Infectious diseases of severe weather-related and flood-related natural disasters

Risk Factors of Wasting-Based Malnutrition in the Flood-Affected Areas of Pakistan: A Cross-Sectional Study

The current study aimed to find the risk factors of wasting in flood-affected areas of Khyber Pakhtunkhwa, Pakistan. Sociodemographic and anthropometric data was collected. Children living in large family are 2.59 times more likely to be wasted (AOR = 2.59, 95% confidence interval (CI): 1.10, 6.10; p value = .029) and children living in medium size family are 2.23 times more likely to be wasted (AOR = 2.23, 95% CI: 1.03, 4.80; p value = .04) as compared to children in small family size. The study underscores the need for targeted interventions to address the identified risk factors and mitigate the impact of flooding on child nutrition.

Fungal diversity in the soil Mycobiome: Implications for ONE health

Today, over 300 million individuals worldwide are afflicted by severe fungal infections, many of whom will perish. Fungi, as a result of their plastic genomes have the ability to adapt to new environments and extreme conditions as a consequence of globalization, including urbanization, agricultural intensification, and, notably, climate change. Soils and the impact of these anthropogenic environmental factors can be the source of pathogenic and non-pathogenic fungi and subsequent fungal threats to public health. This underscores the growing understanding that not only is fungal diversity in the soil mycobiome a critical component of a functioning ecosystem, but also that soil microbial communities can significantly contribute to plant, animal, and human health, as underscored by the One Health concept. Collectively, this stresses the importance of investigating the soil microbiome in order to gain a deeper understanding of soil fungal ecology and its interplay with the rhizosphere microbiome, which carries significant implications for human health, animal health and environmental health.

An optical system to detect, surveil, and kill flying insect vectors of human and crop pathogens

Sustainable and effective means to control flying insect vectors are critically needed, especially with widespread insecticide resistance and global climate change. Understanding and controlling vectors requires accurate information about their movement and activity, which is often lacking. The Photonic Fence (PF) is an optical system that uses machine vision, infrared light, and lasers to identify, track, and interdict vectors in flight. The PF examines an insect's outline, flight speed, and other flight parameters and if these match those of a targeted vector species, then a low-power, retina-safe laser kills it. We report on proof-of-concept tests of a large, field-sized PF (30 mL × 3 mH) conducted with Aedes aegypti, a mosquito that transmits dangerous arboviruses, and Diaphorina citri, a psyllid which transmits the fatal huanglongbing disease of citrus. In tests with the laser engaged, < 1% and 3% of A. aegypti and D. citri, respectfully, were recovered versus a 38% and 19% recovery when the lacer was silenced. The PF tracked, but did not intercept the orchid bee, Euglossa dilemma. The system effectively intercepted flying vectors, but not bees, at a distance of 30 m, heralding the use of photonic energy, rather than chemicals, to control flying vectors.

Global Research on Natural Disasters and Human Health: a Mapping Study Using Natural Language Processing Techniques

PURPOSE OF REVIEW

This review aimed to systematically synthesize the global evidence base for natural disasters and human health using natural language processing (NLP) techniques.

RECENT FINDINGS

We searched Embase, PubMed, Scopus, PsycInfo, and Web of Science Core Collection, using titles, abstracts, and keywords, and included only literature indexed in English. NLP techniques, including text classification, topic modeling, and geoparsing methods, were used to systematically identify and map scientific literature on natural disasters and human health published between January 1, 2012, and April 3, 2022. We predicted 6105 studies in the area of natural disasters and human health. Earthquakes, hurricanes, and tsunamis were the most frequent nature disasters; posttraumatic stress disorder (PTSD) and depression were the most frequently studied health outcomes; mental health services were the most common way of coping. Geographically, the evidence base was dominated by studies from high-income countries. Co-occurrence of natural disasters and psychological distress was common. Psychological distress was one of the top three most frequent topics in all continents except Africa, where infectious diseases was the most prevalent topic. Our findings demonstrated the importance and feasibility of using NLP to comprehensively map natural disasters and human health in the growing literature. The review identifies clear topics for future clinical and public health research and can provide an empirical basis for reducing the negative health effects of natural disasters.

Climate Change and Child Health Equity

The climate crisis is a major public health threat for children, disproportionately affecting the most vulnerable populations. Climate change causes a myriad of health issues for children, including respiratory illness, heat stress, infectious disease, the effects of weather-related disasters, and psychological sequelae. Pediatric clinicians must identify and address these issues in the clinical setting. Strong advocacy from pediatric clinicians is needed to help prevent the worst effects of the climate crisis and to support the elimination of use of fossil fuels and enactment of climate-friendly policies.

Novel insights into impacts of the "7.20" extreme rainstorm event on water supply security of Henan Province, China: Levels and health risks of tap water disinfection by-products

Spatial distributions, levels, and comprehensive assessments of post-flood tap water disinfection by-products (DBPs) were first studied in Henan Province after the "7.20" Extreme Rainstorm Event in 2021. DBPs levels and health risks in tap water were higher in areas flooded (waterlogged) by storm or upstream flood discharge (WA) and rainstorm-affected areas (RA) compared with other areas (OA), suggesting that extreme rainstorm and flooding events may somehow exacerbate DBPs contamination of tap water through disinfection. WA sites were characterized as contamination hotspots. The results revealed high haloacetic acids (HAAs) levels in WA (Avg: 57.79 μg·L^-1) and RA (Avg: 32.63 μg·L^-1) sites. Compared with normal period, DBPs-caused cancer risk increased by 3 times, exceeding the negligible risk level. Cancer risk came primarily from the ingestion of trihalomethanes (THMs) (>80%), children were the sensitive group. Those between 30 and 69 showed approximately 1.7 times higher disability-adjusted life yearsper person-yearthan other age groups. Apart from regulated DBPs, bromochloracetic acid (BCAA) and dibromoacetonitrile (DBAN) appear to be the main toxicity contributors in these samples. Our results provide a scientific basis for preventing and controlling health risks from tap water DBPs and for assessing the social benefits and burdens of emergency disinfection.

Rural Embodiment and Community Health: an Anthropological Case Study on Biocultural Determinants of Tropical Disease Infection and Immune System Development in the USA

Purpose of Review

Biocultural methods are critically important for identifying environmental and socioeconomic factors linked with tropical disease risk and outcomes. For example, embodiment theory refers to the process by which lived experiences impact individual biology. Increased exposure to pathogens, chronic psychosocial stress, and unequal resource access are all outcomes linked with discrimination and poverty. Through lived experiences, race and socioeconomic inequality can literally become embodied-get under the skin and affect physiology-impacting immune responses and contributing to lifelong health disparities. Yet, few studies have investigated tropical disease patterns and associated immune function using embodiment theory to understand lasting physiological impacts associated with living in a high-pathogen environment.

Recent Findings

Here, we use preliminary data drawn from the Rural Embodiment and Community Health (REACH) study to assess whether pathogen exposure and immune stimulation within a sample of children from the Mississippi Delta are associated with household income. We also test whether immune marker levels-assessed with enzyme-linked immunosorbent assays using dried blood spot samples-vary between the REACH sample and a similarly aged nationally representative NHANES sample. Immune marker levels did not differ significantly between REACH participants living below vs. above the federal poverty line, yet immunoglobulin E levels-a marker of macroparasite infection-were higher among REACH study participants compared to the NHANES sample.

Summary

These results may suggest community-level pathogenic exposures (i.e., parasitic infections) are embodied by REACH participants with implications for long-term immune function, potentially resulting in immune aspects that differ from nationally representative samples.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40475-023-00282-z.

Klimawandel und Kindergesundheit – Ein Aufruf zum Handeln

Der Klimawandel ist eine stille Krise und die größte Bedrohung unserer Zeit. Hitze, Extremwetterereignisse und Luftverschmutzung haben besondere Auswirkungen auf Frühgeburtlichkeit, akute und chronische Atemwegserkrankungen, Allergien und Asthma. Auch die Zunahme infektiöser Erkrankungen sowie eine erhöhte Exposition durch Karzinogene sowie deren Folgen werden beobachtet. Neben der Gefahr des Klimawandels für die somatische, hat die Krise auch Einfluss auf die mentale Gesundheit von Heranwachsenden und aggraviert das soziale Ungleichgewicht, wovon Kinder und Jugendliche in besonderer Weise betroffen sind.

Um die von Wissenschaftler:innen prognostizierten Szenarien abzuwenden, braucht es zum einen ein rasches und umfängliches Agieren der Politik, aber auch ein Neudenken unseres Selbstverständnisses als für Kinder- und Jugendgesundheit Verantwortliche sowie eine grundlegende Neuordnung von Prioritäten. Als Akteur:innen im Gesundheitswesen stehen wir besonders in der Verantwortung, uns für eine gesunde Erde einzusetzen. Dies kann und muss schon heute auf verschiedenen Ebenen, als Ärzt:innen, Wissenschaftler:innen, auf Ebenen der Patient:innenversorgung und der Fachgesellschaften erfolgen, um allen Kindern und Jugendlichen eine lebenswerte Zukunft zu ermöglichen.

Increased incidence of cutaneous Staphylococcusaureus infections after the 2010 floods in the Var department of France: Rumour or reality?

BACKGROUND

Natural disasters are typically associated with the emergence of infectious diseases. On 15 June 2010, severe storms caused flooding in the Var department (France). A rumour about increased risk of Staphylococcusaureus skin infections after bathing in the sea began to circulate on Internet a few days after the floods. The aim of this study was to compare the rumour with the true incidence of cases of infection.

METHODS

Since 1999, we have been conducting a prospective survey of S. aureus skin infections in our hospital to study their clinical, laboratory and epidemiologic features. We compared data on cases of Staphylococcus skin infection recorded in our institution from 2008 to 2012.

RESULTS

We found that there was no increase in S. aureus skin infections after the floods compared to the previous and subsequent years.

CONCLUSION

We had a unique opportunity to check the rumoured increase in incidence of infectious disease with the true incidence. In our study, the fear of S. aureus skin infections following flooding proved to be unfounded.

Texas professionals are employing a one health approach to protect the United States against biosecurity threats

Texas is a geographically large state with large human and livestock populations, many farms, a long coastal region, and extreme fluctuations in weather. During the last 15 years, the state of Texas has frequently suffered disasters or catastrophes causing extensive morbidity and economic loss. These disasters often have complicated consequences requiring multi-faceted responses. Recently, an interdisciplinary network of professionals from multiple academic institutions has emerged to collaborate in protecting Texas and the USA using a One Health approach. These experts are training the next generation of scientists in biopreparedness; increasing understanding of pathogens that cause repetitive harm; developing new therapeutics and vaccines against them; and developing novel surveillance approaches so that emerging pathogens will be detected early and thwarted before they can cause disastrous human and economic losses. These academic One Health partnerships strengthen our ability to protect human and animal health against future catastrophes that may impact the diverse ecoregions of Texas and the world.

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Texas has suffered from numerous disasters or catastrophes, often more than other US states.

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These disasters have caused tremendous morbidity, mortality, and economic loss.

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Texas professionals are partnering in One Health ways to mitigate such catastrophes.

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These numerous collaborations are important to Texas, the USA, and abroad.

Climate Change Related Catastrophic Rainfall Events and Non-Communicable Respiratory Disease: A Systematic Review of the Literature

Climate change is increasing the frequency and intensity of extreme precipitation events, the impacts of which disproportionately impact urban populations. Pluvial flooding and flooding related sewer backups are thought to result in an increase in potentially hazardous human-pathogen encounters. However, the extent and nature of associations between flooding events and non-communicable respiratory diseases such as chronic bronchitis, asthma, and chronic obstructive pulmonary disease (COPD) are not well understood. This research seeks to characterize the state of research on flooding and NCRDs through a systematic review of the scientific literature. We conducted a systematic search of PubMed, Web of Science, and Scopus for published scholarly research papers using the terms flooding, monsoon, and tropical storm with terms for common NCRDs such as asthma, COPD, and chronic bronchitis. Papers were included if they covered research studies on individuals with defined outcomes of flooding events. We excluded review papers, case studies, and opinion pieces. We retrieved 200 articles from PubMed, 268 from Web of Science and 203 from Scopus which comprised 345 unique papers. An initial review of abstracts yielded 38 candidate papers. A full text review of each left 16 papers which were included for the review. All papers except for one found a significant association between a severe weather event and increased risk for at least one of the NCRDs included in this research. Our findings further suggest that extreme weather events may worsen pre-existing respiratory conditions and increase the risk of development of asthma. Future work should focus on more precisely defining measure of health outcomes using validated tools to describe asthma and COPD exacerbations. Research efforts should also work to collect granular data on patients’ health status and family history and assess possible confounding and mediating factors such as neighborhood water mitigation infrastructure, housing conditions, pollen counts, and other environmental variables.

Heavy Rainfall, Sewer Overflows, and Salmonellosis in Black Skimmers (Rynchops niger)

Extreme weather events, particularly heavy rainfall, are occurring at greater frequency with climate change. Although adverse human health effects from heavy rainfall are often publicized, impacts to free-ranging wildlife populations are less well known. We first summarize documented associations of heavy rainfall on wildlife health. We then report a novel investigation of a salmonellosis outbreak in a colony of black skimmers (Rynchops niger) in Florida, USA. During June-September 2016, heavy rainfall resulted in the discharge of millions of gallons of untreated wastewater into the Tampa Bay system, contaminating the water body, where adult skimmers foraged. At least 48 fledglings died, comprising 39% of the colony's nesting season's offspring. Of eight examined deceased birds from the colony, six had a systemic salmonellosis infection. Isolates were identified as Salmonella enterica serotype Typhimurium. Their pulsed-field gel electrophoresis patterns were identical to each other and matched those from several human Salmonella sp. infections. Differences among whole-genome sequences were negligible. These findings and the outbreak's epidemic curve suggest propagated transmission occurred within the colony. A multidisciplinary and One Health approach is recommended to mitigate any adverse effects of climate change-driven stochastic events, especially when they place already imperiled wildlife at further risk.

Exposure Assessment for Tropical Cyclone Epidemiology

PURPOSE OF REVIEW

Tropical cyclones impact human health, sometimes catastrophically. Epidemiological research characterizes these health impacts and uncovers pathways between storm hazards and health, helping to mitigate the health impacts of future storms. These studies, however, require researchers to identify people and areas exposed to tropical cyclones, which is often challenging. Here we review approaches, tools, and data products that can be useful in this exposure assessment.

RECENT FINDINGS

Epidemiological studies have used various operational measures to characterize exposure to tropical cyclones, including measures of physical hazards (e.g., wind, rain, flooding), measures related to human impacts (e.g., damage, stressors from the storm), and proxy measures of distance from the storm's central track. The choice of metric depends on the research question asked by the study, but there are numerous resources available that can help in capturing any of these metrics of exposure. Each has strengths and weaknesses that may influence their utility for a specific study. Here we have highlighted key tools and data products that can be useful for exposure assessment for tropical cyclone epidemiology. These results can guide epidemiologists as they design studies to explore how tropical cyclones influence human health.

Individual hurricane evacuation intentions during the COVID-19 pandemic: insights for risk communication and emergency management policies

The U.S. 2020 hurricane season was extraordinary because of a record number of named storms coinciding with the COVID-19 pandemic. This study draws lessons on how individual hurricane preparedness is influenced by the additional risk stemming from a pandemic, which turns out to be a combination of perceptions of flood and pandemic risks that have opposite effects on preparedness behavior. We conducted a survey in early June 2020 of 600 respondents in flood-prone areas in Florida to obtain insights into households' risk perceptions and preparedness for the upcoming hurricane season under COVID-19. The results show that concerns over COVID-19 dominated flood risk perceptions and negatively impacted people's evacuation intentions. Whereas hotel costs were the main obstacle to evacuating during Hurricane Dorian in 2019 in the same geographic study area, the main evacuation obstacle identified in the 2020 hurricane season is COVID-19. Our statistical analyses investigating the factors influencing evacuation intentions show that older individuals are less likely to evacuate under a voluntary order, because they are more concerned about the consequences of becoming infected by COVID-19. We observe similar findings based on a real-time survey we conducted in Florida with another group of respondents under the threat of Hurricane Eta at the end of the hurricane season in November 2020. We discuss the implications of our findings for risk communication and emergency management policies that aim to improve hurricane preparedness when dealing with additional health risks such as a pandemic, a situation that may be exacerbated under the future climate.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11069-021-05064-2.

Over half of known human pathogenic diseases can be aggravated by climate change

It is relatively well accepted that climate change can affect human pathogenic diseases; however, the full extent of this risk remains poorly quantified. Here we carried out a systematic search for empirical examples about the impacts of ten climatic hazards sensitive to greenhouse gas (GHG) emissions on each known human pathogenic disease. We found that 58% (that is, 218 out of 375) of infectious diseases confronted by humanity worldwide have been at some point aggravated by climatic hazards; 16% were at times diminished. Empirical cases revealed 1,006 unique pathways in which climatic hazards, via different transmission types, led to pathogenic diseases. The human pathogenic diseases and transmission pathways aggravated by climatic hazards are too numerous for comprehensive societal adaptations, highlighting the urgent need to work at the source of the problem: reducing GHG emissions.

An assessment of flood event along Lower Niger using Sentinel-1 imagery

Flood incidence, especially in global south countries, is one of the most challenging natural disasters in the light of changing climates, especially in Africa. This is because African countries have a large sub-section of vulnerable people who either live within flood-prone areas or depend on flood-prone areas for their means of livelihood such as we have in Nigeria. Recent flood disasters in Nigeria have been of major concern to people, communities, and institutions. Several studies have been conducted on flood events and their impacts in Nigeria. However, most of these studies are on public perception, flood modeling (rainfall-runoff), and the provision of binary maps with few studies engaging in the use of satellite observations, especially the use of Synthetic Aperture Radar, SAR, to enhance flood early warning designs, especially in Sub-Saharan Africa. This study is aimed at assessing the 2018 flood event in Lokoja, Kogi State, Nigeria, using the Sentinel-1 imagery. The study confirmed that a total of 69 buildings out of 611 buildings were affected by the flood disaster with about 24,902 people displaced by this singular flood event. The study shows that backscattering from microwave sensors provides very useful information for highlighting inundated areas that could prove useful in forecasting, monitoring, and precision-based flood early warning designs before, during, and after flood events.

Climate Change and Emerging Food Safety Issues: A Review

ABSTRACT

Throughout the past decades, climate change has been one of the most complex global issues. Characterized by worldwide alterations in weather patterns, along with a concomitant increase in the temperature of the Earth, climate change will undoubtedly have significant effects on food security and food safety. Climate change engenders climate variability: significant variations in weather variables and their frequency. Both climate variability and climate change are thought to threaten the safety of the food supply chain through different pathways. One such pathway is the ability to exacerbate foodborne diseases by influencing the occurrence, persistence, virulence and, in some cases, toxicity of certain groups of disease-causing microorganisms. Food safety can also be compromised by various chemical hazards, such as pesticides, mycotoxins, and heavy metals. With changes in weather patterns, such as lower rainfall, higher air temperature, and higher frequency of extreme weather events among others, this translates to emerging food safety concerns. These include the shortage of safe water for irrigation of agricultural produce, greater use of pesticides due to pest resistance, increased difficulty in achieving a well-controlled cold chain resulting in temperature abuse, or the occurrence of flash floods, which cause runoff of chemical contaminants in natural water courses. Together, these can result in foodborne infection, intoxication, antimicrobial resistance, and long-term bioaccumulation of chemicals and heavy metals in the human body. Furthermore, severe climate variability can result in extreme weather events and natural calamities, which directly or indirectly impair food safety. This review discusses the causes and impacts of climate change and variability on existing and emerging food safety risks and also considers mitigation and adaptation strategies to address the global warming and climate change problem.

HIGHLIGHTS

Using search-constrained inverse distance weight modeling for near real-time riverine flood modeling: Harris County, Texas, USA before, during, and after Hurricane Harvey

Flooding poses a serious public health hazard throughout the world. Flood modeling is an important tool for emergency preparedness and response, but some common methods require a high degree of expertise or may be unworkable due to poor data quality or data availability issues. The conceptually simple method of inverse distance weight modeling offers an alternative. Using stream gauges as inputs, this study interpolated stream elevation via inverse distance weight modeling under 15 different model input parameter scenarios for Harris County, Texas, USA, from August 25th to September 15th, 2017 (before, during, and after Hurricane Harvey inundated the county). A digital elevation model was used to identify areas where modeled stream elevation exceeded ground elevation, indicating flooding. Imagery and observed high water marks were used to validate the models' outputs. There was a high degree of agreement (between 79 and 88%) between imagery and model outputs of parameterizations visually validated. Quantitative validations based on high water marks were also positive, with a Nash-Sutcliffe efficiency of in excess of .6 for all parameterizations relative to a Nash-Sutcliffe efficiency of the benchmark of 0.56. Inverse distance weight modeling offers a simple, accurate method for first-order estimations of riverine flooding in near real-time using readily available data, and outputs are robust to some alterations to input parameters.

Minireview: Epidemiological impact of arboviral diseases in Latin American countries, arbovirus-vector interactions and control strategies

Mosquitoes are the most crucial insects in public health due to their vector capacity and competence to transmit pathogens, including arboviruses, bacterias and parasites. Re-emerging and emerging arboviral diseases, such as yellow fever virus (YFV), dengue virus (DENV), zika virus (ZIKV), and chikungunya virus (CHIKV), constitute one of the most critical health public concerns in Latin America. These diseases present a significant incidence within the human settlements increasing morbidity and mortality events. Likewise, among the different genus of mosquito vectors of arboviruses, those of the most significant medical importance corresponds to Aedes and Culex. In Latin America, the mosquito vector species of YFV, DENV, ZIKV, and CHIKV are mainly Aedes aegypti and Ae. Albopictus. Ae. aegypti is recognized as the primary vector in urban environments, whereas Ae. albopictus, recently introduced in the Americas, is more prone to rural settings. This minireview focuses on what is known about the epidemiological impact of mosquito-borne diseases in Latin American countries, with particular emphasis on YFV, DENV, ZIKV and CHIKV, vector mosquitoes, geographic distribution, and vector-arbovirus interactions. Besides, it was analyzed how climate change and social factors have influenced the spread of arboviruses and the control strategies developed against mosquitoes in this continent.

Identifying the research gap of zoonotic disease in displacement: a systematic review

Background

Outbreaks of zoonotic diseases that transmit between animals and humans, against a backdrop of increasing levels of forced migration, present a major challenge to global public health. This review provides an overview of the currently available evidence of how displacement may affect zoonotic disease and pathogen transmission, with the aim to better understand how to protect health and resilience of displaced and host populations.

Methods

A systematic review was conducted aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Between December 2019 - February 2020, PubMed, Web of Science, PLoS, ProQuest, Science Direct and JSTOR were searched for literature. Studies were included based on a focus on zoonotic disease risks in displacement and/or humanitarian emergencies, and relevance in terms of livestock dependency of the displaced populations. Evidence was synthesised in form of a table and thematic analysis.

Results

Of all records, 78 papers were selected for inclusion. Among the included studies, the majority were based on secondary data, including literature reviews (n=43) and case studies (n=5), while the majority of papers covered wide geographical areas such as the Global South (n=17) and Africa (n=20). The review shows significant gaps in the literature, which is specifically lacking primary data on zoonotic diseases in displacement. Risk factors for the transmission of zoonoses in displacement are based on generic infectious disease risks, which include the loss of health services, increased population density, changes in environment, reduced quality of living conditions and socio-economic factors. Regardless of the presence of these disease drivers during forced migration however, there is little evidence of large-scale zoonotic disease outbreaks linked directly to livestock in displacement.

Conclusion

Due to the lack of primary research, the complex interlinkages of factors affecting zoonotic pathogen transmission in displacement remain unclear. While the presence of animals may increase the burden of zoonotic pathogens, maintaining access to livestock may improve livelihoods, nutrition and mental health, with the potential to reduce people’s vulnerability to disease. Further primary interdisciplinary and multi-sectoral research is urgently required to address the evidence gaps identified in this review to support policy and program development.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41256-021-00205-3.

Epidemiologic Impacts in Acute Infectious Disease Associated with Catastrophic Climate Events Related to Global Warming in the Northeast of Mexico

Rising global temperatures and seawater temperatures have led to an increase in extreme weather patterns leading to droughts and floods. These natural phenomena, in turn, affect the supply of drinking water in some communities, which causes an increase in the prevalence of diseases related to the supply of drinking water. The objective of this work is to demonstrate the effects of global warming on human health in the population of Monterrey, Mexico after Hurricane Alex. We interpolated data using statistical downscaling of climate projection data for 2050 and 2080 and correlated it with disease occurrence. We found a remarkable rise in the incidence of transmissible infectious disease symptoms. Gastrointestinal symptoms predominated and were associated with drinking of contaminated water like tap water or water from communal mobile water tanks, probably because of the contamination of clean water, the disruption of water sanitation, and the inability to maintain home hygiene practices.

A Predictive Human Health Risk Assessment of Non-Choleraic Vibrio spp. during Hurricane-Driven Flooding Events in Coastal South Carolina, USA

Densely populated, low-lying coastal areas are most at-risk for negative impacts from increasing intensity of storm-induced flooding. Due to the effects of global warming and subsequent climate change, coastal temperatures and the magnitude of storm-induced flooding are projected to increase, creating a hospitable environment for the aquatic Vibrio spp. bacteria. A relative risk model analysis was used to determine which census block groups in coastal South Carolina have the highest risk of Vibrio spp. exposure using storm surge flooding as a proxy. Coastal block groups with dense vulnerable sub-populations exposed to storm surge have the highest relative risk, while inland block groups away from riverine-mediated storm surge have the lowest relative risk. As Vibriosis infections may be extremely severe or even deadly, the best methods of infection control will be regular standardized coastal and estuarine water monitoring for Vibrio spp. to enable more informed and timely public health advisories and help prevent future exposure.

Update on Climate Change: Its Impact on Respiratory Health at Work, Home, and at Play

Climate change is a crisis of vast proportions that has serious implications for pulmonary health. Increasing global temperatures influence respiratory health through extreme weather events, wildfires, prolonged allergy seasons, and worsening air pollution. Children, elderly patients, and patients with underlying lung disease are at elevated risk of complications from these effects of climate change. This paper summarizes the myriad ways in which climate change affects the respiratory health of patients at home and in outdoor environments and outlines measures for patients to protect themselves.

Search for Campylobacter spp. Reveals High Prevalence and Pronounced Genetic Diversity of Arcobacter butzleri in Floodwater Samples Associated with Hurricane Florence in North Carolina, USA

Climate change and associated extreme weather events can have massive impacts on the prevalence of microbial pathogens in floodwaters. However, limited data are available on foodborne zoonotic pathogens such as Campylobacter or Arcobacter in hurricane-associated floodwaters in rural regions with intensive animal production. With a high density of intensive animal production as well as pronounced vulnerability to hurricanes, eastern North Carolina presents unique opportunities in this regard. Our findings revealed widespread incidence of the emerging zoonotic pathogen Arcobacter butzleri in floodwaters from Hurricane Florence. We encountered high and largely unexplored diversity while also noting the potential for regionally abundant and persistent clones. We noted pronounced partitioning of the floodwater genotypes into two source-associated clades. The data will contribute to elucidating the poorly understood ecology of this emerging pathogen and highlight the importance of surveillance of floodwaters associated with hurricanes and other extreme weather events for Arcobacter and other zoonotic pathogens.

In September 2018, Hurricane Florence caused extreme flooding in eastern North Carolina, USA, a region highly dense in concentrated animal production, especially swine and poultry. In this study, floodwater samples (n = 96) were collected as promptly post-hurricane as possible and for up to approximately 30 days and selectively enriched for Campylobacter using Bolton broth enrichment and isolation on modified charcoal cefoperazone deoxycholate agar (mCCDA) microaerobically at 42°C. Only one sample yielded Campylobacter, which was found to be Campylobacter jejuni with the novel sequence type 2866 (ST-2866). However, the methods employed to isolate Campylobacter readily yielded Arcobacter from 73.5% of the floodwater samples. The Arcobacter isolates failed to grow on Mueller-Hinton agar at 25, 30, 37, or 42°C microaerobically or aerobically but could be readily subcultured on mCCDA at 42°C microaerobically. Multilocus sequence typing of 112 isolates indicated that all were Arcobacter butzleri. The majority (85.7%) of the isolates exhibited novel sequence types (STs), with 66 novel STs identified. Several STs, including certain novel ones, were detected in diverse waterbody types (channel, isolated ephemeral pools, floodplain) and from multiple watersheds, suggesting the potential for regionally dominant strains. The genotypes were clearly partitioned into two major clades, one with high representation of human and ruminant isolates and another with an abundance of swine and poultry isolates. Surveillance of environmental waters and food animal production systems in this animal agriculture-dense region is needed to assess potential regional prevalence and temporal stability of the observed A. butzleri strains as well as their potential association with specific types of food animal production.

IMPORTANCE Climate change and associated extreme weather events can have massive impacts on the prevalence of microbial pathogens in floodwaters. However, limited data are available on foodborne zoonotic pathogens such as Campylobacter or Arcobacter in hurricane-associated floodwaters in rural regions with intensive animal production. With a high density of intensive animal production as well as pronounced vulnerability to hurricanes, eastern North Carolina presents unique opportunities in this regard. Our findings revealed widespread incidence of the emerging zoonotic pathogen Arcobacter butzleri in floodwaters from Hurricane Florence. We encountered high and largely unexplored diversity while also noting the potential for regionally abundant and persistent clones. We noted pronounced partitioning of the floodwater genotypes into two source-associated clades. The data will contribute to elucidating the poorly understood ecology of this emerging pathogen and highlight the importance of surveillance of floodwaters associated with hurricanes and other extreme weather events for Arcobacter and other zoonotic pathogens.

The microbiota as a candidate biomarker for SPA pools and SPA thermal spring stability after seismic events

Worldwide, the location of thermal springs overlaps seismic areas, and the higher occurrence of earthquakes may impact on water stability and safety. The hydrogeological perturbations pose environmental and public health risks that can be monitored by well-established chemical, physical and biological parameters. Specific health concerns involve the exposure of the population to the medical or wellness uses of SPA thermal waters, e.g. in respiratory or hydropinic treatments as well as during rehabilitative or recreational activities in pools. Since SPA waters are characterized by their own microbiota, we analysed by 16S amplicon sequencing the dynamics of water microbial communities after the August 2017 Ischia island earthquake. For the first time, we report the impact of a seismic event on a thermal spring water, whose microbiota was deeply characterized before and immediately after the natural disaster. The biodiversity stability of the water underwent a dramatic disturbance following the earthquake, as summarized by a Shannon index moving from 1.300 during May 2016-July 2017, up to 1.600 during the first 20-70 h after the event and slightly slowing down to 1.500 after 30 days and to 1.400 after 6 months. Microbiota analysis showed a sudden reduction of the relative abundance of autochthone thermophilic species within the first 20 h and a parallel increase of other thermophilic species as well as of ectopic bacteria from soil, sediments, sea, freshwater and wastewaters. Cultivable mesophilic bacteria were observed only in the first 20 h sample (7 × 10³/L), even if the presence of faecal contamination traces was detected by Real Time PCR also up to 70 h after the disaster. OTUs analysis of putative metabolic functions showed several changes between pre and post event, such as in the distribution of Sulphur metabolizing and Carbon fixation species. The restoration of the original pattern followed a slow trend, requiring over six months. The observed results confirm the impact of the earthquake on the microbiota structure of the underground thermal spring water, suggesting further perspectives for monitoring water stability and safety issues by a metagenomic approach.

Impacts of flood on health of Iranian population: Infectious diseases with an emphasis on parasitic infections

Background

Outbreaks of infectious diseases are the major concern after flooding. Flood makes people displacement which would be more complicated with inadequate sanitation. Settling in crowded shelters in absence of clean water and inaccessibility to health care services makes people more vulnerable to get infection. This review aimed to discuss about potential undesirable outcomes of flooding occurred in 2019 in Iran.

Methods

A comprehensive search was carried out in databases including PubMed, Google scholar, Scopus, Science Direct, Iran medex, Magiran and SID (Scientific information database) from 2000 to 2019. All original descriptive articles on flood were concerned. Related articles on flood disturbance were considered. Also, publication of red cross society was considered as only reliable reference in evaluation of consequences of flood occurred in 2019 in Iran.

Results

Flooding in Iran, was started in March 2019 and lasted to April 2019. Flood affected 31 provinces and 140 rivers burst their banks, and southwestern Iran being hit most severely. According the reports of international federation of red cross society, 3800 cities and villages were affected by the floods with 65,000 destroyed houses and 114,000 houses partially damaged. Also 70 hospitals or health care centers with 1200 schools were damaged along with many infrastructures including 159 main roads and 700 bridges.

Conclusions

Considering 365,000 displaced persons and estimation of mentioned damages, it was one of the greatest natural disaster during the last 20 years. Various risk factors in favor of infectious diseases such as overcrowding, disruption of sewage disposal, poor standards of hygiene, poor nutrition, negligible sanitation and human contact among refugees provide suitable conditions for increased incidence of infectious diseases after flooding and also cause epidemics.More attention is needed to provide hygienic situation for people after natural disasters including flood.

A 15 Year Evaluation of West Nile Virus in Wisconsin: Effects on Wildlife and Human Health

West Nile virus (WNV) is the most important and widespread mosquito-borne virus in the United States (U.S.). WNV has the ability to spread rapidly and effectively, infecting more than 320 bird and mammalian species. An examination of environmental conditions and the health of keystone species may help predict the susceptibility of various habitats to WNV and reveal key risk factors, annual trends, and vulnerable regions. Since 2002, WNV outbreaks in Wisconsin varied by species, place, and time, significantly affected by unique climatic, environmental, and geographical factors. During a 15 year period, WNV was detected in 71 of 72 counties, resulting in 239 human and 1397 wildlife cases. Controlling for population and sampling efforts in Wisconsin, rates of WNV are highest in the western and northwestern rural regions of the state. WNV incidence rates were highest in counties with low human population densities, predominantly wetland, and at elevations greater than 1000 feet. Resources for surveillance, prevention, and detection of WNV were lowest in rural counties, likely resulting in underestimation of cases. Overall, increasing mean temperature and decreasing precipitation showed positive influence on WNV transmission in Wisconsin. This study incorporates the first statewide assessment of WNV in Wisconsin.

Mould Infections of Traumatic Wounds: A Brief Narrative Review

Mould infections may follow traumatic injuries, with direct fungal inoculum in the site of injury and subsequent angioinvasion, possibly resulting in tissue necrosis and systemic dissemination. The pathogenesis of mould infections following trauma injuries presents unique features compared with classical mould infections occurring in neutropenic or diabetic patients, because a large fraction of post-traumatic mould infections is observed in previously healthy individuals. Most of the published clinical experience and research on mould infections following traumatic injuries regards soldiers and infections after natural disasters. However, following trauma and soil contamination (e.g., agricultural or automotive injuries) other immunocompetent individuals may develop mould infections. In these cases, delays in correct diagnosis and treatment may occur if pertinent signs such as necrosis and absent or reduced response to antibacterial therapy are not promptly recognized. Awareness of mould infections in at-risk populations is needed to rapidly start adequate laboratory workflow and early antifungal therapy in rapidly evolving cases to improve treatment success and reduce mortality.

A time-trend ecological study for identifying flood-sensitive infectious diseases in Guangxi, China from 2005 to 2012

BACKGROUND

Flood-related damage can be very severe and include health effects. Among those health impacts, infectious diseases still represent a significant public health problem in China. However, there have been few studies on the identification of the spectrum of infectious diseases associated with floods in one area. This study aimed to quantitatively identify sensitive infectious diseases associated with floods in Guangxi, China.

METHODS

A time-trend ecological design was conducted. A descriptive analysis was first performed to exclude infectious diseases with low incidence from 2005 to 2012 in ten study sites of Guangxi. The Wilcoxon rank-sum test was applied to examine the difference in the ten-day attack rate of infectious diseases between the exposure and control periods with different lagged effects. Negative binomial, zero-inflated Poisson and zero-inflated negative binomial models were used to examine the relationship and odd ratios (ORs) of the risk of floods on infectious diseases of preliminary screening.

RESULTS

A total of 417,271 infectious diseases were notified. There were 11 infectious diseases associated with floods in the preliminary screening process for flood-sensitive infectious diseases. The strongest effect was shown with a 0-9 ten-day lag in different infectious diseases. Multivariate analysis showed that floods were significantly associated with an increased the risk of bacillary dysentery (odds ratio (OR) = 1.268, 95% confidence interval (CI): 1.072-1.500), acute haemorrhagic conjunctivitis (AHC, OR = 3.230, 95% CI: 1.976-5.280), influenza A (H₁N₁) (OR = 1.808, 95% CI: 1.721-1.901), tuberculosis (OR = 1.200, 95% CI: 1.036-1.391), influenza (OR = 2.614, 95% CI: 1.476-4.629), Japanese encephalitis (OR = 2.334, 95% CI: 1.119-4.865), and leptospirosis (OR = 1.138, 95% CI: 1.075-1.205), respectively.

CONCLUSION

The spectrum of infectious diseases which are associated with floods are bacillary dysentery, AHC, influenza A (H₁N₁), tuberculosis, influenza, Japanese encephalitis and leptospirosis in Guangxi. Floods can result in differently increased risk of these diseases, and public health action should be taken to control a potential risk of these diseases after floods.

Companion Animals Welfare in Non-Epidemic Emergencies: The Case of Central Italy, Post-Earthquake 2016/2017

Among the several factors affecting animal welfare, non-epidemic emergencies are very stressful events. In the aftermath of earthquakes or during flooding, snowstorms and wildfires, companion animals are subject to injuries and deep stress, abandonment or loss resulting in the overcrowding of animal shelters, or in emergent free-roaming populations representing a potential public health threat to the affected communities. The loss of animals often also results in significant psychological trauma for their guardians. For these reasons in all phases of calamities, the care of companion animals becomes essential. This paper describes the activities that were carried out for the veterinary care of dogs and cats affected by the earthquakes that occurred in central Italy from August 2016 to January 2017. These disasters provided an opportunity to test an integrated emergency management system in which several actors participated to aid, assist and accommodate the companion animals, whether owned or strays, affected by the catastrophic events.

Climate variability and hospitalizations due to infectious diarrheal diseases in a municipality of the Western Brazilian Amazon Region

Morbimortality due to infectious diarrheal diseases still is a serious health issue in Brazil and is highly related to factors such as weather, environment, and people's life conditions. This study aimed to analyze the relationship between hospitalization rates due to infectious diarrheal diseases among the population of the municipality of Rio Branco (AC), Brazil and precipitation, river level, humidity and temperature between 2000 and 2013. Data were retrieved from the Hospital Information System of the SUS (Unified Health System), the National Institute of Meteorology and the National Water Agency. Multiple Poisson and negative binomial regression models were adjusted. Results showed that there is a positive association between hospitalization due to infectious diarrheal diseases and the level of the Acre river (RR: 1.07; CI 95%: 1.04 to 1.1); these hospitalization rates fell 14% between 2000 and 2013 (RR: 0.86; CI 95%: 0.85 to 0.87). The most vulnerable group was the age group of less than 1 year of age. This study showed the vulnerability of an Amazonian city to climate variability and its respective epidemiological influence on the incidence of hospitalizations due to infectious diarrheal diseases.

Epidemiological analysis of respiratory and intestinal infectious diseases in three counties of Sichuan: the baseline survey of Disaster Mitigation Demonstration Area in western China

Background

Natural disasters can indirectly induce epidemics of infectious diseases through air and water pollution, accelerated pathogen reproduction, and population migration. This study aimed to explore the epidemiological characteristics of the main infectious diseases in Sichuan, a province with a high frequency of natural disasters.

Methods

Data were collected from the local Centers for Disease Control infectious disease reports from Lu, Shifang and Yuexi counties from 2011 to 2015 and from the baseline survey of the Disaster Mitigation Demonstration Area in Western China in 2016. Principal component regression was used to explore the main influencing factors of respiratory infectious diseases (RIDs).

Results

The incidence rates of RIDs and intestinal infectious diseases (IIDs) in 2015 were 78.99/100,000, 125.53/100,000, 190.32/100,000 and 51.70/100,000, 206.00/100,000, 69.16/100,000 in Lu, Shifang and Yuexi respectively. The incidence rates of pulmonary tuberculosis (TB) was the highest among RIDs in the three counties. The main IIDs in Lu and Shifang were hand-foot-mouth disease (HFMD) and other infectious diarrhea; however, the main IIDs in Yuexi was bacillary dysentery. The proportions of illiterate and ethnic minorities and per capita disposable income were the top three influencing factors of RIDs.

Conclusions

TB was the key point of RIDs prevention among the three counties. The key preventable IIDs in Lu and Shifang were HFMD and other infectious diarrhea, and bacillary dysentery was the major IIDs in Yuexi. The incidence rates of RIDs was associated with the population composition, the economy and personal hygiene habits.

Linking Water Quality to Aedes aegypti and Zika in Flood-Prone Neighborhoods

The ability of ecosystems to regulate water quality and flood events has been linked to health outcomes, including mosquito-borne illnesses. In the San Juan Bay Estuary watershed of Puerto Rico, habitat alterations and land-use development have disrupted watershed hydrology, exacerbating wastewater discharges and subjecting some neighborhoods to frequent flooding events. In 2016, the mosquito-borne illness Zika became a new cause for concern. We hypothesized that nutrient-enriched flood water could provide pulses of supplemental nutrients to local mosquito populations. We conducted a field study in six neighborhoods adjacent to the estuary to assess whether environmental variability of nutrient inputs could be linked to breeding habitat containers, Aedes aegypti larvae and adults, and the acquisition of Zika virus by adult mosquitoes. The most frequently flooded neighborhood had consistently higher levels of nitrogen in estuary water, leaf detritus, containers, and adult mosquitoes compared to other neighborhoods. Adult body nitrogen was significantly related to both nitrogen content of containers and leaf detritus from the local trapping area. Disseminated Zika concentration in adult Ae. aegypti tended to decrease as body carbon and nitrogen increased. Our study provides preliminary evidence that environmental variability in nutrient inputs can influence viral acquisition by mosquito vectors. This suggests that management actions to reduce flooding and improve water quality should go hand-in-hand with more traditional vector control methods, such as aerial spraying, to help control spread of vector-borne diseases.

Natural disasters and economic losses: controlling external migration, energy and environmental resources, water demand, and financial development for global prosperity

The objective of the study is to examine the impact of natural disasters on external migration, price level, poverty incidence, health expenditures, energy and environmental resources, water demand, financial development, and economic growth in a panel of selected Asian countries for a period of 2005-2017. The results confirm that natural disasters in the form of storm and flood largely increase migration, price level, and poverty incidence, which negatively influenced country's economic resources, including enlarge healthcare expenditures, high energy demand, and low economic growth. The study further presented the following results: i) natural resource depletion increases external migration, ii) FDI inflows increase price level, iii) increase healthcare spending and energy demand decreases poverty headcount, iv) poverty incidence and mortality rate negatively influenced healthcare expenditures, v) industrialization increases energy demand, and vi) agriculture value added, fertilizer, and cereal yields required more water supply to produce greater yield. The study emphasized the need to magnify the intensity of natural disasters and create natural disaster mitigation unit to access the human and infrastructure cost and attempt quick recovery for global prosperity.

A Comparative Study on Rapid Wastewater Treatment Response to Refugee Crises

Large-scale population displacement can overwhelm wastewater treatment facilities and increase environmental pollution in the host communities. Academic research has discussed features that improve wastewater treatment systems' resiliency toward other types of disasters and rapidly changing operation conditions. Concepts that contribute to successful startup, refurbishment, and operation of biological treatment systems during refugee responses are yet to be identified. This study takes a novel approach to analyzing wastewater treatment system resiliency by presenting an input-mediator-output model analysis on advanced wastewater treatment delivery during refugee response in Jordan and Finland in 2015-2016. By comparing two distinctively different case studies, the research identifies principles that contribute to timely refugee response in advanced wastewater treatment systems on the dimensions of human resources, project environment, and wastewater treatment technology. These principles include 1) clear role division between agencies and stakeholders, 2) improving "human capacity" for rapid response decisions, 3) selecting a process that fits the regulative and operational environment, 4) enabling direct and fast information sharing, and 5) establishing fast-track permitting processes for disaster conditions. Wastewater treatment system operators, regulative authorities, and aid organizations can use these findings to support rapid decision-making in future disaster response situations.

Hydrometeorology and flood pulse dynamics drive diarrheal disease outbreaks and increase vulnerability to climate change in surface-water-dependent populations: A retrospective analysis

BACKGROUND

The impacts of climate change on surface water, waterborne disease, and human health remain a growing area of concern, particularly in Africa, where diarrheal disease is one of the most important health threats to children under 5 years of age. Little is known about the role of surface water and annual flood dynamics (flood pulse) on waterborne disease and human health nor about the expected impact of climate change on surface-water-dependent populations.

METHODS AND FINDINGS

Using the Chobe River in northern Botswana, a flood pulse river-floodplain system, we applied multimodel inference approaches assessing the influence of river height, water quality (bimonthly counts of Escherichia coli and total suspended solids [TSS], 2011-2017), and meteorological variability on weekly diarrheal case reports among children under 5 presenting to health facilities (n = 10 health facilities, January 2007-June 2017). We assessed diarrheal cases by clinical characteristics and season across age groups using monthly outpatient data (January 1998-June 2017). A strong seasonal pattern was identified, with 2 outbreaks occurring regularly in the wet and dry seasons. The timing of outbreaks diverged from that at the level of the country, where surface water is largely absent. Across age groups, the number of diarrheal cases was greater, on average, during the dry season. Demographic and clinical characteristics varied by season, underscoring the importance of environmental drivers. In the wet season, rainfall (8-week lag) had a significant influence on under-5 diarrhea, with a 10-mm increase in rainfall associated with an estimated 6.5% rise in the number of cases. Rainfall, minimum temperature, and river height were predictive of E. coli concentration, and increases in E. coli in the river were positively associated with diarrheal cases. In the dry season, river height (1-week lag) and maximum temperature (1- and 4-week lag) were significantly associated with diarrheal cases. During this period, a 1-meter drop in river height corresponded to an estimated 16.7% and 16.1% increase in reported diarrhea with a 1- and 4-week lag, respectively. In this region, as floodwaters receded from the surrounding floodplains, TSS levels increased and were positively associated with diarrheal cases (0- and 3-week lag). Populations living in this region utilized improved water sources, suggesting that hydrological variability and rapid water quality shifts in surface waters may compromise water treatment processes. Limitations include the potential influence of health beliefs and health seeking behaviors on data obtained through passive surveillance.

CONCLUSIONS

In flood pulse river-floodplain systems, hydrology and water quality dynamics can be highly variable, potentially impacting conventional water treatment facilities and the production of safe drinking water. In Southern Africa, climate change is predicted to intensify hydrological variability and the frequency of extreme weather events, amplifying the public health threat of waterborne disease in surface-water-dependent populations. Water sector development should be prioritized with urgency, incorporating technologies that are robust to local environmental conditions and expected climate-driven impacts. In populations with high HIV burdens, expansion of diarrheal disease surveillance and intervention strategies may also be needed. As annual flood pulse processes are predominantly influenced by climate controls in distant regions, country-level data may be inadequate to refine predictions of climate-health interactions in these systems.

Impact of the 2013 Floods on the Incidence of Malaria in Almanagil Locality, Gezira State, Sudan

Background: Heavy rain hit Sudan in August 2013 with subsequent flash floods in different parts of the country. This study investigated the impact of the flooding on incidence of malaria in Almanagil Locality in central Sudan.

Methods: This observational retrospective study compared malaria data sets during rainfall seasons in the Almanagil Locality in the year of flooding (2013) with those of corresponding rainfall seasons of previous two non-flood years (2011 and 2012).

Results: A marked increase of new malaria cases and incidence rate was observed in the 13 sentinel malaria notification sites in the locality  (IR increased from 6.09 per 100,000 person­days in 2011 [95 % CI: 5.93-6.26] and 6.48 in 2012 [95 % CI: 6.31-6.65] to 8.24 in 2013 [95 % CI: 8.05-8.43] ; P< 0.0001), with a peaking of the incidence rate in the under-5-years age group (IR for this age group jumped from 9.80 per 100,000 person­days in 2011 [95 % CI: 9.29­10.32] and 10.00 in 2012 [95 % CI: 9.52­10.49] to 15.02 in 2013 [95 % CI: 14.41­15.64]). A noticeable increase in the slide positivity rate (P< 0.0001) was observed in the 12-week period of 2013 (SPR = 20.86% [95 % CI: 20.40 ­21.32%]) compared with the same periods in 2011 (SPR = 8.72% [95 % CI: 8.36 ­9.08%]) and 2012 (SPR = 12.62% [95 % CI: 12.24 ­13.01%]), with a more marked rise of the SPR in the under-5-year age group. Hospital data showed increase in both the inpatient and outpatient incidence proportions in the study period of 2013 compared to those of the years 2011 and 2012. Hospital OPD incidence proportion in 2013 was 19.7% (95% CI: 19.24­20.18%) compared to 12.85% (95% CI: 12.48­13.23%) in 2011, and 12.16% (95% CI: 11.82­12.51%) in 2012. The < 5 year old groups were responsible for the overall rise in the proportion of malaria cases in 2013 , particularly the < 1 year old group which more than doubled in the 2013 period compared to both 2011 and 2012 periods (Age­specific proportion of the outpatient malaria cases of the < 1 year old group in 2013 was19.5% [95% CI: 18.5­20.6%]  compared to 7.7% [95% CI: 6.9­8.6%] in 2011 and 8.1% [95% CI: 7.3­8.9%] in 2012. Incidence proportion of severe malaria cases (inpatients) increased to 22.5 % (95 % CI: 21.5 to 23.6 %) in the study period of 2013 compared to 19.8 % (95 % CI: 18.6 to 21.0 %) in 2011 and 18.4 % (95 % CI: 17.4 to 19.5) in 2012. The increase in the proportion of severe malaria cases was mainly due to a higher proportion of children < 5 years of age and especially to a higher proportion of children < 1 year of age.

Conclusion: The study revealed a significant increase in the incidence rate of malaria in Almanagil Locality following the flash flood of August 2013. The flooding had the highest impact on the malaria incidence of the under-5-years age group, and particularly of the under-1-year age group.

Keywords: Flood, Flooding, Malaria, Disaster, Sudan, Gezira, Almanagil

Recent advances in the understanding and management of mucormycosis

Mucormycoses were difficult-to-manage infections owing to limited diagnostic tools and therapeutic options. We review here advances in pathology understanding, diagnostic tools including computed tomography, and serum polymerase chain reaction and therapeutic options.

Infectious Diseases After Hydrologic Disasters

Hydrologic disasters, including hurricanes, tsunamis, and severe flooding, have been associated with infectious diseases, particularly among vulnerable and displaced populations in resource-poor settings. Skin and soft tissue infections, gastrointestinal infections, respiratory infections, zoonotic infections, and vector-borne diseases each present unique threats to human health in this setting. Increased emergency physician awareness of these infectious diseases and their diagnosis and management helps optimize medical care for survivors after a hydrologic disaster and safeguard the health of disaster responders.

Risk factors and risk factor cascades for communicable disease outbreaks in complex humanitarian emergencies: a qualitative systematic review

Background

Communicable diseases are a major concern during complex humanitarian emergencies (CHEs). Descriptions of risk factors for outbreaks are often non-specific and not easily generalisable to similar situations. This review attempts to capture relevant evidence and explore whether it is possible to better generalise the role of risk factors and risk factor cascades these factors may form.

Methods

A systematic search of the key databases and websites was conducted. Search terms included terms for CHEs (United Nations Office for the Coordination of Humanitarian Affairs definition) and terms for communicable diseases. Due to the types of evidence found, a thematic synthesis was conducted.

Results

26 articles met inclusion criteria. Key risk factors include crowded conditions, forced displacement, poor quality shelter, poor water, sanitation and hygiene, lack of healthcare facilities and lack of adequate surveillance. Most identified risk factors do not relate to specific diseases, or are specific to a group of diseases such as diarrhoeal diseases and not to a particular disease within that group. Risk factors are often listed in general terms but are poorly evidenced, not contextualised and not considered with respect to interaction effects in individual publications. The high level of the inter-relatedness of risk factors became evident, demonstrating risk factor cascades that are triggered by individual risk factors or clusters of risk factors.

Conclusions

CHEs pose a significant threat to public health. More rigorous research on the risk of disease outbreaks in CHEs is needed, from a practitioner and from an academic point of view.

Incidences of Waterborne and Foodborne Diseases After Meteorologic Disasters in South Korea

BACKGROUND

Climate change could increase the number of regions affected by meteorologic disasters. Meteorologic disasters can increase the risk of infectious disease outbreaks, including waterborne and foodborne diseases. Although many outbreaks of waterborne diseases after single disasters have been analyzed, there have not been sufficient studies reporting comprehensive analyses of cases occurring during long-term surveillance after multiple disasters, which could provide evidence of whether meteorologic disasters cause infectious disease outbreaks.

OBJECTIVES

This study aimed to assess the nationwide short-term changes in waterborne and foodborne disease incidences after a meteorologic disaster.

METHODS

We analyzed cases after all 65 floods and typhoons between 2001 and 2009 using the Korean National Emergency Management Agency's reports. Based on these data, we compared the weekly incidences of Vibrio vulnificus septicemia (VVS), shigellosis, typhoid fever, and paratyphoid fever before, during, and after the disasters, using multivariate Poisson regression models. We also analyzed the interactions between disaster characteristics and the relative risk of each disease.

FINDINGS

Compared with predisaster incidences, the incidences of VVS and shigellosis were 2.49-fold (95% confidence interval, 1.47-4.22) and 3.10-fold (95% confidence interval, 1.21-7.92) higher, respectively, the second week after the disaster. The incidences of VVS and shigellosis peaked the second week postdisaster and subsequently decreased. The risks of typhoid and paratyphoid fever did not significantly increase throughout the 4 weeks postdisaster. The daily average precipitation interacted with VVS and shigellosis incidences, whereas disaster type only interacted with VVS incidence patterns.

CONCLUSIONS

The incidences of VVS and shigellosis were associated with meteorologic disasters, and disaster characteristics were associated with the disease incidence patterns postdisaster. These findings provide important comprehensive evidence to develop and support policies for managing and protecting public health after meteorologic disasters.

Climate variability and dengue hemorrhagic fever in Southeast Sulawesi Province, Indonesia

To determine the association of climatic factors and dengue hemorrhagic fever and to develop the prediction approach of future dengue transmission. The study used totally monthly dengue hemorrhagic fever cases at Health Office Kendari, Southeast Sulawesi, Indonesia. Monthly meteorological data, consisting of temperature, rainfall, and humidity, was obtained from the Meteorology, Climatology and Geophysics Agency in Kendari district. All data analysis, including Spearman and Poisson distribution, was carried out in R Studio (version 3.3.2) utilizing the R statistical language version 2.15. The highest rate of dengue hemorrhagic fever cases was found in January, February, and March. Temperature averages at lag 2 (p = 0.53, p < 0.0001), lag 3 (p = 0.59, p < 0.0001), and lag 4 (p = 0.41, p < 0.01)) correlated with the incident rate of DHF. The average temperature at lag 2 was found to have a positive impact on the incidence of DHF by Poisson function. This study provides preliminary evidence of the influence of climatic factors on dengue transmission.

Surface water flooding, groundwater contamination, and enteric disease in developed countries: A scoping review of connections and consequences

Significant volumes of research over the past four decades has sought to elucidate the social, infrastructural, economic, and human health effects of climate change induced surface flooding. To date, epidemiological and public health studies of flooding events have focused on mental health effects, vector-borne diseases, and infectious enteric disease due to floodwater contact (i.e. typically low consumption rates). The inherent nature of groundwater (i.e. out of sight, out of mind) and the widely held belief that aquifers represent a pristine source of drinking water due to natural attenuation may represent the "perfect storm" causing direct consumption of relatively large volumes of surface flood-contaminated groundwater. Accordingly, the current study sought to systematically identify and synthesize all available peer-reviewed literature pertaining to the nexus between surface flooding, groundwater contamination and human gastroenteric outcomes. Just 14 relevant studies were found to have been published during the period 1980-2017, thus highlighting the fact that this potentially significant source of climate-related exposure to environmental infection has remained understudied to date. Studies differed significantly in terms of type and data reporting procedures, making it difficult to discern clear trends and patterns. Approximately 945 confirmed cases of flood-related enteric disease were examined across studies; these concurred with almost 10,000 suspected cases, equating to approximately 20 suspected cases per confirmed case. As such, no regional, national or global estimates are available for the human gastrointestinal health burden of flood-related groundwater contamination. In light of the demonstrable public health significance of the concurrent impacts of groundwater susceptibility and climate change exacerbation, strategies to increase awareness about potential sources of contamination and motivate precautionary behaviour (e.g. drinking water testing and treatment, supply interruptions) are necessary. Mainstreaming climate adaptation concerns into planning policies will also be necessary to reduce human exposure to waterborne sources of enteric infection.

Relationship of environmental disturbances and the infectious potential of fungi

Fungi are critical organisms for the environment and offer many benefits to modern society through their application in the pharmaceutical, beverage and food industries. In contrast, fungal pathogens are emerging threats to humans, animals, plants and insects with potential to cause devastating mortality, morbidity and economic loss. Outbreaks associated with anthropogenic alterations of the environment, including climate change-related events such as natural disasters, are responsible for human, animal and plant disease. Similarly, fungi and their metabolites also have a negative impact in agriculture, posing a serious threat to our food supplies. Here, we describe the existing knowledge and importance of understanding the relationship of fungi and the environment in the context of human, animal and plant disease. Our goal is to encourage communication between scientists and the general public to create informed awareness about the impact of fungi in their daily lives and their environment.

The Effect of the 2015 Earthquake on the Bacterial Community Compositions in Water in Nepal

We conducted a study to examine the effect of seasonal variations and the disruptive effects of the 2015 Nepal earthquake on microbial communities associated with drinking water sources. We first characterized the microbial communities of water samples in two Nepali regions (Kathmandu and Jhapa) to understand the stability of microbial communities in water samples collected in 2014. We analyzed additional water samples from the same sources collected from May to August 2015, allowing the comparison of samples from dry-to-dry season and from dry-to-monsoon seasons. Emphasis was placed on microbes responsible for maintaining the geobiochemical characteristics of water (e.g., ammonia-oxidizing and nitrite-oxidizing bacteria and archaea and sulfate-reducing bacteria) and opportunistic pathogens often found in water (Acinetobacter). When examining samples from Jhapa, we identified that most geobiochemical microbe populations remained similar. When examining samples from Kathmandu, the abundance of microbial genera responsible for maintaining the geobiochemical characteristics of water increased immediately after the earthquake and decreased 8 months later (December 2015). In addition, microbial source tracking was used to monitor human fecal contamination and revealed deteriorated water quality in some specific sampling sites in Kathmandu post-earthquake. This study highlights a disruption of the environmental microbiome after an earthquake and the restoration of these microbial communities as a function of time and sanitation practices.

Applying a New Framework for Public Health Systems Recovery following Emergencies and Disasters: The Example of Haiti following a Major Earthquake and Cholera Outbreak

Emergencies can often directly impact health systems of an affected region or country, especially in resource-constrained areas. Health system recovery following an emergency is a complex and dynamic process. Health system recovery efforts have often been structured around the World Health Organization's health systems building blocks as demonstrated by the Post-Disaster Needs Assessment. Although this structure is valuable and well known, it can overlook the intricacies of public health systems. We retrospectively examine public health systems recovery, a subset of the larger health system, following the 2010 Haiti earthquake and cholera outbreak, through the lens of the 10 essential public health services. This framework illustrates the comprehensive nature of and helps categorize the activities necessary for a well-functioning public health system and can complement other assessments. Outlining the features of a public health system for recovery in structured manner can also help lay the foundation for sustainable long-term development leading to a more robust and resilient health system.

Evacuation of Pets During Disasters: A Public Health Intervention to Increase Resilience

During a disaster, many pet owners want to evacuate their pets with them, only to find that evacuation and sheltering options are limited or nonexistent. This disregard for companion animal welfare during a disaster can have public health consequences. Pet owners may be stranded at home, unwilling to leave their pets behind. Others refuse evacuation orders or attempt to reenter evacuation sites illegally to rescue their animals. Psychopathologies such as grief, depression, and posttraumatic stress disorder are associated with pet abandonment during an evacuation. Health care workers may refuse to work if their animals are in danger, leaving medical facilities understaffed during crises. Zoonotic disease risk increases when pets are abandoned or left to roam, where they are more likely to encounter infected wildlife or unowned animals than they would if they were safely sheltered with their owners. These sequelae are not unique to the United States, nor to wealthy countries. Emergency planning for companion animals during disasters is a global need in communities with a significant pet population, and will increase resilience and improve public health.

The public health planners' perfect storm: Hurricane Matthew and Zika virus

Hurricane Matthew threatened to be one of the most powerful Hurricanes to hit the United States in a century. Fortunately, it avoided making landfall on Florida, the eye of the Hurricane remaining centered 40 miles off the Florida coast. Even so it has resulted in over $7 Billion USD in damage according to initial estimates with much of the damage ongoing in severe flooding. Response to and recovery from Hurricane Matthew challenged Florida's public health services and resources just as emergency Zika-specific congressional funding to combat Zika outbreaks in Florida had become available. Hurricanes can disrupt the urban environment in a way that increases the likelihood of vector-borne illnesses and their aftermath can severely strain the very infectious disease and infection control academe needed to combat vector-borne outbreaks. This commentary attempts to examine the challenges posed by Hurricane Matthew in Florida's efforts to contain Zika.

Water-Related Impacts of Climate Change on Agriculture and Subsequently on Public Health: A Review for Generalists with Particular Reference to Pakistan

Water-related impacts due to change in climatic conditions ranging from water scarcity to intense floods and storms are increasing in developing countries like Pakistan. Water quality and waterborne diseases like hepatitis, cholera, typhoid, malaria and dengue fever are increasing due to chaotic urbanization, industrialization, poor hygienic conditions, and inappropriate water management. The morbidity rate is high due to lack of health care facilities, especially in developing countries. Organizations linked to the Government of Pakistan (e.g., Ministry of Environment, Ministry of Climate Change, Planning and Development, Ministry of Forest, Irrigation and Public Health, Pakistan Meteorological Department, National Disaster Management, Pakistan Agricultural Research Centre, Pakistan Council for Research in Water Resources, and Global Change Impact Study Centre), United Nation organizations, provincial government departments, non-governmental organizations (e.g., Global Facility and Disaster Reduction), research centers linked to universities, and international organizations (International Institute for Sustainable Development, Food and Agriculture, Global Climate Fund and World Bank) are trying to reduce the water-related impacts of climate change, but due to lack of public awareness and health care infrastructure, the death rate is steadily increasing. This paper critically reviews the scientific studies and reports both at national and at international level benefiting generalists concerned with environmental and public health challenges. The article underlines the urgent need for water conservation, risk management, and the development of mitigation measures to cope with the water-related impacts of climate change on agriculture and subsequently on public health. Novel solutions and bioremediation methods have been presented to control environmental pollution and to promote awareness among the scientific community. The focus is on diverse strategies to handle the forthcoming challenges associated with water resources management.