The Impact of Climate Change on the Emergence and Reemergence of Diseases Transmitted by Mosquitoes in Temperate Regions: An Umbrella Review

Mosquito-borne diseases represent a global public health concern and are responsible for over 700 000 deaths globally every year. Additionally, many mosquito species have undergone a dramatic global expansion due to various factors, including climate change, and forecasts indicate that mosquito populations will persist in dispersing beyond their present geographic range, namely in temperate climates. The research literature on this topic has grown in recent years, including some systematic evidence synthesis. However, to provide a comprehensive overview of this growing literature needed for policy action, a summary of this evidence, including existing systematic reviews, is required. This study aims to undertake an umbrella review that explores the impacts of climate change on the emergence and reemergence of diseases transmitted by mosquitoes in temperate zones and the publication of the protocol is a fundamental step to ensure the credibility, transparency and reproducibility of this research. Studies published in scientific journals indexed by PubMed, EMBASE, Cochrane Library, Epistemonikos, and Web of Science Core Collection to be included in this umbrella review will meet the following criteria: the topic of study (climate change and mosquito-borne diseases), regions (temperate zones), study designs (systematic reviews and meta-analysis), language (any) and date (since inception until December 31st, 2023). Titles and abstracts from selected articles will be evaluated by two authors independently and any discrepancy will be resolved through consensus or, if not possible, through a third author. The data will be extracted, and the risk of bias will be evaluated. The quality of the methodology of the included reviews will be assessed using AMSTAR 2. A narrative synthesis will examine the included systematic reviews. The quality of evidence for all outcomes will be judged using the Grading of Recommendations Assessment, Development and Evaluation working group methodology.

Impacts of climate change on water-related mosquito-borne diseases in temperate regions: A systematic review of literature and meta-analysis

To describe the epidemiology of Ross River virus (RRV) infection in the endemic Darwin region of tropical northern Australia and to develop a predictive model for RRV infections. Analysis of laboratory confirmed cases of RRV infection between 01 January 1991 and 30 June 2006, together with climate, tidal and mosquito data collected weekly over the study period from 11 trap sites around Darwin. The epidemiology was described, correlations with various lag times were performed, followed by Poisson modelling to determine the best main effects model to predict RRV infection. Ross River virus infection was reported equally in males and females in 1256 people over the 15.5 years. Average annual incidence was 113/100 000 people. Infections peaked in the 30-34 age-group for both sexes. Correlations revealed strong associations between monthly RRV infections and climatic variables and also each of the four implicated mosquito species populations. Three models were created to identify the best predictors of RRV infections for the Darwin area. The climate-only model included total rainfall, average daily minimum temperature and maximum tide. This model explained 44.3% deviance. Using vector-only variables, the best fit was obtained with average monthly trap numbers of Culex annulirostris, Aedes phaecasiatus, Aedes notoscriptus and Aedes vigilax. This model explained 59.5% deviance. The best global model included rainfall, minimum temperature and three mosquito species. This model explained 63.5% deviance, and predicted disease accurately. We have produced a model that accurately predicts RRV infections throughout the year, in the Darwin region. Our model also indicates that predicted anthropogenic global climatic changes may result in an increase in RRV infections. Further research needs to target other high-risk areas elsewhere in tropical Australia to ascertain the best local climatic and vector predictive RRV infection models for each region. This methodology can also be tested for assessing utility of predictive models for other mosquito-borne diseases endemic to locations outside Australia.

Risk of Rupture and All Cause Mortality of Abdominal Aortic Ectasia: A Systematic Review and Meta-Analysis

The purpose of the present article is to present a review of the Ross River virus (RRV) and Barmah Forest virus (BFV) literature in relation to potential implications for future disease in tropical northern Australia. Ross River virus infection is the most common and most widespread arboviral disease in Australia, with an average of 4,800 national notifications annually. Of recent concern is the sudden rise in BFV infections; the 2005-2006 summer marked the largest BFV epidemic on record in Australia, with 1,895 notifications. Although not life-threatening, infection with either virus can cause arthritis, myalgia, and fatigue for 6 months or longer, resulting in substantial morbidity and economic impact. The geographic distribution of mosquito species and their seasonal activity is determined in large part by temperature and rainfall. Predictive models can be useful tools in providing early warning systems for epidemics of RRV and BFV infection. Various models have been developed to predict RRV outbreaks, but these appear to be mostly only regionally valid, being dependent on local ecological factors. Difficulties have arisen in developing useful models for the tropical northern parts of Australia, and to date no models have been developed for the Northern Territory. Only one model has been developed for predicting BFV infections using climate and tide variables. It is predicted that the exacerbation of current greenhouse conditions will result in longer periods of high mosquito activity in the tropical regions where RRV and BFV are already common. In addition, the endemic locations may expand further within temperate regions, and epidemics may become more frequent in those areas. Further development of predictive models should benefit public health planning by providing early warning systems of RRV and BFV infection outbreaks in different geographical locations.

IntroductionHealth systems’ (HS) adaptations to climate change (CC) cover two major, and interrelated dimensions: (1) Environmental sustainability—actions aimed at limiting the negative impact of HS on the environment (eg, by reducing greenhouse gas emissions) and (2) Climate resilience—adaptations focused on improving HS’ ability to cope with the impact of CC (eg, by improving HS preparedness to climate-induced natural disasters). Within both dimensions, a diversity of actions, at different HS levels, can take place. The general objective is to provide health policy makers with a comprehensive evidence-based set of recommendations on the scope and effectiveness of HS adaptations to CC.Methods and analysisAn umbrella review will be conducted. Systematic reviews will be included if: (1) They focus on HS adaptations to CC (including both environmental sustainability and climate resilience strategies/actions), (2) Were published since 2015 and (3) Report a quality appraisal of included studies. Five databases were searched: (1) MEDLINE via PubMed, (2) Scopus, (3) Web of science core collection, (4) ProQuest Central and (5) The Cochrane Database of Systematic Reviews. Two reviewers will independently assess studies’ eligibility, conduct quality appraisal and perform data extraction. Data will be synthesised using both quantitative and qualitative methods. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses will guide the reporting of results.Ethics and disseminationEthical approval is not required, as this study involves the collection and analysis of secondary data only. The results will be submitted for publication in a peer-reviewed journal and disseminated via dedicated research channels and social media platforms.PROSPERO registration numberCRD420251052647.

China has experienced noticeable changes in climate over the past 100 years and the potential impact climate change has on transmission of mosquito-borne infectious diseases poses a risk to Chinese populations. The aims of this paper are to summarize what is known about the impact of climate change on the incidence and prevalence of malaria, dengue fever and Japanese encephalitis in China and to provide important information and direction for adaptation policy making. Fifty-five papers met the inclusion criteria for this study. Examination of these studies indicates that variability in temperature, precipitation, wind, and extreme weather events is linked to transmission of mosquito-borne diseases in some regions of China. However, study findings are inconsistent across geographical locations and this requires strengthening current evidence for timely development of adaptive options. After synthesis of available information we make several key adaptation recommendations including: improving current surveillance and monitoring systems; concentrating adaptation strategies and policies on vulnerable communities; strengthening adaptive capacity of public health systems; developing multidisciplinary approaches sustained by an new mechanism of inter-sectional coordination; and increasing awareness and mobilization of the general public.

Amongst the arthritis-causing arboviruses, i.e. those spread by insects, the alphavirus group is of special interest. These viruses occasionally cause vast outbreaks, such as O'nyong-nyong in Africa in 1959. In Fennoscandia, Sindbis-related Ockelbo, Pogosta, or Karelian fever viruses have been found to cause significant morbidity. The major symptoms in addition to joint inflammation are fever, fatigue, headache and rash. The joint symptoms may persist for weeks, even months. The diagnosis is based on the clinical picture and serology. The causative viruses are closely related but not identical. It appears that at least in Finland the Pogosta disease is more common than thought, and the symptoms may often be overlooked. Several factors related to the viruses, their hosts, and global environmental changes may affect the spread of these viruses. All over the world arbovirus-caused diseases have increased, because of global changes.

Anthropogenic climate change and allergen exposure: The role of plant biology

Climate change is a pervasive global issue that threatens the livelihoods and wellbeing of billions living globally. Climate change is a risk multiplier impacting all ecosystems, society, and sectors of the economy. The agriculture sector is one such sector that is highly vulnerable to changes in climate. In a country like Nepal where rainfed agriculture is a dominant occupation and a key pillar of the country’s economy, climate change brings risks and negative consequences for on-farm production, farmers' livelihoods as well as on the country’s development. The impacts of climate change including rising temperatures, an increase in the frequency or intensity of extreme weather events such as drought, and shifts in the rainfall seasonality, can cause a decline in food production and threaten the quality of food supplies, leading to reduced food security. The rise in the global population will increase global demand for food which implies that agriculture needs to boost production and increase yields, among other things. The unprecedented risks posed by climate change potentially undermine the ability of farms and farm holders to grow adequate and quality food. The severity of these risks varies due to a range of underlying factors including low economic development, their location, existing biophysical and socioeconomic conditions, and institutional arrangements. While the impacts of climate change on food production as well as agricultural practices in Nepal have been documented, there is a dearth in scholarly literature that has assessed the impacts of climate change on household food security in Nepal incorporating farmers’ perspectives and in particular smallholder subsistence farmers. Furthermore, there is only modest literature that has examined geographical variations in those experiences and understandings. This PhD study aimed, therefore, to investigate the effects of climate change on agricultural practices and food security, with a focus on subsistence smallholder farmers in three main agro- ecological zones of Nepal known as The Mountains, Hills, and the Terai. The study aimed to respond to the primary research question: How are Nepalese farming communities being impacted by climate change and how are they responding to ensure their continued food security? To answer this main research, question the study posed the following secondary research questions: Q1. How is climate changing and how is it impacting subsistence agriculture? Q2. What are the farmers experiencing and what is their understanding? a. Are there gender differences in understanding and experiencing? Q3. What is the state of food insecurity among these farmers? a. How is it being impacted by climate change? Q4. What adaptation strategies have been adopted by smallholder farmers to address threats to agricultural practices and food security from climate change and other pressures? Both the qualitative and qualitative data were collected using multiple methods to address the identified research questions. Methods included a narrative literature review, systematic review, face to face interviews with farmers, individual interviews with key informants and focus groups with the women's group. Climate data on temperature between 1971-2013 and rainfall between 1967-2013 were analysed. Additionally, secondary data on crop yield from 1980 to 2016 were also analysed to gain a better empirical understanding of the relations between climate change and yield pattern and to triangulate and validate the findings from the interviews. Quantitative data on cereal crop yields and climate data were systematically tabulated and further statistically analysed using software R. This study employed the Bayesian approach to statistical modelling. Besides, this study undertook an integrated risk assessment of food insecurity using the Bayesian Belief Network model to reflect how the risk of food insecurity is influenced under two scenarios: (1) current climate conditions and (2) the influences of different adaptation strategies employed. NVivo was used for content analysis for qualitative data obtained from the key informant interview and focus group data and analysis of transcripts from farmers' structured interviews. The findings showed that agricultural practices have undergone various changes over the past 30 years. Climate change impacts were experienced by farmers in all three agro-ecological zones of Nepal. However, the impacts varied between these zones in terms of frequency and intensity. The effect of climate change was highly pronounced in the Mountains zone followed by the Hills and the Terai. The results confirmed that rural subsistence smallholder farmers dependent on rainfed agriculture are vulnerable to climate change impacts. Moreover, it disproportionately affects the poor farmers whose income hinges solely on agriculture and associated activities. Boosting agricultural production and empowering these smallholders is key to enhancing their food security. The experiences reported by farmers are well aligned with the trend of the climatic variables obtained from climate data analysis, highlighting the importance of perception-based survey in complementing climate research. The study demonstrated both the climatic and non-climatic factors are affecting agricultural practices as well as household food security of these farming communities. It is, therefore, difficult to isolate the influence of any of these factors. This was supported by the findings from the risk assessment undertaken by Bayesian modelling. Based on Bayesian modelling, the smallholder farmers mainly at the Mountain zone were at the risk of food insecurity. The measures to increase the adaptive capacity of these smallholders were found to help them manage the risk of food insecurity. Addressing the complicated and multifaceted concerns of climate change and food security needs multidisciplinary and multisectoral adaptation interventions acknowledging underlying biophysical, social, economic, geographical and environmental circumstances. Farmers have taken some actions to adapt and reduce the worsening impacts of climate change. Nevertheless, farmers encountered several barriers in effectively adapting to climate change. This study concluded there is an urgent need for a transformative level of intervention that warrants a coordinated action and collaboration between relevant stakeholders working in this field, including governments and non-governmental organizations, to target the most vulnerable and the needy smallholder farmers addressing the constraints and pressures they face. Policy and decision-makers should work extensively and sensitively with smallholders to ensure the maintenance of their livelihood and to guarantee their food security. Combining local and scientific knowledge is needed to help direct research and tailor adaptation solutions that meet local conditions and needs.

The effects of global warming have long been a focus of scientists’ attention, not only since the USA rejected the Kyoto Protocol, which was drafted to curb the emission of so‐called greenhouse gases. The potential consequences of increasing the Earth's temperature by just a few degrees include a rise in ocean levels due to melting of the polar ice caps, parching of the land and changes of storm, flood and drought patterns. These scenarios are mainly debated among climatologists, but biologists are adding a further dimension with another potentially disastrous effect. ‘In the past five years, there has been increasing discussion about global warming and its potential impact on diseases like malaria and dengue fever in the tropics and even in temperate zones’, Uriel Kitron, Professor of Epidemiology at the University of Illinois in Urbana‐Champaign, said. Indeed, many scientists point to global warming as a factor in the spread of malaria and other vector‐borne infectious diseases. This camp believes that global warming is likely to disturb a delicate equilibrium and contribute to new epidemics of malaria, yellow and dengue fever and encephalitis. Kitron has been studying the invasion of the tiger mosquito in Illinois, LaCrosse encephalitis in the Great Lakes region, and dengue and malaria in Trinidad, Kenya and Mozambique. His research, however, does not clearly link global warming with the spread of these diseases. ‘Vector‐borne diseases have an extremely complex ecology, which renders transmission and what it takes to produce disease not that simple and clear cut’, he said. > Many scientists believe that global warming is likely to disturb a delicate equilibrium and contribute to new epidemics of malaria, yellow and dengue fever and encephalitis Unlike Kitron's middle‐of‐the‐road view, much of the scientific thinking on the topic is polarised, and seems to be tinged with politics. Paul Epstein, Associate …

BackgroundThere has been no evidence of transmission of mosquito-borne arboviruses of equine or human health concern to date in the UK. However, in recent years there have been a number of outbreaks of viral diseases spread by vectors in Europe. These events, in conjunction with increasing rates of globalisation and climate change, have led to concern over the future risk of mosquito-borne viral disease outbreaks in northern Europe and have highlighted the importance of being prepared for potential disease outbreaks. Here we assess several UK mosquito species for their potential to transmit arboviruses important for both equine and human health, as measured by the presence of viral RNA in saliva at different time points after taking an infective blood meal.ResultsThe following wild-caught British mosquitoes were evaluated for their potential as vectors of zoonotic equine arboviruses: Ochlerotatus detritus for Venezuelan equine encephalitis virus (VEEV) and Ross River virus (RRV), and Culiseta annulata and Culex pipiens for Japanese encephalitis virus (JEV). Production of RNA in saliva was demonstrated at varying efficiencies for all mosquito-virus pairs. Ochlerotatus detritus was more permissive for production of RRV RNA in saliva than VEEV RNA. For RRV, 27.3% of mosquitoes expectorated viral RNA at 7 days post-infection when incubated at 21 °C and 50% at 24 °C. Strikingly, 72% of Cx. pipiens produced JEV RNA in saliva after 21 days at 18 °C. For some mosquito-virus pairs, infection and salivary RNA titres reduced over time, suggesting unstable infection dynamics.ConclusionsThis study adds to the number of Palaearctic mosquito species that demonstrate expectoration of viral RNA, for arboviruses of importance to human and equine health. This work adds to evidence that native mosquito species should be investigated further for their potential to vector zoonotic mosquito-borne arboviral disease of equines in northern Europe. The evidence that Cx. pipiens is potentially an efficient laboratory vector of JEV at temperatures as low as 18 °C warrants further investigation, as this mosquito is abundant in cooler regions of Europe and is considered an important vector for West Nile Virus, which has a comparable transmission ecology.

Climate change is increasingly influencing the epidemiology of Plasmodium vivax malaria, particularly in temperate regions where shifting environmental conditions are altering transmission dynamics. This scoping review examined the impact of climate change on P. vivax malaria by evaluating the roles of temperature, precipitation, and vector habitat expansion in driving transmission patterns. Systematic research and synthesis of peer-reviewed literature, climate models, and epidemiological data were conducted to assess the interplay between climatic factors and malaria risk. Findings revealed that rising temperatures extend mosquito breeding seasons and reduce winter mortality, while changes in precipitation and humidity create favorable conditions for vector proliferation. Additionally, the expansion of Anopheles mosquito habitats into higher latitudes and elevations, coupled with prolonged transmission periods, increases the risk of malaria resurgence in previously non-endemic temperate regions. Human factors such as migration, socioeconomic disparities, and land-use changes further exacerbate transmission risks. The review underscored the need for integrated public health strategies, including enhanced surveillance, vector control, and climate-informed risk assessments, to mitigate the impact of climate change on P. vivax malaria. Proactive measures and interdisciplinary collaboration are essential to address the evolving threat of malaria in temperate climates and to prevent its re-emergence in vulnerable populations. Keywords: Plasmodium vivax malaria, Climate change, Temperate regions, Vector dynamics, Malaria transmission.

The 2021 China report of the Lancet Countdown on health and climate change: seizing the window of opportunity

For decades, researchers have debated whether climate change has an adverse impact on diseases, especially infectious diseases. They have identified a strong relationship between climate variables and vector’s growth, mortality rate, reproduction, and spatiotemporal distribution. Epidemiological data further indicates the emergence and re-emergence of infectious diseases post every single extreme weather event. Based on studies conducted mostly between 1990-2018, three aspects that resemble the impact of climate change impact on diseases are: (a) emergence and re-emergence of vector-borne diseases, (b) impact of extreme weather events, and (c) social upliftment with education and adaptation. This review mainly examines and discusses the impact of climate change based on scientific evidences in published literature. Humans are highly vulnerable to diseases and other post-catastrophic effects of extreme events, as evidenced in literature. It is high time that human beings understand the adverse impacts of climate change and take proper and sustainable control measures. There is also the important requirement for allocation of effective technologies, maintenance of healthy lifestyles, and public education.