Infectious Disease

Deer Tick, Lyme Disease VectorInfectious diseases like malaria, schistosomiasis, dengue fever, and zika virus are responsible for large burdens of disease globally and are highly sensitive to changes in environmental conditions, including temperature, soil moisture and precipitation patterns, deforestation, dams and irrigation projects, and others. It’s an urgent priority to better understand how land management practices alter the risk of these diseases in different settings and what types of interventions can reduce exposure to these diseases. Most emerging diseases globally are zoonotic diseases (with both human and animal hosts), and clearer understanding of anthropogenic influences on the emergence of zoonotic diseases (like HIV and Ebola) is another priority in planetary health research. Given the implications for food security and livelihoods, as well as for the state of global biodiversity, animal disease is also an important subtheme of disease ecology in the planetary health research context.

Learning Objectives

  • L1: Understand the environment-host-pathogen disease triangle and provide examples.
  • L2: Explain how environmental change can change the incidence, prevalence, geographical distribution, and/or severity of infectious diseases.
  • L3: Describe the criteria for an infectious disease hot spot and explain their characteristics with regard to environmental change.
  • L4: Recognize the interface between human and animal health in the contexts of environmental change and infectious diseases.


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Gorris ME, Cat LA, Zender CS, Treseder KK. Coccidioidomycosis Dynamics in Relation to Climate in the Southwestern United States . GeoHealth [Internet]. 2018. Publisher's VersionAbstract

Valley fever is endemic to the southwestern United States. Humans contract this fungal disease by inhaling spores of Coccidioides spp. Changes in the environment can influence the abundance and dispersal of Coccidioides spp., causing fluctuations in valley fever incidence. We combined county-level case records from state health agencies to create a regional valley fever database for the southwestern United States, including Arizona, California, Nevada, New Mexico, and Utah. We used this data set to explore how environmental factors influenced the spatial pattern and temporal dynamics of valley fever incidence during 2000–2015. We compiled climate and environmental geospatial data sets from multiple sources to compare with valley fever incidence. These variables included air temperature, precipitation, soil moisture, surface dust concentration, normalized difference vegetation index, and cropland area. We found that valley fever incidence was greater in areas with warmer air temperatures and drier soils. The mean annual cycle of incidence varied throughout the southwestern United States and peaked following periods of low precipitation and soil moisture. From year-to-year, however, autumn incidence was higher following cooler, wetter, and productive springs in the San Joaquin Valley of California. In southcentral Arizona, incidence increased significantly through time. By 2015, incidence in this region was more than double the rate in the San Joaquin Valley. Our analysis provides a framework for interpreting the influence of climate change on valley fever incidence dynamics. Our results may allow the U.S. Centers for Disease Control and Prevention to improve their estimates of the spatial pattern and intensity of valley fever endemicity.

Hasan MA, Mouw C, Jutla A, Akanda AS. Quantification of rotavirus diarrheal risk due to hydroclimatic extremes over South Asia: Prospects of satellite-based observations in detecting outbreaks . GeoHealth [Internet]. 2017. Publisher's VersionAbstract

Rotavirus is the most common cause of diarrheal disease among children under five. Especially in South Asia, rotavirus remains the leading cause of mortality in children due to diarrhea. As climatic extremes and safe water availability significantly influence diarrheal disease impacts in human populations, hydroclimatic information can be a potential tool for disease preparedness. In this study, we conducted a multivariate temporal and spatial assessment of thirty-four (34) climate indices calculated from ground and satellite earth observations to examine the role of temperature and rainfall extremes on the seasonality of rotavirus transmission in Bangladesh. We extracted rainfall data from the Global Precipitation Measurement (GPM) and temperature data from the Moderate Resolution Imaging Spectroradiometer (MODIS) sensors to validate the analyses and explore the potential of a satellite-based seasonal forecasting model. Our analyses found that the number of rainy days and nighttime temperature range from 16°C to 21°C are particularly influential on the winter transmission cycle of rotavirus. The lower number of wet days with suitable cold temperatures for an extended time accelerates the onset and intensity of the outbreaks. Temporal analysis over Dhaka also suggested that water logging during monsoon precipitation influences rotavirus outbreaks during a summer transmission cycle. The proposed model shows lag components, which allowed us to forecast the disease outbreaks one to two-months in advance. The satellite data-driven forecasts also effectively captured the increased vulnerability of dry-cold regions of the country, compared to the wet-warm regions.

Alkishe AA, Peterson AT, Samy AM. Climate change influences on the potential geographic distribution of the disease vector tick Ixodes ricinus . PLoS ONE [Internet]. 2017. Publisher's VersionAbstract


Ixodes ricinus is a species of hard tick that transmits several important diseases in Europe and North Africa, including Lyme borreliosis and tick-borne encephalitis. Climate change is affecting the geographic distributions and abundances of arthropod vectors, which in turn influence the geographic distribution and epidemiology of associated vector-borne diseases. To date, few studies have investigated effects of climate change on the spatial distribution of I. ricinus at continental extents. Here, we assessed the potential distribution of I. ricinus under current and future climate conditions to understand how climate change will influence the geographic distribution of this important tick vector in coming decades.


We used ecological niche modeling to estimate the geographic distribution of I. ricinus with respect to current climate, and then assessed its future potential distribution under different climate change scenarios. This approach integrates occurrence records of I. ricinus with six relevant environmental variables over a continental extent that includes Europe, North Africa, and the Middle East. Future projections were based on climate data from 17 general circulation models (GCMs) under 2 representative concentration pathway emissions scenarios (RCPs), for the years 2050 and 2070.


The present and future potential distributions of I. ricinus showed broad overlap across most of western and central Europe, and in more narrow zones in eastern and northern Europe, and North Africa. Potential expansions were observed in northern and eastern Europe. These results indicate that I. ricinus populations could emerge in areas in which they are currently lacking, posing increased risks to human health in those areas. However, the future of I. ricinusticks in some important regions such the Mediterranean was unclear owing to high uncertainty in model predictions.

Lana RM, da Gomes MFC, de Lima TFM, Honório NA, Codeço CT. The introduction of dengue follows transportation infrastructure changes in the state of Acre, Brazil: A network-based analysis . PLoS Neglected Tropical Diseases [Internet]. 2017. Publisher's VersionAbstract

Human mobility, presence and passive transportation of Aedes aegypti mosquito, and environmental characteristics are a group of factors which contribute to the success of dengue spread and establishment. To understand this process, we assess data from dengue national and municipal basins regarding population and demographics, transportation network, human mobility, and Ae. aegypti monitoring for the Brazilian state of Acre since the first recorded dengue case in the year 2000 to the year 2015. During this period, several changes in Acre’s transport infrastructure and urbanization have been started. To reconstruct the process of dengue introduction in Acre, we propose an analytic framework based on concepts used in malaria literature, namely vulnerability and receptivity, to inform risk assessments in dengue-free regions as well as network theory concepts for disease invasion and propagation. We calculate the probability of dengue importation to Acre from other Brazilian states, the evolution of dengue spread between Acrean municipalities and dengue establishment in the state. Our findings suggest that the landscape changes associated with human mobility have created favorable conditions for the establishment of dengue virus transmission in Acre. The revitalization of its major roads, as well as the increased accessibility by air to and within the state, have increased dengue vulnerability. Unplanned urbanization and population growth, as observed in Acre during the period of study, contribute to ideal conditions for Ae. aegyptimosquito establishment, increase the difficulty in mosquito control and consequently its local receptivity.

Myers SS. Planetary health: protecting human health on a rapidly changing planet . The Lancet [Internet]. 2017. Publisher's VersionAbstract

The impact of human activities on our planet's natural systems has been intensifying rapidly in the past several decades, leading to disruption and transformation of most natural systems. These disruptions in the atmosphere, oceans, and across the terrestrial land surface are not only driving species to extinction, they pose serious threats to human health and wellbeing. Characterising and addressing these threats requires a paradigm shift. In a lecture delivered to the Academy of Medical Sciences on Nov 13, 2017, I describe the scale of human impacts on natural systems and the extensive associated health effects across nearly every dimension of human health. I highlight several overarching themes that emerge from planetary health and suggest advances in the way we train, reward, promote, and fund the generation of health scientists who will be tasked with breaking out of their disciplinary silos to address this urgent constellation of health threats. I propose that protecting the health of future generations requires taking better care of Earth's natural systems.

Azage M, Kumie A, Worku A, Bagtzoglou AC, Anagnostou E. Effect of climatic variability on childhood diarrhea and its high risk periods in northwestern parts of Ethiopia . PLoS ONE [Internet]. 2017. Publisher's VersionAbstract


Increasing climate variability as a result of climate change will be one of the public health challenges to control infectious diseases in the future, particularly in sub-Saharan Africa including Ethiopia.


To investigate the effect of climate variability on childhood diarrhea (CDD) and identify high risk periods of diarrheal diseases.


The study was conducted in all districts located in three Zones (Awi, West and East Gojjam) of Amhara Region in northwestern parts of Ethiopia. Monthly CDD cases for 24 months (from July 2013 to June 2015) reported to each district health office from the routine surveillance system were used for the study. Temperature, rainfall and humidity data for each district were extracted from satellite precipitation estimates and global atmospheric reanalysis. The space-time permutation scan statistic was used to identify high risk periods of CDD. A negative binomial regression was used to investigate the relationship between cases of CDD and climate variables. Statistical analyses were conducted using SaTScan program and StataSE v. 12.


The monthly average incidence rate of CDD was 11.4 per 1000 (95%CI 10.8–12.0) with significant variation between males [12.5 per 1000 (95%CI 11.9 to 13.2)] and females [10.2 per 1000 (95%CI 9.6 to 10.8)]. The space-time permutation scan statistic identified the most likely high risk period of CDD between March and June 2014 located in Huletej Enese district of East Gojjam Zone. Monthly average temperature and monthly average rainfall were positively associated with the rate of CDD, whereas the relative humidity was negatively associated with the rate of CDD.


This study found that the most likely high risk period is in the beginning of the dry season. Climatic factors have an association with the occurrence of CDD. Therefore, CDD prevention and control strategy should consider local weather variations to improve programs on CDD.

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