This review focuses on some of the more ground-shifting advances of recent decades, particularly those at the molecular and cellular level that illuminate mechanisms underpinning the natural ecology of tick-host-pathogen interactions and the consequent epidemiology of zoonotic infections in humans. Knowledge of components of tick saliva, now recognized as the central pillar in the tick's ability to complete its blood meal and the pathogen's differential ability to use particular hosts for transmission, has burgeoned with new molecular techniques. Functional studies have linked a few of them to saliva-assisted transmission of non-systemic infections between co-feeding ticks, the quantitative key to persistent cycles of the most significant tick-borne pathogen in Europe. Human activities, however, may be equally important in determining dynamic patterns of infection incidence in humans.

Using laboratory-bred natural rodent hosts that had been castrated and then implanted with either testosterone or inert oil, we have shown that testosterone causes prolonged and more intense infections of a tick-borne piroplasm, Babesia microti. This will result in more ticks becoming infected while feeding. Sexually active male rodents with high testosterone levels are also known to show increased locomotory activity and reduced innate and acquired resistance to tick feeding, so that more ticks are likely to be picked up and then fed successfully by these hosts. As a result, the transmission potential of B. microti is significantly increased via hosts with high rather than low testosterone levels. It is argued that testosterone helps to generate the observed aggregated distributions of parasites amongst their hosts, which also enhances parasite persistence.