Clermont Ferrand is north of Lyon. I took a day trip from Lyon to meet with some of the staff at INRA.
INRA is the worlds second greatest producer of publications in the agricultural sciences. It has 250 laboratories and 45 experimental units across 13 scientific divisions and 17 research centres. It has a community of 13,000 people including 7903 permanent staff, 1849 full time researchers, 2353 interns and 556 PhD students with INRA grants. INRA has an annual budget of 850.89 million euros, 77% of funds come from the Ministry of Research and 20% from other public funded sources ( figures from 2017).Auvergne- Rhône- Alpes in Clermont Ferrand is one of the 17 centres in France
Clermont Ferrand is the capital of the Auvergne region, the city is overlooked by its dormant volcanic mountains. Isabelle told me the hills glow red in the summer:
Isabelle is a Research Engineer at the site in Theix,
In collaboration with other centres, Isabelle has been involved in building a tick risk map for France, it looks at the suitability for the presence of ticks. It looks at the landscape index, density of ungulates, density of humans and the climatic indicators. The project is ongoing and findings are not published yet.
Isabelle spoke about a project she was involved in called Lymesnap, the project wanted to collect information on episodes of Erythema migrans (EM). The project was developed in collaboration with the hospital in Clermont Ferrand, and people were recruited to participate in a study where they took photographs of the EM rash and completed a questionnaire and they were offered counselling on Lyme disease. When a picture was submitted they were reviewed to decide if they were EM and the discussion included whether the person had received appropriate treatment. The project was promoted throughout the region in the media, newspapers, visits to local businesses and at GP and Hospitals. The project is completed and analysis of the work continues.
This project is looking at the human use of walking trails in Metropolitan France. The information provided by those hiking will make it possible to estimate the human exposure to tick bite, to identify the risk of bites and to propose preventative measures. Hikers are asked to register the area they are hiking by providing GPS co-ordinates and completing a questionnaire. It can be completed online and it is promoted widely.
This is the link to the reporting portal- if you open it in Google chrome the settings should translate it into English! https://www6.ara.inra.fr/epia/Sites-Web/FREQRANDO
The reporting portal also includes information on ticks and tick removal
Xavier is a Biologist, with a particular interest in molecular biology. He is currently the director of the INRA research centre in Clermont Ferrand.
Xavier has been involved in a project which looked at the transmission cycles of tick borne pathogens. It is known that many pathogens are maintained by multiple hosts and can involve multiple strains with different phenotypic characteristics, investigating how different host species contribute to transmission is crucial to properly assess and manage disease risk. The study emphasised the importance of taking co-infection patterns into account to better understand the genetic structure of pathogen populations and to link these patterns with the way in which pathogens spread and are maintained in host communities. The work demonstrated that combining high throughput sequence typing with network tools and statistical modelling is a promising approach for characterising transmission cycles of multi host pathogens.
Other projects have looked at how Borrelia invades ticks?, How the tick responds to environmental changes?, Spatial patterns of risk of exposure to ticks and allow for mapping of human risk?.
Maude came to have a chat with me at lunchtime as we had mutual acquaintances, Maude had been living and working up until 2018 with Caroline Millins and Roman Biek at Glasgow University. Caroline is a clinician in Anatomic Pathology and Roman is a researcher. Caroline and Roman are supervising the work being undertaken on the Western Isles.
Maude moved to Clermont Ferrand at the end of 2018 and is working on a range of projects which includes some work on ticks.
Sylvian joined by video conference to have a discussion on some of his work. He is an engineer in social sciences at INRA, he works with others on the social aspects of Lyme disease. His approach is to bridge the gap between Public health and sociology. In France there have been studies undertaken on peoples perceptions/social constructions of tick risk. People imagine the tick risk to be present everywhere and many people are very afraid, those living in urban areas are less likely to come into contact with ticks and therefore have minimal risk of contracting Lyme disease. It is suggested that Lyme disease has been portrayed to be a disease everyone should be fearful off, it was thought this social construction is made worse through media and politics.
A study was developed to look at peoples fear with the hope the results could be used to modify public health policies to help the prevention policies against ticks. The researchers wanted to gain an understanding of how people view the risks for themselves and their families and how they view the media constructions of the risk. Many social approaches were used within the study and in the rural areas of Clermont Ferrand Lyme disease has been known about for approx 50 years, discussing ticks was not new to them, contact with ticks is expected and the people know how to cope and they do not fear them. Generally people integrate the management of ticks into their life, they see it as normal, they do know many people with Lyme disease but they do not see it as a big problem. Their view is that climate change is a factor causing the increase in the problem.
In the study in cities the results are very different, generally people have no experience of ticks and their knowledge is based of the information provided by the media which has been seen as scaremongering. The study found that people interpretate the media messages as ‘ticks make you ill’ and ‘you should avoid forests/trees’, people link forests and mountains with tick risk. This understanding is a public health problem as it is causing people to stop taking part in outdoor activities.
The study identified that people need to be informed going out and speaking to people to provide information and challenge peoples interpretation of the media messages. Using the knowledge from published papers on tick risk, and the precautions that can be taken as they are key in prevention of Lyme disease. Social conflict theory demonstrates that information such as in the media can be taken at face value- people do not find out any other information or explore other views on the topic. This study found that speaking to people and explaining the risks can lead to people changing their mind. Although not everyone responds to this method, many farmers in France have Lyme disease and behaviour change education has been targeted but they are not willing to change. Health professionals, students and the general public especially those with children are very open to the behaviour change messages.