlert projects, offering an ideal setting to investigate the ecological drivers of arboviral circulation and to test innovative field tools. A central goal of this work is to improve the collection of blood-fed female mosquitoes, which can be analyzed to determine their host feeding preferences, providing insight into potential transmission routes of WNV.

To share and develop more integrated and effective surveillance strategies, a three-day meeting was organized. During this visit, one of the key goals was to further explore collaboration and comparison with wetlands near Rotterdam, another study site shared by the PDPC and IDAlert projects. By contrasting ecological dynamics and surveillance methods between these northern and southern European wetlands, researchers aim to better understand regional variability in West Nile virus circulation and improve transnational early warning systems.

Throughout the meeting, researchers carried out intensive fieldwork within the park, deploying BG-Sentinel and resting traps, and conducting mosquito aspirator sampling across a range of habitats, including rice fields, wetlands, and peri-urban areas. Furthermore, participants explored the use of passive acoustic monitoring systems to assess bird community composition and detect shifts that may impact viral dynamics. These acoustic tools offer new opportunities to track the presence and behavior of avian reservoir species over time.

Complementing these efforts, researchers received hands-on training in the use of FTA cards, which are small sampling devices placed in the field to collect mosquito saliva. These cards, developed at Erasmus MC, enable the non-invasive detection of arboviruses using molecular techniques and represent a promising method for monitoring viral circulation.

A meeting shaped by diverse expertise and career stages

One of the key strengths of the gathering was the rich diversity of disciplines and career stages represented, fostering dynamic exchange and cross-pollination of ideas. The meeting brought together experts in epidemiological modeling, virology, vector ecology, and environmental science, creating a vibrant forum for advancing integrated approaches to climate-sensitive disease surveillance.

Among the participants was Joacim Rocklöv, from Heidelberg University (Germany), coordinator of the IDAlertEuropean project, which focuses on understanding how climate change influences the emergence and transmission of infectious diseases to strengthen Europe’s public health resilience. He was joined by PhD candidate Julian Heidecke, who contributed to the modeling and risk assessment discussions.

Reina Sikkema, a virologist from Erasmus MC (The Netherlands), participates in IDAlert and represents the Pandemic and Disaster Preparedness Center (PDPC), which brings together experts to improve readiness for emerging health threats. She co-leads a frontrunner project at PDPC together with Maarten Schrama, ecologist, from Leiden University, who also participated. Within a large transdisciplinary team, they investigate how salinization and landscape change influence the ecology of mosquitoes and birds and how these changes modulate the risk of virus transmission. They were accompanied by team members Jordy Van der Beek, Tijmen Hartung, and Erley Lizarazo, each contributing to the interdisciplinary dialogue.

Local hosts from the Centre for Advanced Studies of Blanes (CEAB-CSIC) included Frederic Bartumeus, co-director of Mosquito Alert, coordinator of the E4Warning project, and partner in IDAlert. He was joined by his research team members Alex Richter-Boix, Catuxa Cerecedo-Iglesias, PhD candidates Nina Bogdanovic and Júlia Rodriguez-Grabalosa, and Olatz San Sebastián; Elisa Mora and Santi Escartín from the Mosquito Alert operational team.

Throughout the workshop, participants engaged in rich, collaborative discussions focused on the development of scalable, ecological, and epidemiological risk indicators, combining traditional and novel technologies in the field, e.g., smart mosquito traps (with automated count and identification of mosquito species), field-grounded molecular techniques, and automated acoustic recording of birds. Together, they explored strategies to model and forecast the risk of WNV and other climate-sensitive vector-borne diseases across Europe, leveraging the strengths of diverse data streams and scientific perspectives.

A new study published in The Lancet Regional Health – Europe calls for urgent, proactive action to address Europe’s growing threat of vector-borne diseases (VBDs)—highlighting lessons learned from endemic regions worldwide. The research, led by the Global Health Resilience group at the Barcelona Supercomputing Center (BSC-CNS), brings together experts from 13 countries across four continents. Several E4Warning partners contributed to the study, reinforcing the project’s commitment to cross-sectoral and international collaboration.

The paper addresses the growing risks posed by climate change, urbanisation, and invasive species such as Aedes albopictus, which are extending transmission seasons and raising the likelihood of disease outbreaks including West Nile virus, dengue, leishmaniasis, and tick-borne encephalitis. In response to these escalating threats, the study emphasizes that Europe must move from reactive responses to proactive, forward-looking strategies. This shift must be grounded in cross-border collaboration, long-term planning, and the integration of local knowledge into health policies. Community-level awareness and engagement are key to ensuring that control measures are both effective and socially accepted.

Citizen science, especially in digitally connected regions, can enhance surveillance and public participation, though it requires overcoming barriers to innovation and data sharing. The study also promotes community-based interventions (CBIs), drawing on successful examples like Brazil’s “Boot Out” campaign, which combined public awareness with practical waste removal efforts. Adapting interventions across Europe requires attention to cultural, legal, and ecological differences, and the authors stress the need to expand asymptomatic and serological surveillance to improve preparedness and early response capacity.

To meet these goals, the authors propose a multi-sectoral “Intervention Toolkit” tailored to European realities, drawing on experiences from countries with long-standing expertise in managing VBDs.

The toolkit includes five key pillars:

1. Clinical case and risk management

2. Integrated vector surveillance and control

3. Adapting the built and natural environment to reduce vector habitats

4. Data harmonisation and development of decision support tools

5. Community engagement, including citizen science platforms

“We propose here five key areas where Europe could and is integrating knowledge from endemic settings on vector and disease control, and advocate for the importance of cross-country knowledge sharing partnerships and integration at the public and policy level,” said Gina Charnley, BSC researcher and first author of the study.

By combining inclusive governance and transdisciplinary knowledge-sharing, the study outlines a clear pathway toward more resilient and equitable public health systems in Europe and beyond. Yet, limited resources and shifting priorities across sectors often hinder implementation, however, moving forward, long-term cross-border collaboration, data harmonisation, and meaningful integration of local and indigenous knowledge will be critical to turning these strategies into lasting, impactful solutions.

Read the full-open access here: https://doi.org/10.1016/j.lanepe.2025.101271.

Charnley, G. E. C., Alcayna, T., Almuedo-Riera, A., Antoniou, C., Badolo, A., Bartumeus, F., Boodram, L.-L., Bueno-Marí, R., Codeço, C., Coelho, F. C., Costa, F., Cox, H., Haddad, N., Ab Hamid, N., Kittayapong, P., Korukluoğlu, G., Michaelakis, A., Maciel-de-Freitas, R., Montalvo, T., Muñoz, J., Sauleda Oliveras, S., Palmer, J. R. B., Barboza Pizard, C. J., Ribeiro, G. S., & Lowe, R. (2025). Strengthening resilience to emerging vector-borne diseases in Europe: Lessons learnt from countries facing endemic transmission. The Lancet Regional Health – Europe, 53, 101271. https://doi.org/10.1016/j.lanepe.2025.101271.