Climate change, extreme rainfall events, drinking water and enteric disease

An ecological study of the spatiotemporal dynamics and drivers of domestically acquired campylobacteriosis in Ireland, 2011-2018

In 2021, Campylobacteriosis was the main gastrointestinal disease in the European Union since 2007 according to the European Centre for Disease Prevention and Control. In the Republic of Ireland, the incidence of the disease is particularly high with approximately 3,000 cases per annum, raising significant concerns for national health authorities with an expected increase in the number of cases in the light of climate change. The current study sought to assess the spatio-temporal patterns of campylobacteriosis in the Republic of Ireland using 20,391 cases from January 2011 to December 2018. An ensemble of spatial statistics techniques including seasonal decomposition, spatial clustering and space-time scanning, were used to elucidate the main individual and spatio-temporal characteristics of the disease in the country. Findings revealed that cases from the paediatric age group (i.e., under 5 years old) were more likely to occur in rural areas (aOR: 1.1.27, CI 95% 1.14-1.41) while cases from the intermediate age group (i.e., >5 & <65 years old) were associated with urban living (aOR: 1.30, CI 95% 1.21-1.4). The disease exhibited a peak during Irish summer, with a stronger seasonal signal reported in counties located on the Western part of the country. Infection hotspots were more likely to occur in urban areas, and more particularly on the Southern part of the island and around the main metropolitan areas. Overall, research findings pointed out the influence of local and spatio-temporally specific socio-demographic and environmental risk factors (i.e., cooking habits, local weather, dietary types) therefore highlighting the need for initiating spatio-temporally targeted health management and surveillance strategies.

Agreement in extreme precipitation exposure assessment is modified by race and social vulnerability

Epidemiologic investigations of extreme precipitation events (EPEs) often rely on observations from the nearest weather station to represent individuals' exposures, and due to structural factors that determine the siting of weather stations, levels of measurement error and misclassification bias may differ by race, class, and other measures of social vulnerability. Gridded climate datasets provide higher spatial resolution that may improve measurement error and misclassification bias. However, similarities in the ability to identify EPEs among these types of datasets have not been explored. In this study, we characterize the overall and temporal patterns of agreement among three commonly used meteorological data sources in their identification of EPEs in all census tracts and counties in the conterminous United States over the 1991-2020 U.S. Climate Normals period and evaluate the association between sociodemographic characteristics with agreement in EPE identification. Daily precipitation measurements from weather stations in the Global Historical Climatology Network (GHCN) and gridded precipitation estimates from the Parameter-elevation Relationships on Independent Slopes Model (PRISM) and the North American Land Data Assimilation System (NLDAS) were compared in their ability to identify EPEs defined as the top 1% of precipitation events or daily precipitation >1 inch. Agreement among these datasets is fair to moderate from 1991 to 2020. There are spatial and temporal differences in the levels of agreement between ground stations and gridded climate datasets in their detection of EPEs in the United States from 1991 to 2020. Spatial variation in agreement is most strongly related to a location's proximity to the nearest ground station, with areas furthest from a ground station demonstrating the lowest levels of agreement. These areas have lower socioeconomic status, a higher proportion of Native American population, and higher social vulnerability index scores. The addition of ground stations in these areas may increase agreement, and future studies intending to use these or similar data sources should be aware of the limitations, biases, and potential for differential misclassification of exposure to EPEs. Most importantly, vulnerable populations should be engaged to determine their priorities for enhanced surveillance of climate-based threats so that community-identified needs are met by any future improvements in data quality.

Legal implications of the climate-health crisis: A case study analysis of the role of public health in climate litigation

Background

Strong scientific evidence affirms that climate change is now a public health emergency. Increasingly, climate litigation brought against governments and corporations utilizes international human rights, environmental and climate laws and policies to seek accountability for climate-destructive and health-harming actions. The health impacts of climate change make litigation an important means of pursuing justice and strategically challenging legal systems. Yet there is scant documentation in the literature of the role that public health has played in climate litigation and the legal weight public health narratives are given in such contexts. Therefore, we assessed to what extent courts of law have used public health harm in legal adjudication and sought to provide practical recommendations to address barriers to positioning legal arguments in public health-centric frames.

Methods

We reviewed legal databases to identify all publicly reported, documented, cases of climate litigation filed in any country or jurisdiction between 1990 and September 2020. For the 1641 cases identified, we quantified the frequency of cases where health concerns were explicitly or implicitly raised.

Findings

Case numbers are trending upwards, notably in high income countries. Resolution remains pending in over half of cases as the majority were initiated in the past three years. Cases were primarily based in climate and human rights law and brought by a wide range of groups and individuals predominantly against governments. About half of the decided cases found in favour for the plaintiffs. Based on this, we selected the 65 cases that were directly linked to public health. We found economic forces and pricing of health risks play a key role, as courts are challenged by litigants to adjudicate on the responsibility for health impacts.

Conclusions

While courts of law are receptive to public health science, significant legal reform is needed to enhance leveraging of public health evidence in legal judgements of climate litigation cases. The integration of a public health mandate into a new eco-centric legal paradigm will optimize its potential to promote human well-being—the core objective underpinning both international law, human rights, and public health. Existing legal doctrines and practices can be enhanced to increase the weight of public health arguments in climate legal action and consequently ensure legal rulings in climate litigation prioritize, protect and promote public health.

Empowering Veterinarians to Be Planetary Health Stewards Through Policy and Practice

Veterinarians are established public health professionals, committing to promote public health when they take their veterinary oath. The issue of climate change and its impact on planetary health is vital to public health, and therefore, it is critical that climate change is regarded as within the veterinary scope of practice. However, climate change is a multi-faceted issue which requires interdisciplinary collaboration and integrated stakeholder involvement in order to establish effective solutions and impactful policies. As a result, in this perspective, we discuss how policy is critical to support veterinarians in the climate change space and argue that more explicit support is needed for veterinarians to take an active role in climate change adaption, resilience, and mitigation. We address the discrepancies between the human health and veterinary professions with respect to providing policy support and capacity for practitioners to be stewards to promote planetary health and shed light on the lack of veterinary capacity in this area. We stress that veterinary professional societies are well equipped to bolster their policies, expand education for veterinary professionals and students in policy and advocacy, and establish calls to action to address climate change and planetary health issues. Ultimately, as public health professionals, veterinarians are uniquely poised to be contributors to climate change solutions and they should be actively involved in policy decision-making and empowered to take active roles in interdisciplinary conversations surrounding this important issue.

Adaptations of Vibrio parahaemolyticus to Stress During Environmental Survival, Host Colonization, and Infection

Vibrio parahaemolyticus (Vp) is an aquatic Gram-negative bacterium that may infect humans and cause gastroenteritis and wound infections. The first pandemic of Vp associated infection was caused by the serovar O3:K6 and epidemics caused by the other serovars are increasingly reported. The two major virulence factors, thermostable direct hemolysin (TDH) and/or TDH-related hemolysin (TRH), are associated with hemolysis and cytotoxicity. Vp strains lacking tdh and/or trh are avirulent and able to colonize in the human gut and cause infection using other unknown factors. This pathogen is well adapted to survive in the environment and human host using several genetic mechanisms. The presence of prophages in Vp contributes to the emergence of pathogenic strains from the marine environment. Vp has two putative type-III and type-VI secretion systems (T3SS and T6SS, respectively) located on both the chromosomes. T3SS play a crucial role during the infection process by causing cytotoxicity and enterotoxicity. T6SS contribute to adhesion, virulence associated with interbacterial competition in the gut milieu. Due to differential expression, type III secretion system 2 (encoded on chromosome-2, T3SS2) and other genes are activated and transcribed by interaction with bile salts within the host. Chromosome-1 encoded T6SS1 has been predominantly identified in clinical isolates. Acquisition of genomic islands by horizontal gene transfer provides enhanced tolerance of Vp toward several antibiotics and heavy metals. Vp consists of evolutionarily conserved targets of GTPases and kinases. Expression of these genes is responsible for the survival of Vp in the host and biochemical changes during its survival. Advanced genomic analysis has revealed that various genes are encoded in Vp pathogenicity island that control and expression of virulence in the host. In the environment, the biofilm gene expression has been positively correlated to tolerance toward aerobic, anaerobic, and micro-aerobic conditions. The genetic similarity analysis of toxin/antitoxin systems of Escherichia coli with VP genome has shown a function that could induce a viable non-culturable state by preventing cell division. A better interpretation of the Vp virulence and other mechanisms that support its environmental fitness are important for diagnosis, treatment, prevention and spread of infections. This review identifies some of the common regulatory pathways of Vp in response to different stresses that influence its survival, gut colonization and virulence.

Household water quality in areas irrigated with wastewater in the Mezquital Valley, Mexico

Wastewater for irrigation in low- and middle-income countries can recharge aquifers and potentially contaminate supply sources. The infiltration rate has increased 13-fold in Mexico's Mezquital Valley, the largest agricultural area wastewater-irrigated worldwide, thus we assume that wastewater had contaminated supply sources. Fecal indicator bacteria (FIB) counts were enumerated in household water of two wastewater-irrigated areas, Tula and Tlahuelilpan, and a groundwater irrigated area, Tecozautla. During 2016-2017, household water, wastewater, and groundwater were sampled, analyzing fecal coliforms, fecal enterococci, and Escherichia coli, following membrane filtration procedures, and confirming the presence of E. coli by polymerase chain reaction. Nearly 50% of household water contained fecal contamination of up to 4.62 × 10⁴ CFU/100 mL. Significant differences between FIB counts in household water from Tula and Tecozautla were observed by Kruskal-Wallis and Dunnett tests. Household water samples from Tula contained highest FIB counts. Wastewater from Tula and Tlahuelilpan contained counts of six orders-of-magnitude of FIB. Counts were high when residual chlorine was <0.2 mg L^-1 and underwater storage. This research serves as a baseline to observe improvement with a newly installed wastewater treatment plant. Safe irrigation wastewater reuse should be performed under strict surveillance, considering human safety a priority.

Understanding national barriers to climate change adaptation for public health: a mixed-methods survey of national public health representatives

Purpose

To uncover the major government constraints to enactment and implementation of public health-targeted climate change adaptation (CCA) strategies in order to equip public health stakeholders and health advocates with the knowledge resources necessary to more effectively mobilize and support CCA for public health responses at the national level.

Design/methodology/approach

A mixed-methods online survey was distributed to the representatives of national public health associations and societies of 82 countries. The survey comprised 15 questions assessing national progress on CCA for public health and the effects of various institutional, economic/financial, technical and sociopolitical barriers on national adaptive capacity.

Findings

Survey responses from 11 countries indicated that national commitments to CCA for public health have increased markedly since prior assessments but significant shortcomings remain. The largest apparent barriers to progress in this domain were poor government coordination, lack of political will and inadequate adaptation finances.

Originality/value

This study is unique in relation to the prior literature on the topic in that it effectively captures an array of country-specific yet cross-cutting adaptation constraints across diverse national contexts. With a deepened understanding of the major determinants of national adaptive capacity, international actors can devise more effective, evidence-informed strategies to support national governments in responding to the health impacts of climate change.