C4D INEMERGENCYRESPONSE Regional Office forSouthAsia number ofdrug-resistantmicrobes inthedatabase. are causedbybacteriaorrickettsia, reflectingalarge The researchersalsofoundthat54.3%ofEIDevents of limitedinfrastructureandhealthresources. undercounted inthenationsaffectedmostbecause to 2010,respectively. Zoonoticdiseasecasesmaybe 21% ofzoonosesfrom1990to2000and potential zoonosesinthedataset,andonly22% outbreakswerecausedbyonly25%of each decade.From1980to1990,80%ofallzoonotic a smallnumbercausethemajorityofoutbreaksin becoming increasinglydiverseovertime,butonly significantly overtime.Zoonoticdiseaseshavebeen respiratory ,Ebolavirus),andareincreasing originate inwildlife(forexample,severeacute disease. Themajorityofthese(71.8%)zoonoses include Ebola,HIV, thebubonicplagueandLyme humans byanimals,insectsandothervectors.These of EIDs)-meaningthattheyweretransmissibleto EID eventsseemtobedominatedbyzoonoses(60.3% 1980 to2013. of disease,havebothincreasedsignificantlybetween The numberofoutbreaks,andthekinds (in the1980s)concomitantwithHIVpandemic.1 controlling forreportingbias,withtheirpeakincidence EID eventshaverisensignificantlyovertimeafter of EIDs)between1940and2004demonstratedthat analysis ofadatabase335EID‘events’(origins burden onglobaleconomiesandpublichealth.An Emerging infectiousdiseases(EIDs)areasignificant INCREASING? INFECTIOUS DISEASEEVENTS ARE OUTBREAKSANDEMERGING

CASE STUDIES: GOOD PRACTICES IN RISK COMMUNICATION 2

CASE STUDY: HURRICANE SANDY AND USE OF SOCIAL MEDIA

CASE STUDIES: EARLY WARNING SYSTEMS AND MOBILE PHONE APPLICATIONS FOR EMERGENCY SITUATIONS INFECTIOUS DISEASE EMERGING INFORMATION SHEET likely tooriginate. on countriesfromwherethe nextimportantEIDisleast majority ofthescientificandsurveillanceeffortfocused disease emergencearepoorlyallocated,withthe authors concludethatglobalresourcestocounter at lowerlatitudeswherereportingeffortislow. The of wildlifezoonoticandvector-borne EIDsoriginating (emerging disease‘hotspots’).Thereisasubstantial risk regions wherenewEIDsaremostlikelytooriginate factors. EIDemergenceprovidesabasisforidentifying driven bysocio-economic,environmental,andecological Emerging infectiousdisease(EID)outbreaksareoften 100 Number of EID events 100 Number of EID events 20 40 60 80 20 40 60 80 0 0 1940 195019601970198019902000 1940 195019601970198019902000 a c Bacteria orrickettsiae orprions Protozoa Fungi Helminths Non drug-resistant Drug-resistant Decade 1 100 100 20 40 60 80 20 40 60 80 0 0 1940 195019601970198019902000 1940 195019601970198019902000 b d Non-zoonotic Zoonotic wildlife Zoonotic non-wildlife Zoonotic unspecified Non vector-borne Vector-borne Decade

COMMUNICATION IN DISASTERS AND EMERGENCIES THEN THINGS TO DO Project PREDICT is enabling global surveillance for began clearing their lands. In a deforested area of that can spillover from animal hosts to Peru, the -carrying species bit 278 people by building capacities to detect and discover times more frequently than the same species in an viruses of potential. The project is part of untouched forest.5 USAID’s Emerging Pandemic Threats program and is led by the UC Davis One Health Institute. Project More recently in Borneo, Malaysia, researchers found Predict estimates that over the past century, the a strong association between patches of deforested number of new infectious cropping up each land and locations of recent malaria outbreaks. As year has nearly quadrupled. Over the past century, the humans worked on recently deforested spaces, vectors number of outbreaks per year has more than tripled. (mosquitoes) that thrived in this new habitat carried the Researchers have been sampling in rain forests (the disease from primates to people.6 planet’s biodiversity laboratory) around the world for zoonotic viruses for seven years and found nearly 1,000 new viruses in more than 20 countries.3 HIV CLIMATE CHANGE came from a rainforest, as did Ebola, , and Climate change is another major factor that increases Zika. These viruses have been circulating among bats, the risk of infectious disease outbreaks. Climate change monkeys and rodents in the rainforests for thousands refers to long-term shifts in weather conditions and of years as part of the ecosystem. The animals are patterns of extreme weather events. A recent report generally not harmed by the viruses. Rather, it is the from The Lancet Countdown reports that the human interaction between human predators and the animals symptoms of climate change to be “unequivocal and that lead to disease outbreaks in populations. potentially irreversible.” With increase in heat waves, weather disasters and spread of disease-carrying mosquitoes, climate change significantly imperils public WHAT ARE SOME OF THE MAIN CAUSES health globally, and disproportionately affects vulnerable OF THE RISE IN EMERGING INFECTIOUS populations in low and middle-income countries DISEASE EVENTS? (LMICs), where poverty, water scarcity, inadequate housing or other crises are already prevalent. Climate DEFORESTATION change is a “threat multiplier.” 7 Rising deforestation is bringing wildlife vectors closer to human settlements, and increasing the risk of Climate changes include alterations in one or more infectious disease outbreaks. A 2017 study found that climate variables including temperature, precipitation, Ebola outbreaks in West and Central Africa mostly wind, and sunshine. These changes may impact the occurred in deforested hotspots.4 In the 1990s, in survival, reproduction, or distribution of disease pathogens Peru, malaria cases rose from 600 per year to 120,000, and hosts, as well as the availability and means of their just after a road was built into a forest and people environment (see table below). CLIMATE EFFECT OF CHANGE IN CLIMATE VARIABLE ON: VARIABLE Vector/ Disease Transmission TEMPERATURE Pathogens need favourable As temperature contrinues In the highlands of Kenya, temperatures to survive, to rise, vectors in hospital admissions develop and reproduce. For low-latitude regions may find for malaria has been e.g. The for new habitats in mid-or high- associated with rainfall malaria paraiste reduces from latitude regions and in areas and high maximum 26 days to be more active at of high altitude, leading to temperature during the higher temperatures. geographical expansion or preceding 3-4 months. shift of diseases. Mosquito vectors can escape harsh climates by resorting to household containers or water tanks. PRECIPITATION Heavy rain may stir up Larval development of some Evidence shows that sediments in water, leading mosquito vectors accelerates diseases transmitted to the accumulation of fecal with increased rain and by rodents sometimes . Drought/low rising temperature. Drought increases during heavy rainfall lead to low river flows, in wet regions can provide rainfall and flooding causing the concentration mosquitpes with more pools events because of altered of effluent water-borne of stagnant water as breeding patterns of human- pathogens places. pathogen-rodent contact HUMIDITY The pathogens of air-borne Mosquitoes survive better infectious disease such as under conditions of high influenza tend to responsive humidity. They also become to humidity condition. For more active when humidity example, absolute humidity rises. and temperature were found to affect influenza virus transmission and survival. SUNSHINE Sunshine hours and In Bangladesh, research temperature act showed that increased synergistically during cholera temperature and prolonged periods to create a favorable sunshine are positively condition for the multiplication related to the monthly cholera of cholera parasite in water. occurrences. WIND Studies have reported a Strong winds ccan reduce Pathogens can spread positive correlaton between the biting opportunities for from regions dust particle association/ mosquitoes, but can extend to other regions through attachment and virus survival/ their flight distance. interregional dust storms. transporting.

A society's vulnerability to climate change induced health risk of infectious diseases is related to its social development and existing public health system and infrastructure. The inadequate financial and medical resources coupled with the less-effective communication and public health education in developing countries limit these societies' ability to prepare for and respond to climate change induced health issues.1 In addition, factors like population increase, urbanization, conflict, and migration are also linked with the spread of infectious diseases. CASE STUDY

Rise in vector borne diseases (such as Malaria) due to deforestation and climate change Due to deforestation, sunlight directly hits the (once-shady) forest floor increasing the temperature of water on the floor, which can aid mosquito breeding. Leaves that make streams and ponds high in tannins disappear due to deforestation. This lowers the acidity and makes the water more turbid which favor the breeding of some species of mosquito over others. Flowing water is often dammed up and pooled. The water table of the forest rises closer to the forest floor because it is no longer taken up by trees (which have been destroyed). This creates swampy areas, which are ideal for breeding mosquitoes. As agriculture replaces forests, re-growth of low lying vegetation provides a much more suitable environment” for the mosquitoes that carry the malaria parasite.

Mosquitoes are not the only carriers of pathogens from the wild to humans. Bats, primates, and even snails can carry disease, and transmission dynamics change for all of these species following forest clearing, often creating a much greater threat to people.8

The greatest effect of climate change on transmission is likely to be observed at the extremes of the range of temperatures at which transmission occurs. For many diseases these lie in the range 14–18 C at the lower end and about 35–40 C at the upper end. By 2080, up to 320 million more people could be affected by malaria because of these new transmission zones. The disease would then also be spreading to people whose immune systems may never have been exposed to malaria, and who may be more vulnerable as a result. By 2100 it is estimated that average global temperatures will have risen by 1.0–3.5 C, increasing the likelihood of many vector-borne diseases in new areas.9,10

REFERENCES

1 Kate E. Jones, Nikkita G. Patel, Marc A. Levy, 6 Fornace K. M, Abidin, T, Alexander N, et al. (2016). Adam Storeygard, Deborah Balk, John L. Association between Landscape Factors and Spatial Gittleman & Peter Daszak (2008). Global trends in Patterns of Plasmodium knowlesi in emerging infectious diseases. Nature 451, 990- Sabah, Malaysia. Emerging Infectious Diseases, 993 (21 February 2008) 22(2), 201-209.

2 Katherine F. Smith, Michael Goldberg, Samantha 7 Watts N, Amann M, et al. (2017). The Lancet Rosenthal, Lynn Carlson, Jane Chen, Cici Chen, Countdown on health and climate change: from 25 Sohini Ramachandran. (2014). Global rise in years of inaction to a global transformation for public human infectious disease outbreaks. Journal of health. Lancet. Published online October 30, 2017. Royal Society Interface 11: 20140950. http://dx.doi.org/10.1016/S0140-6736(17)32464-9

3 Project PREDICT: http://www.vetmed.ucdavis. 8 How Forest Loss Is Leading To a Rise in Human edu/ohi/predict/ Disease https://e360.yale.edu/features/how_forest_loss_is_ 4 Rulli et al 2017. The nexus between forest leading_to_a_rise_in_human_disease_malaria_zika_ fragmentation in Africa and Ebola virus disease climate_change outbreaks. Scientific Reports; 7:41613. 9 Lindsay S. W. and Martens W. J. M. Malaria in the 5 Vittor AY, Gilman RH, Tielsch J, et al. (2006). African highlands: Past, present and future [694kB] The effect of deforestation on the human-biting Bulletin of the WHO 76 33-45 (1998) rate of darlingi, the primary vector of Falciparum malaria in the Peruvian Amazon. 10 Githeko, A. K., Lindsay, S. W., Confalonieri, U. E. American Journal of Trop Med Hyg. 2006 Jan; et al Climate change and vector-borne diseases: A 74(1):3-11. regional analysis [268kB] Bulletin of the WHO 78 1136-1147 (2000)