Behind the scene, something else is pulling the strings: emphasizing parasitic manipulation in vector-borne diseases.

Merging the field of epidemiology with those of evolutionary and behavioural ecology can generate considerable fundamental knowledge, as well as help to guide public health policies. An attempt is made here to integrate these disciplines by focusing on parasitic manipulation in vector-borne diseases. Parasitic manipulation is a fascinating strategy of transmission which occurs when a parasite alters phenotypic trait(s) of its host in a way that enhances its probability of transmission. Vector-borne parasites are responsible for many of the most harmful diseases affecting humans, and thus represent public health priority. It has been shown for several decades that viruses, bacteria and protozoa can alter important features of their arthropod vector and vertebrate host in a way that increases their probability of transmission. Here, we review these changes, including, the feeding behaviour, survival and immune system of the vector, as well as attraction, defensive behaviour, blood characteristics and immune system of the vertebrate host. Based on the classic measure of vector-borne disease transmission R(0), additional changes, such as, vertebrate host choice by infected vectors or parasite development duration in the vector are expected. Reported or expected phenotypic changes are discussed in terms of costs and benefits to the parasite, its vector, and the vertebrate host. Introducing the parasitic manipulation concept into vector-borne diseases clearly highlights fruitful avenues not only for fundamental research, but also for developing strategies for disease control.