Short- and long-term causes of West Nile virus risk in Europe: a spatiotemporal model accounting for under-reporting

Models that provide risk maps for zoonoses often lack (i) a spatiotemporal autocorrelation component, yet crucial in understanding the spread of infectious diseases, (ii) accounting for heterogeneity in case reporting, and (iii) a causal framework for explanatory variables. Here, we addressed these limitations with a model system, West Nile virus, a vector-borne pathogen transmitted in a bird reservoir, and affecting humans and horses. We built a spatiotemporal occupancy model and fitted it to notified (human and horse) case data. Based on a directed acyclic graph, we estimated the causal effects of conjectural weather variables (i.e. changing in the short-term) vs. structural variables (i.e. changing in the long-term) on WNV circulation in the bird reservoir, besides assessing variables associated with case reporting. By computing population attributable fractions, we found the contribution of conjectural weather variables to WNV outbreaks in Europe to be globally higher than the structure of the bird community.