Climate change futures: health, ecological and economic dimensions

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SPECIFIC RECOMMENDATIONS Preventing deforestation is the most significant environmental intervention for limiting the spread of malaria. Deforested areas are prone to flooding and habitat fragmentation increases mosquito-breeding sites, while removing habitat for predators, such as larvae-eating fish and adult mosquito-eating bats. In urban areas, environmental modifications (for example, culverts and drainage ditches), if properly maintained, can be important in the control of transmission. Using new knowledge about the interactions between climate and disease, 14 southern African countries, including Mozambique, have established the Southern African Regional Climate Outlook Forum (SARCOF), to make use of seasonal forecasts to develop Health Early Warning Systems, plan public health interventions and allocate resources. Regional efforts like SAR- COF have the potential to greatly reduce the intensity of malaria outbreaks, and such cooperative programs should be encouraged and supported. Global initiatives have been developed to reduce the morbidity and mortality from malaria. The World Health Organization’s “Roll-Back-Malaria” program and the Global Fund to Fight AIDS, Tuberculosis and Malaria have generated many programs to control malaria. The campaigns include community use of pesticide-impregnated bed nets (sometimes sold through “social marketing” schemes, elsewhere distributed free), pesticide (DDT or pyrethrins) spraying of houses, and mass treatment programs to interrupt transmission. The combination of approaches can be effective — if the programs are sustained. The long-term health, ecological, resistance-generating impacts and economic costs of pesticides used for control are always of concern. Figure 2.7 Floodplains Provide Breeding Sites for Mosquitoes Image: Creatas WEST NILE VIRUS A DISEASE OF WILDLIFE AND A FORCE OF GLOBAL CHANGE Paul Epstein Douglas Causey BACKGROUND West Nile virus (WNV), first identified in Uganda in 1937, is a zoonosis (a disease involving animals), with “spill-over” to humans. WNV poses significant risks to humans and wildlife as well as to zoo and domestic animals. The disease was unknown in the Americas until the summer of 1999, when it appeared suddenly in Queens, NY, and led to numerous cases with nervous system involvement and seven deaths in humans. Since 1990, outbreaks of WNV encephalitis have occurred in humans in Algeria, Romania, the Czech Republic, the Democratic Republic of the Congo, Russia, Israel, the US, and Canada plus epizootics affecting horses in Morocco, Italy, El Salvador, Mexico, the US and France, and in birds in Israel and in the US. Since 1999 in the US, WNV activity in mosquitoes, humans or animals has been reported in all states except Hawaii, Alaska and Oregon (CDC 2005). 41 | INFECTIOUS AND RESPIRATORY DISEASES CASE STUDIES
A new flavivirus, Usutu, akin to WNV, has recently emerged in Europe (Weissenböck et al. 2002). Many members of this Japanese B encephalitis family of viruses are capable of infecting humans, horses and wildlife. not adequately support healthy fish populations that consume mosquito larvae. SIGNIFICANT OUTBREAKS OF WNV IN THE PAST DECADE 42 | INFECTIOUS AND RESPIRATORY DISEASES CASE STUDIES THE ROLE OF CLIMATE While it is not known how WNV entered the US, anomalous weather conditions can amplify flaviviruses that circulate among urban mosquitoes, birds and mammals. Large European outbreaks of WNV in the past decade reveal that drought was a common feature (Epstein and DeFilippo 2001). An analysis of weather patterns coinciding with urban outbreaks of St. Louis encephalitis (SLE) in US cities reveals a similar association (Monath and Tsai 1987). SLE is referred to in this case study to analyze the meteorological determinants of WNV because of their similar life cycles, involving the same mosquitoes plus birds and animals. SLE first occurred in the US in 1933, during the ‘Dust Bowl,’ and low water tables are associated with SLE outbreaks in Florida (Shaman et al. 2002). WNV is an urban-based mosquito-borne disease. Culex pipiens, the primary mosquito vector (carrier) for WNV, thrives in city storm-catch basins, where small pools of nutrient-rich water remain in the drains during droughts (Spielman 1967). Warm temperatures accompanying droughts also accelerate the maturation of viruses within the mosquitoes, enhancing the potential for transmission. Shrinking water sites can concentrate infected birds and the mosquitoes biting them, and drought may reduce the predators of mosquitoes, such as dragonflies and damselflies. The first part of the life cycle of WNV and SLE is the “maintenance cycle.” This involves the culex mosquitoes (that preferentially bite birds) and the birds. Drought and warmth appear to amplify this cycle, increasing the “viral load” in birds and mosquitoes. When droughts yield to late summer rains, other types of mosquitoes breed in the open, standing water. These mosquitoes bite birds, humans and other animals, acting as “bridge vectors” to transfer the infection. Factors other than weather and climate contribute to outbreaks of WNV and SLE. Antiquated urban drainage systems leave more fetid pools in which mosquitoes can breed, and stagnant rivers and streams do Romania 1996: A significant outbreak of WNV occurred in 1996 in Romania in the Danube Valley and in Bucharest. This episode, with hundreds experiencing neurological disease and 17 fatalities, coincided with a prolonged drought and a heat wave (Savage et al. 1999). Russia 1999: A large outbreak of WNV occurred in Russia in the summer of 1999, following a warm winter, spring drought and summer heat wave (Platanov et al. 1999). US 1999: In the spring and summer of 1999, a severe drought (following a mild winter), affected Northeast and Mid-Atlantic states, and a three-week July heat wave enveloped the Northeast. Israel 2000: WNV was first reported in Israel in 1951 (Marberg et al. 1956), a major stopover for migrating birds. In 2000 the region was especially dry, as drought conditions prevailed across southern Europe and the Middle East, from Spain to Afghanistan. US 2002-2005: In the summer of 2002 much of the West and Midwest experienced severe spring and summer drought, compounded by a warm winter leaving little snowpack in the Rockies. An explosion of WNV cases occurred, across 44 states, the District of Columbia and five Canadian provinces. The summers of 2003 and 2004 saw persistent transmission in areas with drought, while spring rains and the summer drought in 2005 were associated with lower levels of transmission. HEALTH AND ECOLOGICAL IMPACTS In the 1999 New York City outbreak, 62 people developed nervous system disease: encephalitis (brain inflammation) and meningoencephalitis (inflammation of the brain and surrounding membrane). Seven died and many of the 55 survivors suffered from prolonged or persistent neurological impairment (Nash et al. 2001). Subsequent outbreaks in the US include 4,161 cases and 284 deaths in 2002; 9,856 cases and
Page 1 and 2: Climate Change Futures Health, Ecol
Page 3 and 4: Published by: The Center for Health
Page 5 and 6: PREAMBLE Hurricane Katrina 4 | PREA
Page 7 and 8: 6 | EXECUTIVE SUMMARY With this in
Page 9 and 10: 8 | EXECUTIVE SUMMARY Other non-lin
Page 11 and 12: THE CASE STUDIES IN BRIEF Floods in
Page 13 and 14: 12 | EXECUTIVE SUMMARY THE CCF PROJ
Page 16 and 17: PART I: The Climate Context Today
Page 18 and 19: (see McCarthy et al. 2001). As glac
Page 20 and 21: Table 1.1 Extreme Weather Events an
Page 22 and 23: DISCONTINUITIES CLIVAR, Climate Var
Page 24 and 25: Figure 1.6 The Frequency of Weather
Page 26 and 27: Figure 1.7 Trends in Events, Losses
Page 28 and 29: • Thawing of permafrost (permanen
Page 30 and 31: CCF-II: GRADUAL WARMING WITH INCREA
Page 32 and 33: PART II: Case Studies
Page 34 and 35: CLIMATE CHANGE AND EMERGING INFECTI
Page 36 and 37: HEALTH IMPACTS Malaria is character
Page 38 and 39: Figure 2.5 Brazil N Brazil COLOMBIA
Page 40 and 41: estimates (over and above current a
Page 44 and 45: 262 deaths in 2003; 7,470 cases and
Page 46 and 47: 98% of the two-year life cycle take
Page 48 and 49: The rise in minimum temperature res
Page 50 and 51: While the role of allergen exposure
Page 52 and 53: AIR QUALITY AND CLIMATE CHANGE ISSU
Page 54 and 55: EXTREME WEATHER EVENTS 1984 and 199
Page 56 and 57: HEALTH AND ECOLOGICAL IMPACTS Heat
Page 58 and 59: Figure 2.20 Projected Excess Deaths
Page 60 and 61: THE ROLE OF CLIMATE Australia exper
Page 62 and 63: Service). Since 2002, severe floods
Page 64 and 65: Table 2.1 Economic Losses in Europe
Page 66 and 67: NATURAL AND MANAGED SYSTEMS adelgid
Page 68 and 69: created unstable conditions conduci
Page 70 and 71: Climate research has already identi
Page 72 and 73: LOSSES ASSOCIATED WITH 1993 HEAVY P
Page 74 and 75: Figure 2.28 Soybean Rust Introducti
Page 76 and 77: Table 2.3 Extreme Weather Events Ca
Page 78 and 79: General measures to reduce the impa
Page 80 and 81: Physiological stresses on reef orga
Page 82 and 83: There are many questions concerning
Page 84 and 85: • Terminating practices that dest
Page 86 and 87: ecome contaminated with viruses and
Page 88 and 89: In 2001 the IPCC fully recognized t
Page 90 and 91: While seawater desalinization is cu
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PART III: Financial Implications, S
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Figure 3.1 Reinsurance Prices Are H
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RISK SPREADING IN DEVELOPED AND DEV
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THE LIMITS OF INSURABILITY Not all
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(also known as “cash-flow underwr
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from areas plagued by persistent dr
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Engagement of the insurance industr
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Industry observers point out that p
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CONCLUSIONS AND RECOMMENDATIONS Jus
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FINANCIAL INSTRUMENTS Regulators an
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of carbon-risk hedging products, su
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Summary Table of Extreme Weather Ev
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Table B.1 Summer Percentage Frequen
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Climate sensitivity for small-scale
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diffuse and do not manifest in sing
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APPENDIX D. LIST OF PARTICIPANTS AT
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Carmenza Robledo Gruppe Oekologie E
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126 | BIBLIOGRAPHY Bibliography AAA
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128 | BIBLIOGRAPHY Chordas, L. Epid
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Ford, S.E. & Tripp, M.R. Diseases a
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132 | BIBLIOGRAPHY Kalkstein, L. S.
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134 | BIBLIOGRAPHY Mills, E. The in
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136 | BIBLIOGRAPHY Rose, J. B., Eps
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138 | BIBLIOGRAPHY Vandyk, J. K., B
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Infectious and Respiratory Diseases
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Climate change futures: health, ecological and economic dimensions

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