Baked Bacteria, Volatile Viruses & Flooded Fungi:

Transcription

1 Baked Bacteria, Vlatile Viruses & Flded Fungi: Infectius Diseases in a Changing Climate Saul R. Hymes, MD Assistant Prfessr f Clinical Pediatrics Stny Brk Children s Hspital SUNY Stny Brk Stny Brk, NY

2 DISCLOSURES Nthing t disclse

3 OBJECTIVES Understand why and hw climate change is relevant t infectius diseases Examine examples f the impact climate is already having n infectius diseases Vectr-brne diseases Changes in seasnal patterns Disaster-related utbreaks Discuss what we can d abut the prblem

4 VIRGINIA CLIMATE CHANGE

5 VIRGINIA CLIMATE CHANGE

6 CLIMATE CHANGE, SHMIMATE SHMANGE Bacteria and viruses live n and infect _us_. Why wuld the temperature and rainfall and envirnment utside affect them? Anyway, sme bacteria like extreme envirnments!

7 CLIMATE CHANGE, SHMIMATE SHMANGE

8 NOT JUST BUGS & US

9 Vectr-brne infectins

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17 CORRELATION CAUSATION? Zika is spreading Lyme is spreading But are we certain this is due t climate change? And if s hw?

18 MOSQUITOES LOVE HEAT AND WET

19 IN A WORD: YES Crrectly mdeled and predicted current knwn Aedes albpictus range based n past present climate data Als predicted future range expansin based n future climate predictins Prfund future implicatins fr disease

20 AEDES GENERA Aedes aegypti is a highly efficient vectr fr: Dengue Fever Yellw Fever Chikungunya Zika Virus Aedes albpictus is a less efficient but still capable vectr fr: Dengue Fever Yellw Fever Chikungunya Zika Virus

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23 IT S HAPPENED BEFORE

24 AND IT CAN AGAIN HERE

25 IT S HAPPENING NOW Data frm the EPA: (still climate change pages n their site fr nw ) Lyme Disease is listed as ne f their indicatrs f climate change s impact n human health Incidence dubled frm (4 8/100,000) natinal data In NE, where mre endemic, Maine, Vermnt, NH had increases f cases/100,000 The disease is mving nrth with the warmer climate

26 LYME IN NORTH AMERICA One study shwed rate f rise f Lyme cases significantly increased with increasingly nrthern latitude (Tuite et al. CMAJ Open, 2013) The areas being warmed prprtinately mre by climate change are being mre affected by Lyme Cntrlled fr multiple ther factrs nne significant 2009: 128 cases reprted 2015: 700 (>400%) Numbers are still small fr nw

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29 Seasnal infectins

30 EXPANDED LYME SEASON Nt just mving gegraphically, but als temprally. Lyme seasn is classically April/May-Octber The ticks hibernate during cld weather and emerge in spring. In past 5 years n Lng Island, lcal Lyme incident cases have expanded int Nvember, December, and this past year, January.

31 SEASONAL INFECTIONS In the literature n this tpic, mst admit changes in seasnal diseases may be difficult t predict (Greer et al. CMAJ, 2008; WHO website). Cld-weather diseases (influenza, RSV) may be attenuated by milder winters Increased migratin int nw milder areas, increasing ppulatin, culd cunteract this als Others (enterviruses) with summer patterns, may becme year-rund

32 Natural disasters

33 NATURAL DISASTERS

34 NATURAL DISASTERS

35 NATURAL DISASTERS

36 NATURAL DISASTERS Hurricanes and flash flds may cause increases in infectius disease utbreaks thrugh multiple ways: Bring salt water rganisms int water and fd supply Bring fresh water r sil rganisms in as abve Sewage cntaminatin due t verladed sewers and strm drains, lss f pwer/pumps Displaced animal vectrs (rats)

37 NATURAL DISASTERS Salt water rganisms Vibri diarrheal illness, infected wunds Aermnas bacteremia, infected wunds Mycbacterium marinum infected wunds Fresh water and sil rganisms Btulism paralysis, death Aermnas Pseudmnas Amebiasis diarrhea, anemia Giardia diarrhea Leginella pneumnia, death

38 NATURAL DISASTERS N access t clean water/sewage cntaminatin All f the abve, especially Giardia, Amebiasis, Vibri Cryptspridium E cli (all frms including EHEC, HUS)--dysentery, shck Shigella/Salmnella dysentery, bacteremia Typhid fever, bacteremia, death Chlera (nt unheard f) Hepatitis A/E liver disease Nrvirus diarrhea

39 NATURAL DISASTERS Displaced animals rats & ther rdents in particular: Plague Hantavirus Typhus Salmnella Rabies

40 THE EXAMPLE OF KATRINA 6 cases f chlera 17 cases f ther Vibri (5 deaths) Nrvirus E cli Salmnella Flu & pneumnia (vercrwding f evacuees)

41 What can I d?

42 WHAT CAN YOU DO? Aside frm drive a hybrid r electric, get slar panels, recycle, etc Familiarize yurself with new and emerging infectins like Lyme, Zika, Dengue, etc. If yu haven t seen them, yu will Expect the usual suspects, but at unsuspected times If it lks like Cxsackie virus in February, it still culd be

43 WHAT CAN YOU DO? Cnsider patients pst-fld, pst-trnad, pst-hurricane: Are they evacuees? Are they vercrwded? D they have clean water? If nt they shuld bil water if they can. Or use prtable pump filter r idine think like yu wuld fr travel medicine Cnsider dd rganisms leginella pneumnia, vibri cellulitis, etc. Call yur lcal ID Dc!

44 THANK YOU Questins?