Climate change is altering the geographic range and seasonality of some insects that can carry diseases, for example Aedes aegypti, the mosquito that is the vector for dengue transmission.
Climate change is influencing the transmission and burden of many infectious diseases worldwide.[1] Rising temperatures, shifting rainfall patterns, and more frequent extreme weather events affect how pathogens, vectors and disease hosts interact. These changes are altering the geographic ranges and seasonal activity of disease-carrying organisms such as mosquitoes and ticks, and influence the growth and survival of bacteria and other pathogens in food and water systems.[1][2][3]:9
Vector-borne diseases like dengue fever, malaria, tick-borne diseases, leishmaniasis, zika fever, chikungunya and Ebola are especially sensitive to climatic conditions. Warmer and wetter conditions expand suitable habitats for vectors, enabling them to survive in areas that were previously too cold or dry.[4]:1045[3] As temperatures rise at higher elevations and latitudes, transmission risks are expected to increase in parts of North America, Europe, and highland regions of Africa and Asia.[4]:1094[5] For example, the range of ticks that transmit Lyme disease and tick-borne encephalitis has expanded, and further warming could lengthen their active seasons.[4]:1094
The health impacts of these climate-related risks are unevenly distributed. Low-income countries and communities with high socio-economic constraints and limited healthcare, infrastructure, and sanitation face the highest vulnerability.[6] Nearly one in three people globally lack access to safe drinking water, which amplifies exposure to waterborne pathogens and related illnesses.[7] These conditions can also affect mental and social well-being and place additional strain on public health systems.
The World Health Organization considers climate change as one of the greatest threats to human health.[9] Global warming, increased rainfall, flooding and drought are some of the consequences of climate change that are leading to the escalation of vector, food and water-borne diseases.[10] Climate change can make it easier for infectious diseases to spread to new regions and surge in areas where they were previously under control. As a result, diseases that have never previously infected humans (Disease X) may 'spill over' from animals and become a threat to humans too.[10][11] More than half (218 out of 375) of infectious diseases that affect humans worldwide have already been worsened by climate change.[12][13]
The successful emergence or reemergence of infectious diseases depend on people coming into contact with the pathogen (for example a virus) but also on the extent to which peoples' resistance is weakened, or the pathogen is strengthened, by changes in the environment.[13]
Climate change can increase the spread of infectious diseases through multiple possible pathways, including:[13]
climatic hazards (such as heatwaves, wildfires, or floods) bringing the disease closer to people (e.g. shifts in the geographical range of species),
climatic hazards bringing people closer to the disease (e.g. heatwaves bringing more people to recreational water activities),
disease strengthened by climatic hazards (e.g. "improved climate suitability for reproduction, acceleration of the life cycle, increasing seasons/length of likely exposure", for example ocean warming can lead to increased Vibriosis outbreaks),
people impaired by climatic hazards (e.g. from malnutrition due to drought conditions).
Infectious diseases that are sensitive to climate can be grouped into:
Climate change is affecting the distribution of these diseases due to the expanding geographic range and seasonality of these diseases and their vectors.[14]:9
Though many infectious diseases are affected by changes in climate, vector-borne diseases, such as malaria, dengue fever and leishmaniasis, present the strongest causal relationship. One reason for that is that temperature and rainfall play a key role in the distribution, magnitude, and viral capacity of mosquitoes, who are primary vectors for many vectors borne diseases. Observation and research detect a shift of pests and pathogens in the distribution away from the equator and towards Earth's poles.[15]
Climate change affects vector-borne diseases by affecting the survival, distribution and behavior of vectors such as mosquitoes, ticks and rodents.[16]:29 The viruses, bacteria and protozoa are carried by these vectors transferring them from one carrier to another.[17] Vectors and pathogens can adapt to the climate fluctuations by shifting and expanding their geographic ranges, which alter the rate of new cases of disease depending on vector-host interaction, host immunity and pathogen evolution.[18] This means that climate change affects infectious diseases by changing the length of the transmission season and their geographical range.[9]
Climate change is leading to latitudinal and altitudinal temperature increases. Global warming projections indicate that surface air warming for a "high scenario" is 4 C, with a likely range of 2.4–6.4 C by 2100.[19] A temperature increase of this size would alter the biology and the ecology of many mosquito vectors and the dynamics of the diseases they transmit such as malaria.
Changes in climate and global warming have significant influences on the biology and distribution of vector-borne diseases, parasites, fungi, and their associated illnesses. Regional changes resulting from changing weather conditions and patterns within temperate climates will stimulate the reproduction of certain insect species that are vectors for disease.
The vectors of transmission are the major reason for the increased ranges and infection of these diseases. If the vector has a range shift, so do the associated diseases; if the vector increases in activity due to changes in climate, then there is an effect on the transmission of disease.[20] However it will be hard to classify exactly why the range shifts or an increase in infection rates occurs as there are many other factors to consider besides climate change, such as human migration, poverty, infrastructure quality, and land usage; but climate change is still potentially a key factor.[21]
Example: The mosquito
One major disease-spreading insect is the mosquito, which can carry diseases like malaria, West Nile virus, and dengue fever. With regional temperatures changing due to climate change, the range of mosquitos will change as well.[22] The range of mosquitoes will move farther north and south, and places will have a longer period of mosquito habitability than at present, leading to an increase in the mosquito population in these areas. This range shift has already been seen in highland Africa. Since 1970, the incidence of malaria in high-elevation areas in East Africa has increased greatly. This has been proven to be caused by the warming of regional climates.[20][23]
Environmental changes, climate variability, and climate change are factors that could affect biology and disease ecology of Anopheles mosquitoes and their disease transmission potential.[24] Anopheles vectors in highland areas are to experience a larger shift in their metabolic rate due to climate change. This climate change is due to the deforestation in the highland areas where these mosquitos' dwell. When the temperature rises, the larvae take a shorter time to mature[25] and, consequently, a greater capacity to produce more offspring. In turn this could potentially lead to an increase in malaria transmission when infected humans are available.
Environmental changes such as deforestation could also increase local temperatures in the highlands thus could enhance the vector capacity of the anopheles.[24] Anopheles mosquitoes are responsible for the transmission of a number of diseases in the world, such as, malaria, lymphatic filariasis and viruses that can cause such ailments, like the O'nyong'nyong virus.[24]
Increased water temperature
High temperatures can alter the survival, replication, and virulence of a pathogen.[26] Higher temperatures can also increase the pathogen yields in animal reservoirs. An increase in yield of bacteria from drinking water delivery systems has been recorded in warmer summer months. During periods of warmer temperatures water consumption rates are also typically higher. Together these increase the probability of pathogen ingestion and infection.[27]
With an increase in both temperature as well as higher nutrient concentrations due to runoff there will be an increase in cyanobacterial blooms.[28]
Cyanobacteria (blue-green algae) bloom on Lake Erie (United States) in 2009. These kinds of algae can cause harmful algal blooms.
The warming oceans and lakes are leading to more frequent harmful algal blooms.[29][30][31] Also, during droughts, surface waters are even more susceptible to harmful algal blooms and microorganisms.[32] Algal blooms increase water turbidity, suffocating aquatic plants, and can deplete oxygen, killing fish. Some kinds of blue-green algae (cyanobacteria) create neurotoxins, hepatoxins, cytotoxins or endotoxins that can cause serious and sometimes fatal neurological, liver and digestive diseases in humans. Cyanobacteria grow best in warmer temperatures (especially above 25 degrees Celsius), and so areas of the world that are experiencing general warming as a result of climate change are also experiencing harmful algal blooms more frequently and for longer periods of time.[33]
Climate change is forecast to have substantial effects on the water cycle, with an increase in both frequency and intensity of droughts and heavy precipitation events.[26]
There is generally an increase in diarrheal disease (except for viral diarrheal disease) during or after elevated ambient temperature, heavy rainfall, and flooding.[36] These three weather conditions are predicted to increase or intensify with climate change in future. A high current baseline rate of the diarrheal diseases is already present in developing countries. Climate change therefore poses a real risk of an increase of these diseases in those regions.[36]
Malaria is a mosquito-borne disease that infects humans and other animals caused by microorganisms in the Plasmodium family. It begins with a bite from an infected female mosquito, which introduces the parasite through its saliva and into the infected host's circulatory system. It then travels through the bloodstream into the liver, where it can mature and reproduce.[37]
Climate is an influential driving force of diseases such as malaria, which kills about 300,000 children annually. Malaria is especially susceptible to the effects of climate change because mosquitoes lack the mechanisms to regulate their internal temperature.[38] This implies that there is a limited range of climatic conditions within which the pathogen (malaria) and vector (a mosquito) can survive, reproduce, and infect hosts.[39] Increased rainfall and temperatures could increase the number of mosquitos indirectly by creating better environments for survival and reproduction, expand larval habitat and food supply.[38][39]
Conservative estimates suggest that the risk of malaria will increase 5–15% by 2100 due to climate change.[40] In Africa alone, there is a projected increase of 16–28% in person-month exposures to malaria by 2100.[41][42]
An estimated 50–100million dengue fever infections occur annually.[47] The cases of dengue fever have been increasing dramatically and is projected to continue to do so with changing climate conditions.[48] In just the past 50 years, transmission has increased drastically with new cases of the disease (incidence) increasing 30-fold.[46][47]
The presence and number of Aedes aegypti mosquitoes is strongly influenced by the amount of water-bearing containers or pockets of stagnant water in an area, daily temperature and variation in temperature, moisture, and solar radiation.[42] Climate change is altering the geographic range and seasonality of the mosquito that can carry dengue.[47][49] While dengue fever is primarily considered a tropical and subtropical disease, the geographic ranges of the Aedes aegypti are expanding.[43] Climate change also contributed to the spread of distinct variants of the disease to new areas, and to the emergence of dengue hemorrhagic fever.
Tick-borne disease, which affect humans and other animals, are caused by infectious agents transmitted bytick bites. A high humidity of greater than 85% is ideal for a tick to start and finish its life cycle.[50] Temperature and vapor play a significant role in determining the range for tick population. More specifically, higher maximum temperatures play the most influential role in sustaining tick populations.[51] Tick life cycles span multiple seasons as they mature from larva to nymph to adult, and infection and spread of diseases such as Lyme disease can happen across the multiple stages and different species of animal hosts.[52]
The expansion of tick populations is concurrent with global climate change. Species distribution models of recent years indicate that the deer tick (Ixodes scapularis) is pushing its distribution to higher latitudes of the Northeastern United States and Canada, as well as pushing and maintaining populations in the South Central and Northern Midwest regions of the United States.[53] Climate models project further expansion of tick habit north into Canada as progressing Northwest from the Northeastern United States. Additionally, however, tick populations are expected to retreat from the Southeastern coast of the U.S., but this has not yet been observed.[54] It's estimated that coinciding with this expansion, increased average temperatures may double tick populations by 2020 as well as bring an earlier start to the tick exposure season.[55][53]
Leishmaniasis is a neglected tropical disease, caused by parasites of the genus Leishmania and transmitted by sandflies. It is distributed mostly in tropical and subtropical regions around the world, wherever the sand flies and suitable animal hosts are present.[56] Around 12 million people around the world are living with leishmaniasis.[56]Risk factors that increase the spread of this disease include poverty, urbanization, deforestation, and climate change.[57][58]
As in other vector-borne diseases, one of the reasons climate changes can affect the incidence of leishmaniasis is the susceptibility of the sandfly vectors to changes in temperature, rainfall and humidity. These conditions alter their range of distribution and seasonality.[57] For example, climate change could increase the suitable conditions for Phlebotomus fly species in Central Europe[59][60] and Lutzomyia longipalpis in the Amazon Basin.[61] Parasite development inside the sand for some species of Leishmania can also be affected by temperature changes.[62]
Ebola
The Ebola virus has caused periodic outbreaks across several African countries. With an average fatality rate of about 40%, the disease has led to more than 28,600 reported cases and 11,310 deaths.[63] Areas undergoing deforestation are among the most likely places for outbreaks due to changes in the landscape bringing wildlife into closer contact with humans.[64][65]
Climate change may indirectly contribute to the rise in Ebola cases. Extreme weather events such as droughts, strong winds, thunderstorms, heat waves, floods, landslides, and shifting rainfall patterns can disrupt wildlife migration, pushing animals out of their natural habitats and nearer to human settlements.[66] For instance, a severe drought in Central Africa intensified food insecurity, leading some West African communities to hunt and consume infected animals such as bats, which likely fueled an Ebola outbreak.[64]
Zika virus, a vector-borne virus was historically presented in cluster outbreaks in the tropical regions of Africa and Asia.[67]Zika fever epidemics have affected larger populations including Micronesia and South Pacific Islands in 2007, and the Americas in 2013.[68] Brazil experienced one of the largest outbreaks of Zika virus with approximately 1.5million cases reported in 2015.[69] Pregnant women infected with Zika virus are at a higher risk of giving birth to children with congenital malformations, including microcephaly.[70]
It is predicted that Zika virus will expose more than 1.3billion new people by 2050 due to climate change.[71] This increase is largely due to the expansion of habitats conducive to vector growth and life cycles, particularly areas with temperatures ranging from 23.9°C to 34°C.[72] Rising temperatures also influence mosquito behavior, leading to higher breeding and biting rates.[73] Extreme climate patterns, such as drought, floods and heatwaves further enhance mosquito breeding conditions and as a result escalate the rate of virus-borne diseases.[74]
There is no direct evidence that the spread of COVID-19 is worsened or caused by climate change, although investigations continue. As of 2020[update], the World Health Organization summarized the current knowledge about the issue as follows: "There is no evidence of a direct connection between climate change and the emergence or transmission of COVID-19 disease. [...] However, climate change may indirectly affect the COVID-19 response, as it undermines environmental determinants of health, and places additional stress on health systems."[75]
A 2021 study found possible links between climate change and transmission of COVID-19 by bats.[76] The authors found that climate-driven changes in the distribution and richness of bat species increased the likelihood of bat-borne coronaviruses in the Yunnan province, Myanmar, and Laos.[76] This region was also the habitat of Sunda pangolins and masked palm civits which were suspected as intermediate hosts of COVID-19 between bats and humans.[76] The authors suggest, therefore, that climate change possibly contributed to some extent to the emergence of the pandemic.[76][77]
Climate changed might induce changes to bat habitats which may have driven them closer to populated areas.[78] Increased aridity and drought periods are predicted to push bats out of their endemic areas and into populated areas.[78] This creates a knock-on effect of increasing their interactions with humans and hence the likelihood of zoonotic disease transfer.[78]
Naegleri Fowleri, a percolozoa, thrives as free-living, thermophilic amoeba in freshwaters such as lakes, rivers, ponds, hot springs.[79] Although infection is still considered rare, cases are becoming more prevelant each year as freshwater temperatures continue to rise. Exposure of this pathogen is more commonly caused by recreational water activities, such as swimming or diving, in freshwaters where the bacteria is present.[79] Humans can become infected when water enters the nasal canal. From there the amoeba penetrate nasal mucous and travel to the brain, creating inflammation and eventually causing primary amoebic meningoenephilitis (PAM);[79] which if not treated immediately can be fatal. Naegleri Fowleri favor warm, moist conditions, feeding off other microorganisms. It is also known to be found in tap water, well water and water distribution tanks as it favors both naturally heated and artificially heated waters, though it has also been known to survive in various temperatures.
Scientist expect that disease outbreaks caused by vibrio (in particular the bacterium that causes cholera, called vibrio cholerae) are increasing in occurrence and intensity.[4]:1107 Vibrio illnesses are waterborne disease and are increasing worldwide as well as being reported where historically it did not occur. Vibrio infections are caused by consuming raw or undercooked seafood, or by exposing an open wound to contaminated sea water. Vibrio infections are most likely to occur during the warm seasons.[80]
The warming climate appears to be playing a substantial role in the increase in cases and area of occurrence.[81] The area of coastline with suitable conditions for vibrio bacteria has increased due to changes in sea surface temperature and sea surface salinity caused by climate change.[14]:12 These pathogens can cause gastroenteritis, cholera, wound infections, and sepsis. It has been observed that in the period of 2011–21, the "area of coastline suitable for Vibrio bacterial transmission has increased by 35% in the Baltics, 25% in the Atlantic Northeast, and 4% in the Pacific Northwest.[14]:12 Furthermore, the increasing occurrence of higher temperature days, heavy rainfall events and flooding due to climate change could lead to an increase in cholera risks.[4]:1045
Skin rashes
Risk assessments have been conducted for extreme health impacts across African countries, especially Kenya, both at the regional and city scale.[2] Rising temperatures and humidity increase the growth of skin-associated bacteria and alter the geographical distribution of other organisms that infect humans. The various microorganisms that make up the skin microflora each have different optimal temperature ranges for survival and growth. Staphylococcus aureus and Corynebacterium sp. amongst others are more tolerant to rising temperatures and higher salt conditions compared to other, non-commensal bacteria.[82]
Diarrheal diseases are one of the most commonly transmitted waterborne diseases.[26] These diseases are transmitted through unsafe drinking water or recreational water contact.[28] Diarrheal diseases account for 10–12% of deaths in children under five, as the second leading cause of death in children this age. They are also the second leading cause of death in low and middle income countries. Diarrhea diseases account for an estimated 1.4–1.9million deaths worldwide.[27]
Fungal infections
Fungal infections will also see an increase due to the warming of certain climates.[20] For example, the fungus Cryptococcus gattii is normally found in warmer climates such as in Australia, but has now been found in Canada. There are now two strains of this fungus in the northwestern part of North America, affecting many terrestrial animals. The spread of this fungus is hypothesized to be linked to climate change.[21]
Emergence of new infectious diseases
There is concern about the emergence of new diseases from the fungal kingdom. Mammals have endothermy and homeothermy, which allows them to maintain elevated body temperature through life; but it can be defeated if the fungi were to adapt to higher temperatures and survive in the body.[83] Fungi that are pathogenic for insects can be experimentally adapted to replicate at mammalian temperatures through cycles of progressive warming. This demonstrates that fungi are able to adapt rapidly to higher temperatures. The emergence of Candida auris on three continents is proposed to be as a result of global warming and has raised the danger that increased warmth by itself will trigger adaptations on certain microbes to make them pathogenic for humans.[84]
Climate change may also lead to new infectious diseases due to changes in microbial and vector geographic range. Microbes that are harmful to humans can adapt to higher temperatures, which will allow them to build better tolerance against human endothermy defences.[83]
Climate change and increasing temperatures will also impact the health of wildlife animals. Climate change will impact wildlife disease, specifically affecting "geographic range and distribution of wildlife diseases, plant and animal phenology, wildlife host-pathogen interactions, and disease patterns in wildlife".[86]
The health of wild animals, particularly birds, is assumed to be an indicator of early climate change effects because very little or no control measures are undertaken to protect them.[9]
Geographic range and distribution of wildlife diseases
Geographic shifts of disease vectors and parasitic disease in the Northern Hemisphere have likely been due to global warming. The range of Parelaphostrongylus odocoilei, a lung parasite that impacts ungulates like caribou and mountain goats, has been shifting northward since 1995, as has a tick vector for Lyme disease and other tick-borne zoonotic diseases known as Ixodes scapularis. It is predicted that climate warming will also lead to changes in disease distribution at certain altitudes. At high elevation in the Hawaiian Islands, for example, it is expected that climate warming will allow for year-round transmission of avian malaria. This increased opportunity for transmission will likely be devastating to endangered native Hawaiian birds that have little or no resistance to the disease.[86]
Phenology and wildlife diseases
Phenology is the study of seasonal cycles, and with climate change the seasonal biologic cycles of many animals have already been affected. For example, the transmission of tick-borne encephalitis (TBE) is higher to humans when early spring temperatures are warmer. The warmer temperatures result in an overlap in feeding activity of ticks who are infected with the virus (nymphal) with ticks who aren't (larval). This overlapped feeding leads to more uninfected larval ticks acquiring the infection and therefore increases the risk of humans being infected with TBE. Conversely, cooler spring temperatures would result in less overlapped feeding activity and would therefore decrease the risk of zoonotic transmission of TBE.[86]
Wildlife host-to-pathogen interaction
The transmission of pathogens happens through either direct contact from a diseased animal to another, or indirectly through a host like infected prey or a vector. Higher temperatures as a result of climate change results in an increased presence of disease producing agents in hosts and vectors, and also increases the "survival of animals that harbor disease".[86] Survival of Parelaphostrongylus tenuis, a brain worm of white-tailed deer that affects moose, could be increased due to the higher temperatures and milder winters caused by climate change. In moose this worm causes fatal neurological disease. Moose are already facing heat stress due to climate change, and may have increased susceptibility to parasitic and infectious diseases like the brain worm.[86]
Wildlife disease patterns
Predicting the impact of climate change on disease patterns in different geographic regions can be difficult, because its effects likely have high variability. This has been more evident in marine ecosystems than terrestrial environments, where massive decline in coral reefs has been observed due to disease spread.[86]
Infectious diseases in domestic animals and livestock
Vector-borne diseases seriously affect the health of domestic animals and livestock (e.g., trypanosomiasis, Rift Valley Fever, and bluetongue). Climate change will also indirectly affect the health of humans through its multifaceted impacts on food security, including livestock and plant crops.[9]
While climate-induced heat stress can directly reduce domestic animals' immunity against all diseases,[87] climatic factors also impact the distribution of many livestock pathogens themselves. For instance, Rift Valley fever outbreaks in East Africa are known to be more intense during the times of drought or when there is an El Nino.[88] Another example is that of helminths in Europe which have now spread further towards the poles, with higher survival rate and higher reproductive capacity (fecundity).[89]:231 Detailed long-term records of both livestock diseases and various agricultural interventions in Europe mean that demonstrating the role of climate change in the increased helminth burden in livestock is actually easier than attributing the impact of climate change on diseases which affect humans.[89]:231
A sheep infected with bluetongue virus
Temperature increases are also likely to benefit Culicoides imicola, a species of midge which spreads bluetongue virus.[88] Without a significant improvement in epidemiological control measures, what is currently considered an once-in-20-years outbreak of bluetongue would occur as frequently as once in five or seven years by midcentury under all but the most optimistic warming scenario. Rift Valley Fever outbreaks in East African livestock are also expected to increase.[90]:747Ixodes ricinus, a tick which spreads pathogens like Lyme disease and tick-borne encephalitis, is predicted to become 5–7% more prevalent on livestock farms in Great Britain, depending on the extent of future climate change.[91]
The impacts of climate change on leptospirosis are more complicated: its outbreaks are likely to worsen wherever flood risk increases,[88] yet the increasing temperatures are projected to reduce its overall incidence in the Southeast Asia, particularly under the high-warming scenarios.[92]Tsetse flies, the hosts of trypanosoma parasites, already appear to be losing habitat and thus affect a smaller area than before.[90]:747
Tropical diseases will likely migrate and become endemic in many other ecosystems due to an increase in mosquito range.[93] Mosquitoes also carry diseases like Dirofilaria immitis (dog heartworm) which affects dogs.
Responses
The policy implications of climate change and infectious diseases fall into two categories:[94]
Adapting to problems that have already arisen, and will continue to develop, due to climate change.
Addressing both of these areas is critical, as those in the poorest countries face the greatest burden. Additionally, when countries are forced to contend with a disease like malaria (for example), their prospects for economic growth are slowed. This contributes to continued and worsening global inequality.[95]
Policies are required that will significantly increase investments in public health in developing countries. This achieves two goals, the first being better outcomes related to diseases like malaria in the affected area, and the second being an overall better health environment for populations.[94] It is also important to focus on "one-health approaches."[94] This means collaborating on an interdisciplinary level, across various geographic areas, to come up with workable solutions. As is the case when responding to the effects of climate change, vulnerable populations including children and the elderly will need to be prioritized by any intervention.
The United Nations Environment Programme states that: "The most fundamental way to protect ourselves from zoonotic diseases is to prevent destruction of nature. Where ecosystems are healthy and biodiverse, they are resilient, adaptable and help to regulate diseases."[96]
Monitoring and research
An Anopheles stephensi mosquito shortly after obtaining blood from a human (the droplet of blood is expelled as a surplus). This mosquito is a vector of malaria, and mosquito control is an effective way of reducing its incidence.
Significant progress has been achieved in surveillance systems, disease and vector control measures, vaccine development, diagnostic tests, and mathematical risk modeling/mapping in recent decades.[9]
A tool that has been used to predict this distribution trend is the Dynamic Mosquito Simulation Process (DyMSiM). DyMSiM uses epidemiological and entomological data and practices to model future mosquito distributions based upon climate conditions and mosquitos living in the area.[97] This modeling technique helps identify the distribution of specific species of mosquito, some of which are more susceptible to viral infection than others.[citation needed]
Scientists are undertaking attribution studies to determine the degree to which climate change affects the spread of infectious diseases. There is also a need for scenario modeling which can help further our understanding of future climate change consequences on infectious disease rates.[95] Surveillance and monitoring of infectious diseases and their vectors is important to better understand these diseases.[98][94] Governments should accurately model changes in vector populations as well as the burden of disease, educate the public on ways to mitigate infection and prepare health systems for the increasing disease load.
↑ Beard C, Eisen R, Barker C, Garofalo J, Hahn M, Hayden M, etal. (2016). "Ch. 5: Vectorborne Diseases. The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment". Climate and Health Assessment. doi:10.7930/j0765c7v (inactive 13 September 2025). Archived from the original on 22 Sep 2016.{{cite book}}: CS1 maint: DOI inactive as of September 2025 (link)
↑ Munga S, Minakawa N, Zhou G, Githeko AK, Yan G (September 2007). "Survivorship of immature stages of Anopheles gambiae s.l. (Diptera: Culicidae) in natural habitats in western Kenya highlands". Journal of Medical Entomology. 44 (5): 758–764. doi:10.1603/0022-2585(2007)44[758:SOISOA]2.0.CO;2 (inactive 11 July 2025). PMID17915505. S2CID10278388.{{cite journal}}: CS1 maint: DOI inactive as of July 2025 (link)
↑ Peterson AT, Campbell LP, Moo-Llanes DA, Travi B, González C, Ferro MC, etal. (September 2017). "Influences of climate change on the potential distribution of Lutzomyia longipalpis sensu lato (Psychodidae: Phlebotominae)". International Journal for Parasitology. 47 (10–11): 667–674. doi:10.1016/j.ijpara.2017.04.007. hdl:11336/43578. PMID28668326.
↑ Walker JT (September 2018). "The influence of climate change on waterborne disease and Legionella: a review". Perspectives in Public Health. 138 (5): 282–286. doi:10.1177/1757913918791198. PMID30156484. S2CID52115812.
↑ Costello A, Abbas M, Allen A, Ball S, Bell S, Bellamy R, etal. (May 2009). "Managing the health effects of climate change: Lancet and University College London Institute for Global Health Commission". Lancet. 373 (9676): 1693–1733. doi:10.1016/S0140-6736(09)60935-1. PMID19447250. S2CID205954939.
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1 2 Kerr R.B., Hasegawa T., Lasco R., Bhatt I., Deryng D., Farrell A., Gurney-Smith H., Ju H., Lluch-Cota S., Meza F., Nelson G., Neufeldt H., Thornton P., 2022: Chapter 5: Food, Fibre and Other Ecosystem Products. In Climate Change 2022: Impacts, Adaptation and Vulnerability [H.-O. Pörtner, D.C. Roberts, M. Tignor, E.S. Poloczanska, K. Mintenbeck, A. Alegría, M. Craig, S. Langsdorf, S. Löschke,V. Möller, A. Okem, B. Rama (eds.)]. Cambridge University Press, Cambridge, United Kingdom and New York, NY, US, pp. 1457–1579 |doi=10.1017/9781009325844.012
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