Impact of climate change on vector- and rodent-borne infectious diseases

Climate change and the emergence and exacerbation of infectious diseases: A review

Experts expressed severe concerns over the possibility of increasing burden of infectious diseases as the planet's climate began to change years ago. There have been increased rates of climate-related catastrophes and as global temperatures rise, emergence of certain viruses has become a serious concern. Vectors are susceptible to changing temperatures as they exhibit innate responses to thermal stress to increase survivability. Climate change impacts virus reservoirs, increasing transmission rates of vectors. Vector-borne diseases have already witnessed increasing numbers compared to before. Certain non-endemic areas are encountering their first-ever infectious disease cases due to increasing temperatures. Tick-borne diseases are undergoing transformations provoking a heightened prevalence. Food-borne illnesses are expected to increase owing to warmer temperatures. It is important to recognize that climate change has a multivariable impact on the transmission of viruses. With climate change comes the potential of increasing interspecies interactions promoting jumps. These factors must be considered, and an informed strategy must be formulated. Adaptation and mitigation strategies are required to curb these diseases from spreading. Despite significant evidence that climate change affects infectious diseases, gaps in research exist. We conducted this review to identify the potential role climate change plays in the emergence of new viruses.

Commentary by the Commission for Hospital Hygiene and Infection Prevention (KRINKO) on the indication-based use of disposable medical gloves in the healthcare sector

Introduction

When using disposable medical gloves, the indications for their use are not always clear in practice, so that they are often worn even in cases where this is neither necessary for the protection of the patient nor for self-protection. This can not only lead to neglect of adequate hand hygiene, but is also ecologically critical in terms of glove consumption and the resources used.

Method

German and international recommendations, including WHO guidelines and information, statements and separate publications on indications and non-indications of disposable medical gloves were evaluated as the basis for deriving the indications for wearing disposable medical gloves.

Results

Typical indications for disposable medical gloves for direct and indirect patient contact, laboratory work and other medical activities are summarized in a table. Situations in which the use of disposable medical gloves is not indicated are also shown separately in tabular form.

Discussion

Further situations are discussed in which the wearing of disposable medical gloves is currently recommended from an infection prevention or occupational health and safety perspective, but should be re-evaluated in the future. In addition to other aspects for reducing glove consumption, such as glove disinfection, guidelines for implementing the use of gloves according to indication are also presented, emphasizing the special role-model function of hygiene staff.

Conclusion

By avoiding the use of disposable medical gloves where there is no indication and by selecting suitable glove material where there is an indication, not only can sustainability be increased, but costs can also be saved without jeopardizing patient and occupational safety.

[Crisis resilience in medical practices and clinics]

BACKGROUND

Climate change because of anthropogenic greenhouse gas emissions increasingly triggers extreme weather events. Of all the continents, Europe is warming the fastest. Heat and drought, forest fires and floods will worsen in Europe even in optimistic global warming scenarios, affecting living conditions across the continent. Extreme weather events threaten energy and food security, ecosystems, infrastructure, water resources, financial stability, and people's healthcare. Many of these risks have already reached critical levels and could take on catastrophic proportions without immediate, decisive action.

OBJECTIVES

This paper outlines current challenges for medical practices and clinics in the context of climate change and provides examples and guidance for strengthening crisis resilience.

MATERIALS AND METHODS

Selective literature review on the different requirements for crisis resilience in practices and clinics was performed.

RESULTS

Medical practices and clinics achieve crisis resilience by high degrees of adaptability and flexibility. They prepare for climate change-related challenges and are, therefore, able to protect themselves and maintain their function in the healthcare system. Recent weather events in Germany revealed insufficient resilience among the healthcare sector; hence, improvements are necessary.

CONCLUSIONS

Changing environmental conditions urgently require the healthcare sector to adapt and effectively strengthen crisis resilience in order to ensure that critical infrastructure remains functional and the population has access to healthcare.

Climate change and public health in Germany - A synthesis of options for action from the German status report on climate change and health 2023

Background

This article represents the conclusion of the updated German status report on climate change and health, which was jointly written by authors from over 30 national institutions and organisations. The objectives are (a) to synthesise the options for action formulated in the report, (b) to combine them into clusters and guiding principles, (c) to address the success factors for implementation, and (d) to combine the options for action into target parameters.

Methods

The options for action from the individual contributions of the status report were systematically recorded and categorised (n=236). Topical clusters were then formed with reference to Essential Public Health Functions, and options for action were assigned to them.

Results

Eight topical clusters of options for action and ten guiding principles were identified. These can be summarised in four overarching meta-levels of action: (a) cross-sectorally coordinated structural and behavioural prevention, (b) monitoring, surveillance, and digitalisation (including early warning systems), (c) development of an ecologically sustainable and resilient public health system, and (d) information, communication, and participation. The main success factors for implementation are the design of governance, positive storytelling and risk communication, proactive management of conflicting goals, and a cross-sectoral co-benefit approach.

Conclusions

Based on the status report, systematically compiled target parameters and concrete options for action are available for public health.

Climate change and health equity: A public health perspective on climate justice

Background

The discourse on climate justice has developed from the theoretical approaches and discussions on environmental justice. A central tenet of the concept of environmental and climate justice is that environmental and climate issues cannot be seen in isolation from issues of social justice.

Methods

A conceptual model was developed on the relationship between climate change impacts, social dimensions, adaptive capacities, biological sensitivity, and health equity in order to systematically analyse climate justice. Based on an exploratory literature review and the evaluation of the individual contributions of the status report on climate change and health, the evidence in Germany on social inequalities in exposure to climate change impacts and vulnerability to their direct and indirect health effects was summarised.

Results

This paper provides an overview of the international debate and examples of evidence on climate justice in Germany. Climate justice in the sense of avoidable, unjust social inequalities in exposure, vulnerability, and the effects of climate mitigation and adaptation measures on health inequalities is still insufficiently addressed in Germany.

Conclusions

A consistent integration of equity issues into climate policy is necessary. With reference to the international literature, options for action and research needs are identified.

Impact of climate change on allergic diseases in Germany

Background

Allergic diseases, especially inhalation allergies, have reached epidemic levels and environmental factors play an important role in their development. Climate change influences the occurrence, frequency, and severity of allergic diseases.

Methods

The contents of this article were selected by the authors and developed section by section according to their expertise and the current state of knowledge. The sections were then discussed and agreed upon amongst all authors.

Results

The article highlights direct and indirect effects of climate change on allergies. It goes into detail about the connections between climate change and (new) pollen allergens as well as (new) occupational inhalation allergens, explains the effects of climate change on the clinical picture of atopic dermatitis, discusses the connections between air pollutants and allergies, and provides information about the phenomenon of thunderstorm asthma.

Conclusions

There is a need for action in the field of pollen and fungal spore monitoring, allergy and sensitisation monitoring, urban planning from an allergological perspective, and changes in the working environment, among others.

Health impacts of extreme weather events - Cascading risks in a changing climate

Background

Extreme weather events represent one of the most tangible impacts of anthropogenic climate change. They have increased in number and severity and a further increase is expected. This is accompanied by direct and indirect negative consequences for human health.

Methods

Flooding events, storms and droughts are analysed here for Germany from a systemic perspective on the basis of a comprehensive literature review. Cascading risks beyond the initial event are also taken into account in order to depict downstream consequences.

Results

In addition to the immediate health burdens caused by extreme weather events such as injuries, long-term consequences such as stress-related mental disorders occur. These stresses particularly affect certain vulnerable groups, e.g. older persons, children, pregnant women or first responders.

Conclusions

A look at the cascading risks described in the international literature allows us to develop precautionary measures for adaptation to the consequences of climate change. Many adaptation measures protect against different risks at the same time. In addition to planning measures, these include, above all, increasing the population's ability to protect itself through knowledge and strengthening of social networks.

Impact of climate change on waterborne infections and intoxications

Progressive climate change holds the potential for increasing human health risks from waterborne infections and intoxications, e. g. through an increase in pathogen concentrations in water bodies, through the establishment of new pathogens or through possible changes in pathogen properties. This paper presents some examples of potential impacts of climate change in Germany. Non-cholera Vibrio occur naturally in seawater, but can proliferate significantly in shallow water at elevated temperatures. In the case of Legionella, climate change could lead to temporary or longer-term increased incidences of legionellosis due to the combination of warm and wet weather. Higher temperatures in piped cold water or lower temperatures in piped hot water may also create conditions conducive to higher Legionella concentrations. In nutrient-rich water bodies, increased concentrations of toxigenic cyanobacteria may occur as temperatures rise. Heavy rainfall following storms or prolonged periods of heat and drought can lead to increased levels of human pathogenic viruses being washed into water bodies. Rising temperatures also pose a potential threat to human health through pathogens causing mycoses and facultatively pathogenic micro-organisms: increased infection rates with non-tuberculous mycobacteria or fungi have been documented after extreme weather events.

Climate change and public health in Germany - An introduction to the German status report on climate change and health 2023

Global warming of 1.5°C and even 2°C is likely to be exceeded during the 21st century. Climate change poses a worldwide threat and has direct and indirect effects on infectious diseases, on non-communicable diseases and on mental health. Not all people are equally able to protect themselves against the impacts of climate change; particularly populations that are vulnerable due to individual factors (children, older persons, those immunocompromised or with pre-existing conditions), social factors (the socially disadvantaged), or living and working conditions (e. g. people who work outdoors) are subject to an increased risk. Concepts such as One Health or Planetary Health provide a framework to frame both climate change itself and adaptation strategies or sets of actions for environmental human and animal health. Knowledge of climate change impacts has grown in recent years, and mitigation and adaptation strategies have been developed.

Impact of climate change on foodborne infections and intoxications

Background

Temperature, precipitation, and humidity are important factors that can influence the spread, reproduction, and survival of pathogens. Climate change affects these factors, resulting in higher air and water temperatures, increased precipitation, or water scarcity. Climate change may thus have an increasing impact on many infectious diseases.

Methods

The present review considers those foodborne pathogens and toxins in animal and plant foods that are most relevant in Germany, on the basis of a selective literature review: the bacterial pathogens of the genera Salmonella, Campylobacter and Vibrio, parasites of the genera Cryptosporidium and Giardia, and marine biotoxins.

Results

As climate change continues to progress, all infections and intoxications discussed here can be expected to increase in Germany.

Conclusions

The expected increase in foodborne infections and intoxications presents a growing public health risk in Germany.