Climate Change and Changes in the Infection Panorama. Birgitta Evengård

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1 Climate Change and Changes in the Infection Panorama Birgitta Evengård 1

2 Global Temperature anomalies for compared to Credit: NASA image by Robert Simmon, based on GISS surface temperature analysis data including ship and buoy data from the Hadley Centre. Caption by Adam Voiland. 2

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9 New shipping routes open Photo: UNEP/GRID Arendal

10 Increased extraction of oil 25 % of natural resources Number of active oil companies 2010 = 43 Photo: Peter Prokosch

11 and minerals In Sweden -29 ongoing project x3-2025

12 Yes-we have a global change of climate but climate changes in the Arctic have increased at almost three x the rate of the rest of the world over the past few decades and are already impacting local communities thus The Arctic can play a vital part in preparing the world for what is to come

13 Impact on the Land and Biota As warming temperatures move northwards, associated trees, plants, wildlife and their diseases will follow Emergence of zoonotic and parasitic diseases in new areas. Projected tree line at end of century ACIA 2004 p991

14 The changed landscape: There are limits to how much a system as in an eco-system can be changed and still recover Beyond those limits it functions differently, and the system changes to some other state

15 resilience

16 Siberian tundra: shrub grassland

17 New species move in and animals follow Zoonotic diseases Willows- Wulik River Photo Courtesy of Mike Brubaker

18 The association between different climatic drivers and the global prevalence and geographic distribution of selected vectorborne diseases observed over the period Among the vector borne diseases shown here, only dengue fever was associated with climate variables at both the global and local levels (high confidence), while malaria and hemorrhagic fever with renal syndrome showed a positive association at the local level (high confidence) IPCC ch Enheten Infektionssjukdomar

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20 Photo: Karen Robinson

21 It is about: Health of humans and animals in a changed landscape 60% of emerging infections are zoonoses

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23 FWS indicators - report Authors: Lena Maria Nilsson Birgitta Evengård Project group: Ann Ragnhild Broderstad Jon Oyvind Odland Constantine Tikhonov Reference group: Jim Berner, Christopher Cornish Alexey Dudarev Gert Mulvad Alan Parkinson

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25 Table 11-2: Number of under-nourished children less than 5 years of age (in millions) in 2000 and 2050, using the NCAR (National Center for Atmospheric Research) climate model (and the A2 scenario from AR4). Results assume no effect of heat on farmers productivity, and no CO 2 fertilization benefits. Adapted from Nelson et al. (2009). Scenario South Asia East Asia/ Pacific Europe and Central Asia Latin America and Caribbean Middle East/ North Africa Sub- Saharan Africa No climate change Climate change All Developing Countries

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27 Photo Courtesy of Vladimir Romanovsky

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29 Cryptosporidium outbreaks in northern Sweden > persons got sick > persons had to boil their drinkingwater for many months Enheten Infektionssjukdomar

30 30 Surveillance-best method

31 Syndromic surveilance for local outbreak detection and awareness. Telephone triage, web-based queiries and over-thecounter pharmacy sales

32 Enheten Infektionssjukdomar

33 WHO The threat of a possible outbreak of dengue fever now exists in Europe and local transmission of dengue was reported for the first time in France and Croatia in 2010 and imported cases were detected in three other European countries In 2012, an outbreak of dengue on Madeira islands of Portugal resulted in over 2000 cases and imported cases were detected in 10 other countries in Europe apart from mainland Portugal.

34 Asian Tiger mosquitos future scenarios

35 Asian Tiger mosquito A. Albopictus an invasive species that has the potential to transmit infectious diseases such as dengue and chikungunya fever

36 Known distribution of A. Albopictus

37 Future climate suitability of A. albopictus

38 Conclusion Similar trends are likely in the future, with an increased risk simulated over northern Europe and slightly decreased risk over southern Europe.

39 Respiratory diseases Figure 2.13 Pollen Grains Electron microscope image of ragweed pollen grains. Image: Johns Hopkins University Figure 2.17 Household Mold Household mold often follows flooding. Image: Chris Rogers CLIMATE CHANGE FUTURES Health, Ecological and Economic Dimensions Website:

40 Potentially climate sensitive zoonotic diseases of concern in circumpolar regions US(Alaska), northern Canada Echinococcosis, rabies, Giardiasis, Cryptosporidiosis Northern Russian Federation Anthrax, leptospirosis Circumpolar Brucella, Toxoplasma, Trichinella, Botulism, Tularemia, West Nile virus Norway Sweden, Finland, Russian Federation Puumalavirus, Tick borne encephalitis borreliosis (Borrelia burgdorferi)

41 (a) Swedish records of Ixodes ricinus ticks from the late 1980s to early 1990s. The smallest dots represent individual records; larger dots indicate 10 and 50 records, respectively. (b) Comparative matching of the estimated distribution of I. ricinus in Sweden (shaded area) with the northern limit of the southern boreal zone (solid line) and the northern limit of the boreo nemoral zone (dashed line). Vegetation Zone data refer to ; tick distribution data refer to the period from the late 1980s to early 1990s. (c) Comparative matching of the estimated distribution of I. ricinus in Sweden (shaded area), showing isopleths for vegetation periods of 170 days (solid line) and 160 and 180 days (dashed lines). Vegetation period data refer to ; tick distribution data refer to the period from the late 1980s to early 1990s. (d) Comparative matching of the estimated distribution of I. ricinus in Sweden (shaded area) with the average date of first frost (15 September; solid line). First frost data refer to ; tick distribution data refer to the period from the late 1980s to early 1990s. (e) Comparative matching of the estimated distribution of I. ricinus in Sweden (shaded area) with snow cover of 150 days (solid line) and 125 and 175 days (dashed lines). Snow cover data refer to ; tick distribution data refer to the period from the late 1980s to early 1990s. Jaenson et al Med Vet Entom 23, , 2009

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43 Climate Related Outbreak of Puumalavirus Infection in Sweden 2007 Virus carried in voles, transmitted by inhalation of rodent excreta Causes hemorrhagic fever with renal syndrome 474 cases in outbreak 30% hospitalized 2 deaths Outbreak related to climate Pettersson etal Emerging Infectious Disease 14(5)

44 Actions to improve knowledge, disease detection and prevention and control Using serosurveys establish baseline levels of infection in people and animals Improve diagnostics, and expand use of molecular typing methods Improve communication strategies targeting: Human and animal health care providers Indigenous communities Public, wildlife and environmental health professionals One Health Expand local, regional, and international networks Establish community based monitoring (eg. Local Environmental Observer network; Circumpolar based monitoring network) International Circumpolar Surveillance (ICS) 44 Circumpolar based monitoring Local Environmental Observer network

45 Helbing, Nature 497:51-59, 2013

46 Ecce homo- Photos P- Prokosch, Nenets, Russia Photo L Bishop Inuits Datum 46

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49 IPCC 2013

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54 IPCC 2013

55 IPCC 2013

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57 IPCC 2013

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