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Effects Of Climate Change On Health Dr Troy GepteNational Grassroots Conference on Climate Change Balai Kalinaw, UP Diliman20-21 April 2009www.philclimatewatch.org
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Effects of Climate Changeon Health
Dr. Troy D. Gepte
Coverage of Presentation
• Overview of the Effects of Climate Change on Health:– Temperature-related and Weather-related effects– Natural Disasters due to extreme climate/weather
events– Other likely health impacts
• Emerging and Re-emerging
Infections and their Impact on Public Health
Health effects
Temperature-relatedillness and death
Extreme weather-related health effects
Air pollution-relatedhealth effects
Water and food-bornediseases
Vector borne and rodent borne diseases
Health Effects
Temperature-relatedillness and death
Extreme weather-related (floods, storms, etc.) health effects
Air pollution-relatedhealth effects
Human exposures
Regional weatherchanges
•Heat waves•Extreme weather•Temperature•Precipitation
Regional weatherchanges
•Heat waves•Extreme weather•Temperature•
•Sea-level rise
Climate ChangeClimate Change
Why are these important?
• These disruptive events have their greatest impact in poor countries.
• The two categories of climatic extremes are:– Simple extremes of very low or very high
temperatures – Complex events: droughts, floods, or
hurricanes
Deadly effects
• Extremes of temperature can kill– The very old, the very young and the frail
are most susceptible
• There will be more intense heatwaves– as well as warmer summers and milder
winters– effects of weather will vary between
populations
Source: WHO
Natural Disasters• Increasing trend in the number of victims due to
natural disasters is:– partly due to better reporting– partly due to increasing population vulnerability, and – may include a contribution from ongoing global
climate change
• Developing countries are poorly equipped to deal with weather extremes– especially in high-risk areas (coastal zones &cities)– Number of people killed, injured or made homeless
by natural disasters is increasing rapidly
Source: WHO
Additional likely health impacts that are hard to assess:
• changes in air pollution and aeroallergen levels• altered transmission of other infectious diseases• effects on food production via climatic influences on
plant pests and diseases• drought and famine• population displacement due to natural disasters,
crop failure, water shortages• destruction of health infrastructure in natural
disasters• conflict over natural resources• direct impacts of heat and cold (morbidity)
Patterns of Infectious Diseases are expected to change
• Climatic factors are related to vector-borne diseases, many enteric illnesses and certain water-related diseases.
• With climate change, we will have a tougher fight against infectious diseases.
• This is most evident in areas where climate variations are marked and especially in vulnerable populations.
Health effects
Temperature-relatedillness and death
Extreme weather-related health effects
Air pollution-relatedhealth effects
Water and food-bornediseases
Vector borne and rodent borne diseases
Health Effects
Temperature-relatedillness and death
Extreme weather-related (floods, storms, etc.) health effects
Air pollution-relatedhealth effects
Human exposures
Regional weatherchanges
•Heat waves•Extreme weather•Temperature•Precipitation
Regional weatherchanges
•Heat waves•Extreme weather•Temperature•
•Sea-level rise
Contaminationpathways
Transmissiondynamics
----rodent
Microbial changes:
Contamination paths
Transmission dynamics
Water and food-bornediseases
Vector borne and borne diseases
Climate ChangeClimate Change
• EID refers to newly identified, previously unknown infections w/c cause public health problems locally or internationally
e.g. SARS, H5N1 influenza, Nipah, Ebola, Hepatitis C, hantavirus, etc.
• The emergence of these diseases may be due to the combined impacts of rapid demographic, environmental, social, technological, lifestyle changes as well as climate change.
Emerging Infectious Diseases (EID)
Emerging Infectious Diseases (EID)
• Previously known diseases but are becoming to be a public health problem for the past two decades •These may vary from one country to another and in different regions of the country
Bacteria Leptospirosis Legionella pneumophila Parasites Paragonimiasis Neurocysticercosis
Viruses Japanese encephalitis Chikungunya Dengue Hepatitis C HIV Monkeypox
Contributors to emerging infections
1. Changing demographics
2. Pressure on the environment
3. International travel and commerce
4. Food supply and food technology
5. Microbial adaptation and change
6. Health systems breakdown
We live closely with insects and animals.
• Anthroponoses vs. Zoonoses
• “Anthroponoses” (such as TB, HIV/AIDS, and measles and indirectly-transmitted, vector-borne anthroponoses (e.g. malaria, dengue fever, yellow fever) ) vs. “Zoonoses” (e.g., rabies in dogs; bubonic plague, bird flu)
2003Monkeypox (in the United States)
2003SARS CoV
1999West Nile Virus (in the United States)
1997Highly Pathogenic Avian influenza
1996New Variant Creuzfeldt-Jacob Disease
1996Nipah Virus
1996Lyssavirus (in Australia)
1994Human Herpesvirus 8
1994Hendra Virus
1994Sabia Virus
1994Cyclospora cayatenensis
1993Sin Nombre Hantavirus
1992Bartonella henselae
1992Barmah Forest Virus
1991Guanarito Virus
1990Hepatitis E virus
1989Hepatitis C virus
1986Human Herpesvirus 6 (HHV 6)
1985Enterocytozoon Bieneusi
1985Human Immunodeficiency Virus 2 (HIV 2)
1983Human Immunodeficiency Virus 1 (HIV 1)
Date identifiedEmerging Infection
Emerging infections in the
past 20 years
Which emerging infections do you think are public health threats to the Philippines?
Re-emerging Infectious Diseases
•Known diseases which reappear after being eradicated (e.g. malaria, polio)• Infections which are increasing in incidence after they have been previously controlled (e.g. Meningococcemia, Plague, Cholera old serotype, Yellow Fever, Diphtheria)
VECTOR-BORNE DISEASE
Malaria and Dengue
• Mosquito vectors that spread malaria and dengue need access to stagnant water in order to breed, and the adults need humid conditions for viability.
• Warmer temperatures enhance vector breeding and reduce the pathogen’s maturation period within the vector organism.
• However, very hot and dry conditions can reduce mosquito survival
Malaria
• Changes in vector-borne diseases are predicted (areas bordering current endemic zones).
• Smaller changes in current endemic areas (seasonal Malaria).
• Most temperate regions would remain unsuitable for transmission
1990
2085
Estimated population at risk of dengue fever under “standard” climate change scenario: 1990, 2085
Source. Hales S et al. Lancet (online) 6 August 2002. http://image.thelancet.com/extras/01art11175web.pdf
.
Food and Water-borne Diseases
• Higher temperatures & heavier rainfall events may increase occurrence of water-borne diseases
• Sanitation services may be severely compromised contributing to potential contamination of local water supplies
• There may also be increases in infectious illnesses in people using recreational waters (e.g. pools & beaches)
• Food-related concerns:– outbreaks of toxic algae in saltwater that contaminate shellfish
(e.g. “red tide”)– increased incidence of food poisoning related to warmer
temperatures that increase the survival of microbes and the spread of toxins
Health effects
Temperature-relatedillness and death
Extreme weather-related health effects
Air pollution-relatedhealth effects
Water and food-bornediseases
Vector borne and rodent borne diseases
Health Effects
Temperature-relatedillness and death
Extreme weather-related (floods, storms, etc.) health effects
Air pollution-relatedhealth effects
Human exposures
Regional weatherchanges
•Heat waves•Extreme weather•Temperature•Precipitation
Regional weatherchanges
•Heat waves•Extreme weather•Temperature•
•Sea-level rise
Contaminationpathways
Transmissiondynamics
----rodent
Microbial changes:
Contamination paths
Transmission dynamics
Water and food-bornediseases
Vector borne and borne diseases
Climate ChangeClimate Change
Changes in agro-ecosystems, hydrology
Socioeconomic and demographic disruption
Effects of food and water shortages
Mental, nutritional,infectious-disease and other effects
How do we monitor?
Source: WHO
How can we respond?
Source: WHO
What should be done now
• Community-wide understanding and response, guided by policies informed by good scientific advice
• Policy-focused assessment of the potential health impacts of climate change
• Advocacy for:– multidisciplinary assessments– obtaining responses to questions asked by
stakeholders– evaluation of risk management adaptation options– addressing research gaps to facilitate decision-
making
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