adapting to climate change jonathan suk 30 june 2010
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Source: Woolhouse, M.E.J. & Gowtage-Sequeria, S. Emerging Infectious Diseases 2005, Vol. 11(12): 1842-1847.
Rank* Driver
1 Changes in land use or agricultural practices2 Changes in human demographics and society3 Poor population health, e.g. HIV, malnutrition4 Hospitals and medial procedures5 Pathogen evolution, e.g. antimicrobial drug resistance,
increased virulence6 Contamination of food sources or water supplies7 International travel8 Failure of public health programmes9 International trade10 Climate change
* Ranked by the number of pathogen species associated with them (most to least).
Main categories of drivers associated with emergence and re-emergence of human pathogens
Drivers of emerging infectious diseases
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Food- and water-borne pathogens with known climate linksDisease Climate linkage
Botulism Food-borne. Temperature link, risk if poorly stored; high temperatures affect risk in fish
Campylobacteriosis Linked to heavy rain
Cholera Linked to heavy rain
Cryptosporidiosis Linked to heavy rain
Giardiasis Linked to heavy rain
VTEC Linked to heavy rain
Hepatitis A Linked to heavy rain
Listeriosis Small risk if inadequate cold storage.
Salmonellosis Food: temperature linkage. Water: linked to heavy rain
Shigellosis Linked to heavy rain
Typhoid / paratyphoid fever
Linked to heavy rain
Yersiniosis Food: temperature linkage. Water: heavy rain.
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Vector-borne diseases/pathogens that may be linked to climate change in EuropeTick-borne Mosquito-
borneOther insect-borne
Rodent-borne
Lyme disease Chikungunya Leishmaniasis Hanta viruses
Tick-borne encephalitis
Dengue* Chandipura virus Hemorrhagic fever with renal syndrome (HFRS)
Human erlichiosis Malaria* Sicilian virus Nefropathia epidemica
Crimean-congo hemorrhagic disease*
West Nile virus Tularaemia Tularaemia
Yellow fever* Toscana virus Plague*
Sindbis virus Phlebotomus fever (Naples virus)
Lymphocytic choriomeningitis virus
Tahnya virus Cowpox virus
Lassa fever*
*Disease not currently prevalent in continental EU region
Current distribution of Aedes albopictus in the EU
Source: Schaffner, F. Development of Aedes albopictus risk maps. TigerMaps project. ECDC, Stockholm 2008. (Forthcoming.)
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Climate change at ECDC
Vulnerability and risk assessments• International workshop on Environmental Change and Infectious
Disease • International workshop on Linking Environmental and
Epidemiologic Data • Risk assessment of vector-borne diseases in the EU (V-borne)• Impact of climate change on food- and water-borne (FWB)
diseases in Europe • Risk maps for Aedes albopictus• Risk maps for dengue fever and aedes aegypti
Adaptation strategies• Chikungunya communication toolkit• Adaptation and vulnerability toolkit
Response• ECDC/WHO risk assessment of
chikungunya in northern Italy
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1. Vector Surveillance: VBORNET
Objectives
To establish a network of expertise in entomology across the EU
To obtain data on vectors of primary concern to health in the EU (mosquitos, ticks)
To promote EU-wide harmonization of standards and methods for vector surveillance
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2. Environmental monitoring
time
Health outcome
sEnvironmental consequences
Climate change
CO2
CO2 CO2
Socio-economic impacts(homelessness,
refugees…)
Indirect exposures
(vector-borne diseases, other infectious
diseases)
Surveillance
Direct exposures
(heat stroke, drowning…)
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3. Adaptation handbook
Background Climate change as a threat multiplier – addressing climate-
sensitive diseases should also benefit public health today
Objectives
To assist EU Member States to conduct national and regional vulnerability assessments as concerns climate change and communicable diseases
To develop comprehensive advice for ECDC and EU Member States on how to implement regionally targeted adaptation strategies to mitigate against future communicable disease transmission due to climate change.
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Pragmatic approach
Identify baseline description (epidemiologic, socio-economic, current disease burden), and note it is changing alongside climate
Identify climate-sensitive diseases most relevant for a given region, and then weighing options for action
Identify climatic drivers (rainfall, drought, temperature) most relevant to these diseases
Develop adaptation strategies with future projections in mind, and engage other sectors where possible
Strategy needs to be evidence-based, but does not necessarily need to involve sophisticated modelling
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Assessment Process
Aim, demarcation
Qua
lity c
ontro
l
Organisational structure:Working group, reference group, etc
Base-line descriptionClimate, diseases, vulnerability factors
Assessment:Vulnerability and impacts
Base-line descriptionAdaptation measures
Assessment:Adaptive strategies and measures
Follow-up/ monitoring: Impacts and measuresPo
licy
decis
ion
Itera
tive
proc
ess
Identifying priorities for action
High
Medium
Low
HighMedium
Low
Weighted significance of climate change on the transmission of a specific infectious disease in an area
High
Medium
Low
Probability of an outbreak/strengt
h of climate change-disease
relationship
Severity of consequence for society risk group
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