THE list of possible threats you might expect to come across on your summer holiday to Europe has, until now, been rather short.
Beyond expected airport delays, eating your body weight in carbs and getting a bit sunburnt - there isn't usually too much to worry about.
But as temperatures rise in our favourite holiday destinations, there may be a new - and buzzier - risk on the horizon.
A range of disease-ridden insects have made their way to north Europe, from places like Africa, Asia and Central and South America.
Three different types of disease-riddled mosquito, three types of infection-prone ticks and one nasty fly species are 'established' in several European countries, according to the most recent annual report by the European Centre for Disease Prevention and Control (ECDC).
Prof Francois Balloux of the University College of London Genetics Institute warns we're likely to see more of these infections in parts of Europe as the climate becomes "more suitable".
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"Many of these insect species prefer warm and humid weather," he explains.
"Their larvae develop faster in warmer temperatures and a longer breeding season allowing larger populations to develop".
The ECDC track the spread of different species of bugs that carry can carry and transmit a number different of viruses to humans.
These include dengue and Zika - which can cause a range of symptoms such as fevers and muscle aches, and in the worst cases make people extremely ill.
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When an insect is 'established' this means they have developed a self-sustaining population that is reproducing.
Just because an insect is established somewhere, it does not mean the disease itself is endemic as not every insect will carry the disease.
Here, we look at nine different diseases you could catch from bugs that are residing in Europe...
1. Chikungunya virus
Spread by : Aedes invasive mosquitoes
Countries where bug is established: Italy, France, Spain, Portugal, Greece, Cyprus, Croatia, Serbia, Montenegro, Bosnia and Herzegovina, Albania, North Macedonia, Romania, Bulgaria Turkey and Madeira (Portugal).
Chikungunya is a virus spread by two different aedes invasive mosquitoes: Aedes and albopictus.
The disease name means "to become contorted" in the African Kimakonde language, as it causes severe muscle and joint pain.
Other symptoms include sudden fever, headache, fatigue, rash, nausea and red eyes.
Most victims will recover within a few weeks, but in some cases, the joint pain may persist for weeks, months or even longer.
It’s usually found in tropical areas like central and South America, Asia and Africa, but the mosquito has made its way to warm parts of Europe.
Last month, one person tested positive for the bug in Paris days ahead of the Olympics.
Most cases in Europe have come from people travelling to places where the disease is endemic.
2. Crimean Congo haemorrhagic fever
Spread by: Hyalomma tick
Countries where bug is established: Spain, Bulgaria and Greece.
Crimean-Congo hemorrhagic fever is a tick-borne virus that can cause severe bleeding and high fever.
It's not very common, but it has been cropping up in Europe.
If someone gets infected, they might start suffering from flu-like symptoms before this progresses to severe bleeding from the eyes and organ failure.
It kills up to 40 per cent of infected people, according to the World Health Organisation (WHO).
In July, British scientists warned the disease could be expanding out of its usual territories and moving towards the UK and France due to climate change.
3. Dengue virus
Spread by: Aedes invasive mosquitoes
Countries where bug is established: Italy, France, Spain, Portugal, Greece, Cyprus, Croatia, Serbia, Montenegro, Bosnia and Herzegovina, Albania, North Macedonia, Romania, Bulgaria Turkey and Madeira (Portugal).
Dengue - also called 'breakbone fever' because of the severe muscle and joint pain it can trigger - is becoming more common in Europe.
It is spread by the Aedes invasive mosquitoes, specifically the aegypti type - also known as the tiger mosquito.
Over the past two years, a record number of cases of dengue were detected in several countries across the continent, including France, Italy and Spain.
The most common symptoms are a high fever, headache and body aches.
About one in 10 of those infected will develop severe dengue, which can result in shock, internal bleeding, and even death.
Last year, the UK government installed additional mosquito traps at ports, service stations, and truck stops throughout south England to counter the growing spread of dengue fever.
4. Leishmaniasis
Spread by: Phlebotomine sand flies
Countries where bug is established: Spain, Italy, Greece and Portugal.
Leishmaniasis is a disease you can get from the bite of an infected sandfly.
It's common in the rainforests, deserts, and urban areas of the Americas, Asia, Africa - and in more recent decades, Europe.
However, a recent survey by the ECDC revealed that isn't mandatory in many European countries to report cases.
This means it is hard to get a true picture of how many countries the disease-carrying flies are established.
It can cause sores on the skin that may develop into painful ulcers.
In some cases, these ulcers can develop in the nose, mouth and throat, causing wounds that can permanently disfigure the patient.
The most serious form of the disease affects internal organs such as the liver and spleen, causing fever, weight loss and anaemia.
If not treated in time, it can cause death.
5. Lyme disease
Spread by: European deer tick (Ixodes ricinus)
Countries where bug is established: United Kingdom, Ireland, France, Germany, Netherlands, Belgium, Luxembourg, Switzerland, Austria, Italy, Spain, Portugal, Greece, Cyprus, Turkey, Poland, Czech Republic, Slovakia, Hungary, Romania, Bulgaria, Serbia, Croatia, Slovenia, Bosnia and Herzegovina, Montenegro, Albania, and North Macedonia.
A bite from tiny ticks, usually found in grassy areas, can result in debilitating Lyme disease.
This is a bacterial infection that is passed on to humans from infected ticks - usually European deer ticks.
Symptoms of Lyme disease include a circular or oval rash around the bite area, as well as fatigue and flu-like symptoms.
In most cases, Lyme disease can be effectively treated with a course of antibiotics.
However, if left untreated, the infection can spread to the heart, joints and nervous system.
Bella Hadid suffered an excruciating 15-year battle with the disease, which she often shared moments of on her social media.
The supermodel, 27, was diagnosed with the condition in 2012 but was struggling with debilitating symptoms long before.
Bugs carrying the disease are mainly located in central Europe, including Austria, Switzerland and Spain.
However, in the last years, there has been a spread of infected ticks northbound, towards Scandinavia and the UK.
How to prevent tick bites - and remove the bugs
There are a few things you can do to lessen your likelihood of tick bites.
Firstly, try and cover as much of your skin as possible while walking outdoors and tuck your trousers into your socks.
You should also be using insect repellent containing DEET on your clothes and skin, and wearing light coloured clothing so you can spot a tick easily.
Also stick to paths where possible when you're out walking.
How can I remove a tick safely?
To remove a tick safely:
- Use fine-tipped tweezers or a tick-removal tool. You can buy these from some pharmacies, vets and pet shops.
- Grasp the tick as close to the skin as possible.
- Slowly pull upwards, taking care not to squeeze or crush the tick. Dispose of it when you have removed it.
- Clean the bite with antiseptic or soap and water.
The chance of getting ill is low. You do not need to do anything else unless you notice a rash or become unwell.
If either of these happen, make sure to see a GP so you can get treatment as soon a possible.
6. Malaria
Spread by: Anopheles mosquitoes
Countries where bug is established: Spain, Portugal, Italy, Greece, Cyprus.
Malaria is an infection caused by a tiny, blood-borne parasite, transmitted by the bites of infected female Anopheles mosquitoes.
It's known as the most deadly mosquito-borne disease on the planet.
Most cases you hear about are from people who catch it while travelling to places where malaria is more common, like Africa or parts of Asia.
Anopheles are present in certain parts of Europe, but, at present do not carry the disease.
However, there have been some cases of local transmission in Europe, when a mosquito becomes infected by a human or 'imported case', and then bites someone in the area.
There are concerns incidents of malaria could also spike on the continent in the future, if conditions are right.
7. Tick-borne encephalitis
Spread by: European deer tick (Ixodes ricinus) and the Siberian tick (Ixodes persulcatus)
Countries where bug is established: European deer tick - United Kingdom, Ireland, France, Germany, Netherlands, Belgium, Luxembourg, Switzerland, Austria, Italy, Spain, Portugal, Greece, Cyprus, Turkey, Poland, Czech Republic, Slovakia, Hungary, Romania, Bulgaria, Serbia, Croatia, Slovenia, Bosnia and Herzegovina, Montenegro, Albania, and North Macedonia.
Siberian tick - Estonia, Latvia, Lithuania, Finland, Sweden (northern parts).
Tick-borne encephalitis is a virus that both the European deer and Siberian tick can carry, and it's something to watch out for in certain parts of Europe.
Most people who catch the virus will have no or only mild flu-like symptoms.
However, the bug can progress to affect the brain and central nervous system and can sometimes be fatal.
The disease-carrying critters, mostly found in long grass or woodland areas, were traditionally only found in central and Eastern Europe.
Nowadays, the virus is also reported in areas of Northern Europe not previously thought to be infected, including the UK.
8. West Nile virus
Spread by: Culex mosquitoes
Countries where bug is established: Spain, Portugal, France, Italy, Greece, Cyprus, Bulgaria, Romania, Serbia, Croatia, Hungary, and Turkey.
West Nile virus is transmitted to humans through Culex mosquitoes that feed on infected birds, which are natural reservoirs for the disease.
Typically, the infection is found in Africa, the Middle East, and parts of Asia.
A few decades ago, the disease made its way to Europe - but only more recently have we seen a rise in cases.
Throughout 2023, 713 locally acquired human cases of the West Nile virus were detected in 123 different regions of nine EU countries, the ECDC said.
Roughly one in five people will develop symptoms, including headache, joint pains, and a rash.
And one per cent will develop severe illness including two brain swelling conditions called encephalitis or meningitis - both of which can be fatal.
9. Zika Virus
Spread by: Aedes invasive mosquitoes
Countries where bug is established: Italy, France, Spain, Portugal, Greece, Cyprus, Croatia, Serbia, Montenegro, Bosnia and Herzegovina, Albania, North Macedonia, Romania, Bulgaria Turkey and Madeira (Portugal).
Zika is generally a mild virus, causing a fever, rash or headache - although most people infected will never develop symptoms.
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But the disease is dangerous for pregnant women because it can lead to premature births, miscarriages and birth defects - including microcephaly, which affected some 2,000 children in Brazil.
There is also an increased risk of neurological complications, including Guillain-Barré syndrome.
What can I do to prevent mosquito bites?
The Fit for Travel website says if you are travelling to an area affected by diseases such as malaria, dengue fever and yellow fever, spread by mosquitoes, you should take action to protect yourself.
Some mosquitoes are more active in the day time while others at night - so it is important to protect yourself at all times.
It says: "If you develop a high temperature (fever) either during or after travelling to an affected area, you should seek medical advice as soon as possible and give details of your recent travel history."
To protect yourself:
Use a good quality insect repellent
The higher the strength, the longer the repellent should prevent mosquitoes landing on you.
An effective repellent contains at least one of; DEET (50% concentration for areas where there is malaria), Icaradin/Picardin (at least 20% concentration, Eucalyptus citriodora oil, hydrated, cyclized (at least 30% concentration), IR3535 (but not for malaria areas).
Apply:
- On all areas of skin not covered by clothes
- After sun screen
- Regularly, particularly if you notice mosquitoes around you
- After swimming, washing or excessive sweating
- On the face, by spraying the repellent on the hands first
Loose clothing
Mosquitoes can bite through tight clothing, so loose-fitted clothing is ideal.
Consider a high neckline, long sleeves, long trousers and socks.
Remember to apply insect repellent on areas not clothed.
Mosquito nets
Mosquito nets can protect you at night when sleeping and are even better if treated with insecticide.
Check for any holes in the net before using it. If a hole is apparent, then this should be mended.
You should tuck the net under your mattress or ground sheet during the night, and either collapse it down, or keep it tucked up during the day to stop insects flying under and into the net.