Climate change and West Nile virus in a highly endemic region of North America

A Scoping Review on the Epidemiology of Orthobunyaviruses of Canadian Public and Animal Health Relevance in the Context of Vector Species

Background: Mosquito-borne orthobunyaviruses are a growing priority for public and animal health in Canada. It is anticipated that disease incidence will increase due to a warming climate, given that habitats are expanding for reservoir hosts and vectors, particularly in Canada. Little is known about the ecology of primary vectors that perpetuate these orthobunyaviruses, including the viral transmission cycle and the impact of climatic and landscape factors. Methods: A scoping review was conducted to describe the current state of knowledge on the epidemiology of orthobunyaviruses relevant to Canada. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines was used to characterize studies focused on vector species. A literature search was conducted in six databases and gray literature. Eligible studies characterized orthobunyavirus epidemiology related to vector species, including viral competency, geospatial distributions, seasonal trends, and/or risk factors. Results: A total of 1734 unique citations were identified. Screening of these citations revealed 172 relevant studies, from which 87 studies presented primary data related to vectors. The orthobunyaviruses included Cache Valley virus (CVV), Jamestown Canyon virus (JCV), Snowshoe Hare virus (SHV), and La Crosse virus (LACV). Surveillance was the predominant study focus, with most citations representing the United States, specifically, LACV surveillance in Tennessee, followed by CVV and JCV in Connecticut. Orthobunyaviruses were detected in many mosquito species across multiple genera, with high vector specificity only being reported for LACV, which included Aedes triseriatus, Aedes albopictus, and Aedes japonicus. Peridomestic areas were positively associated with infected mosquitoes compared with dense forests. Orthobunyavirus infections, coinfections, and gut microbiota affected mosquito feeding and breeding behavior. Conclusion: Knowledge gaps included Canadian surveillance data, disease modeling, and risk projections. Further research in these areas, especially accounting for climate change, is needed to guide health policy for prevention of orthobunyaviral disease.

Climate crisis risks to elderly health: strategies for effective promotion and response

The climate crisis significantly impacts the health and well-being of older adults, both directly and indirectly. This issue is of growing concern in Canada due to the country's rapidly accelerating warming trend and expanding elderly population. This article serves a threefold purpose: (i) outlining the impacts of the climate crisis on older adults, (ii) providing a descriptive review of existing policies with a specific focus on the Canadian context, and (iii) promoting actionable recommendations. Our review reveals the application of current strategies, including early warning systems, enhanced infrastructure, sustainable urban planning, healthcare access, social support systems, and community engagement, in enhancing resilience and reducing health consequences among older adults. Within the Canadian context, we then emphasize the importance of establishing robust risk metrics and evaluation methods to prepare for and manage the impacts of the climate crisis efficiently. We underscore the value of vulnerability mapping, utilizing geographic information to identify regions where older adults are most at risk. This allows for targeted interventions and resource allocation. We recommend employing a root cause analysis approach to tailor risk response strategies, along with a focus on promoting awareness, readiness, physician training, and fostering collaboration and benchmarking. These suggestions aim to enhance disaster risk management for the well-being and resilience of older adults in the face of the climate crisis.

Ecological Niche and Positive Clusters of Two West Nile Virus Vectors in Ontario, Canada

West Nile virus (WNV) is a mosquito-borne pathogen associated with uncommon but severe neurological complications in humans, especially among the elderly and immune-compromised. In Northeastern North America, the Culex pipiens/restuans complex and Aedes vexans are the two principal vector mosquito species/species groups of WNV. Using a 10-year surveillance dataset of WNV vector captures at 118 sites across an area of 40,000 km2 in Eastern Ontario, Canada, the ecological niches of Cx. pipiens/restuans and Aedes vexans were modeled by random forest analysis. Spatiotemporal clusters of WNV-positive mosquito pools were identified using Kulldorf's spatial scan statistic. The study region encompasses land cover types and climate representative of highly populated Southeastern Canada. We found highest vector habitat suitability in the eastern half of the study area, where temperatures are generally warmer (variable importance > 0.40) and residential and agricultural cropland cover is more prominent (variable importance > 0.25). We found spatiotemporal clusters of high WNV infection rates around the city of Ottawa in both mosquito vector species. These results support the previous literature in the same region and elsewhere suggesting areas surrounding highly populated areas are also high-risk areas for vector-borne zoonoses such as the WNV.

California Serogroup Viruses in a Changing Canadian Arctic: A Review

The Arctic is warming at four times the global rate, changing the diversity, activity and distribution of vectors and associated pathogens. While the Arctic is not often considered a hotbed of vector-borne diseases, Jamestown Canyon virus (JCV) and Snowshoe Hare virus (SSHV) are mosquito-borne zoonotic viruses of the California serogroup endemic to the Canadian North. The viruses are maintained by transovarial transmission in vectors and circulate among vertebrate hosts, both of which are not well characterized in Arctic regions. While most human infections are subclinical or mild, serious cases occur, and both JCV and SSHV have recently been identified as leading causes of arbovirus-associated neurological diseases in North America. Consequently, both viruses are currently recognised as neglected and emerging viruses of public health concern. This review aims to summarise previous findings in the region regarding the enzootic transmission cycle of both viruses. We identify key gaps and approaches needed to critically evaluate, detect, and model the effects of climate change on these uniquely northern viruses. Based on limited data, we predict that (1) these northern adapted viruses will increase their range northwards, but not lose range at their southern limits, (2) undergo more rapid amplification and amplified transmission in endemic regions for longer vector-biting seasons, (3) take advantage of northward shifts of hosts and vectors, and (4) increase bite rates following an increase in the availability of breeding sites, along with phenological synchrony between the reproduction cycle of theorized reservoirs (such as caribou calving) and mosquito emergence.

Patterns of West Nile Virus in the Northeastern United States Using Negative Binomial and Mechanistic Trait-Based Models

West Nile virus (WNV) primarily infects birds and mosquitoes but has also caused over 2,000 human deaths, and >50,000 reported human cases in the United States. Expected numbers of WNV neuroinvasive cases for the present were described for the Northeastern United States, using a negative binomial model. Changes in temperature-based suitability for WNV due to climate change were examined for the next decade using a temperature-trait model. WNV suitability was generally expected to increase over the next decade due to changes in temperature, but the changes in suitability were generally small. Many, but not all, populous counties in the northeast are already near peak suitability. Several years in a row of low case numbers is consistent with a negative binomial, and should not be interpreted as a change in disease dynamics. Public health budgets need to be prepared for the expected infrequent years with higher-than-average cases. Low-population counties that have not yet had a case are expected to have similar probabilities of having a new case as nearby low-population counties with cases, as these absences are consistent with a single statistical distribution and random chance.

Effects of land use and weather on the presence and abundance of mosquito-borne disease vectors in a urban and agricultural landscape in Eastern Ontario, Canada

Weather and land use can significantly impact mosquito abundance and presence, and by consequence, mosquito-borne disease (MBD) dynamics. Knowledge of vector ecology and mosquito species response to these drivers will help us better predict risk from MBD. In this study, we evaluated and compared the independent and combined effects of weather and land use on mosquito species occurrence and abundance in Eastern Ontario, Canada. Data on occurrence and abundance (245,591 individuals) of 30 mosquito species were obtained from mosquito capture at 85 field sites in 2017 and 2018. Environmental variables were extracted from weather and land use datasets in a 1-km buffer around trapping sites. The relative importance of weather and land use on mosquito abundance (for common species) or occurrence (for all species) was evaluated using multivariate hierarchical statistical models. Models incorporating both weather and land use performed better than models that include weather only for approximately half of species (59% for occurrence model and 50% for abundance model). Mosquito occurrence was mainly associated with temperature whereas abundance was associated with precipitation and temperature combined. Land use was more often associated with abundance than occurrence. For most species, occurrence and abundance were positively associated with forest cover but for some there was a negative association. Occurrence and abundance of some species (47% for occurrence model and 88% for abundance model) were positively associated with wetlands, but negatively associated with urban (Culiseta melanura and Anopheles walkeri) and agriculture (An. quadrimaculatus, Cs. minnesotae and An. walkeri) environments. This study provides predictive relationships between weather, land use and mosquito occurrence and abundance for a wide range of species including those that are currently uncommon, yet known as arboviruses vectors. Elucidation of these relationships has the potential to contribute to better prediction of MBD risk, and thus more efficiently targeted prevention and control measures.

Vector Specificity of Arbovirus Transmission

More than 25% of human infectious diseases are vector-borne diseases (VBDs). These diseases, caused by pathogens shared between animals and humans, are a growing threat to global health with more than 2.5 million annual deaths. Mosquitoes and ticks are the main vectors of arboviruses including flaviviruses, which greatly affect humans. However, all tick or mosquito species are not able to transmit all viruses, suggesting important molecular mechanisms regulating viral infection, dissemination, and transmission by vectors. Despite the large distribution of arthropods (mosquitoes and ticks) and arboviruses, only a few pairings of arthropods (family, genus, and population) and viruses (family, genus, and genotype) successfully transmit. Here, we review the factors that might limit pathogen transmission: internal (vector genetics, immune responses, microbiome including insect-specific viruses, and coinfections) and external, either biotic (adult and larvae nutrition) or abiotic (temperature, chemicals, and altitude). This review will demonstrate the dynamic nature and complexity of virus–vector interactions to help in designing appropriate practices in surveillance and prevention to reduce VBD threats.

West Nile virus is predicted to be more geographically widespread in New York State and Connecticut under future climate change

The effects of climate change on infectious diseases are a topic of considerable interest and discussion. We studied West Nile virus (WNV) in New York (NY) and Connecticut (CT) using a Weather Research and Forecasting (WRF) model climate change scenario, which allows us to examine the effects of climate change and variability on WNV risk at county level. We chose WNV because it is well studied, has caused over 50,000 reported human cases, and over 2200 deaths in the United States. The ecological impacts have been substantial (e.g., millions of avian deaths), and economic impacts include livestock deaths, morbidity, and healthcare-related expenses. We trained two Random Forest models with observational climate data and human cases to predict future levels of WNV based on future weather conditions. The Regional Model used present-day data from NY and CT, whereas the Analog Model was fit for states most closely matching the predicted future conditions in the region. Separately, we predicted changes to mosquito-based WNV risk using a trait-based thermal biology approach (Mosquito Model). The WRF model produced control simulations (present day) and pseudo-global warming simulations (future). The Regional and Analog Models predicted an overall increase in human cases of WNV under future warming. However, the Analog Model did not predict as strong of an increase in the number of human cases as the Regional Model, and predicted a decrease in cases in some counties that currently experience high numbers of WNV cases. The Mosquito Model also predicted a decrease in risk in current high-risk areas, with an overall reduction in the population-weighted relative risk (but an increase in area-weighted risk). The Mosquito Model supports the Analog Model as making more realistic predictions than the Regional Model. All three models predicted a geographic increase in WNV cases across NY and CT.

Updated distribution maps of predominant Culex mosquitoes across the Americas

BACKGROUND

Estimates of the geographical distribution of Culex mosquitoes in the Americas have been limited to state and provincial levels in the United States and Canada and based on data from the 1980s. Since these estimates were made, there have been many more documented observations of mosquitoes and new methods have been developed for species distribution modeling. Moreover, mosquito distributions are affected by environmental conditions, which have changed since the 1980s. This calls for updated estimates of these distributions to understand the risk of emerging and re-emerging mosquito-borne diseases.

METHODS

We used contemporary mosquito data, environmental drivers, and a machine learning ecological niche model to create updated estimates of the geographical range of seven predominant Culex species across North America and South America: Culex erraticus, Culex nigripalpus, Culex pipiens, Culex quinquefasciatus, Culex restuans, Culex salinarius, and Culex tarsalis.

RESULTS

We found that Culex mosquito species differ in their geographical range. Each Culex species is sensitive to both natural and human-influenced environmental factors, especially climate and land cover type. Some prefer urban environments instead of rural ones, and some are limited to tropical or humid areas. Many are found throughout the Central Plains of the USA.

CONCLUSIONS

Our updated contemporary Culex distribution maps may be used to assess mosquito-borne disease risk. It is critical to understand the current geographical distributions of these important disease vectors and the key environmental predictors structuring their distributions not only to assess current risk, but also to understand how they will respond to climate change. Since the environmental predictors structuring the geographical distribution of mosquito species varied, we hypothesize that each species may have a different response to climate change.

The Role of Temperature in Transmission of Zoonotic Arboviruses

We reviewed the literature on the role of temperature in transmission of zoonotic arboviruses. Vector competence is affected by both direct and indirect effects of temperature, and generally increases with increasing temperature, but results may vary by vector species, population, and viral strain. Temperature additionally has a significant influence on life history traits of vectors at both immature and adult life stages, and for important behaviors such as blood-feeding and mating. Similar to vector competence, temperature effects on life history traits can vary by species and population. Vector, host, and viral distributions are all affected by temperature, and are generally expected to change with increased temperatures predicted under climate change. Arboviruses are generally expected to shift poleward and to higher elevations under climate change, yet significant variability on fine geographic scales is likely. Temperature effects are generally unimodal, with increases in abundance up to an optimum, and then decreases at high temperatures. Improved vector distribution information could facilitate future distribution modeling. A wide variety of approaches have been used to model viral distributions, although most research has focused on the West Nile virus. Direct temperature effects are frequently observed, as are indirect effects, such as through droughts, where temperature interacts with rainfall. Thermal biology approaches hold much promise for syntheses across viruses, vectors, and hosts, yet future studies must consider the specificity of interactions and the dynamic nature of evolving biological systems.

Using Earth observation images to inform risk assessment and mapping of climate change-related infectious diseases

The number of human cases of several climate-related infectious diseases, including tick- and mosquito-borne diseases, has increased in Canada and other parts of the world since the end of the last century. Predicting and mapping the risks associated with these diseases using environmental and climatic determinants derived from satellite images is an emerging method that can support research, surveillance, prevention and control activities and help to better assess the impacts of climate change in Canada. Earth observation images can be used to systematically monitor changes in the Earth's surface and atmosphere at different scales of time and space. These images can inform estimation and monitoring of environmental and climatic determinants, and thus disease prediction and risk mapping. The current array of Earth observation satellites provides access to a large quantity and variety of data. These data have different characteristics in terms of spatial, temporal and thematic precision and resolution. The objectives of this overview are to describe how Earth observation images may inform risk assessment and mapping of tick-borne and mosquito-borne diseases in Canada, their potential benefits and limitations, the implications and next steps.

Short-term Forecasting of Daily Abundance of West Nile Virus Vectors Culex pipiens-restuans (Diptera: Culicidae) and Aedes vexans Based on Weather Conditions in Southern Québec (Canada)

Since 2002, human cases of West Nile virus (WNV) have occurred every year in southern Canada, but WNV risk remains challenging to predict. Here, we explored the ability of weather-based forecasting models to predict the seasonal abundance of two WNV vector species (Culex pipiens-restuans and Aedes vexans) in Québec, Canada, and explored the importance of accounting for larvicide use and local habitat (forest park vs residential garden). A gamma-generalized linear model predicting mosquito abundance was developed based on an approach previously used in Ontario combining temperature and precipitation during the days preceding mosquito captures. This model was calibrated and validated for each species with independent entomological datasets from the Montréal region collected in 2013 and 2014. Culex pipiens-restuans abundance was associated with mean degree days (dd; >9°C) over the 22 d before mosquito capture and with mean precipitation over the 71 d before capture; Ae. vexans abundance with the mean dd (>12°C) over the 24 d before capture and mean precipitation over the 30 d before capture. These results are consistent with temperature effects on immature development rates and adult activity, and effects of precipitation on the abundance and suitability of breeding sites. Taking into account larvicide use and habitat significantly improved the predictions. This study provides evidence that weather conditions can yield robust short-term predictions of the regional daily mosquito abundance, particularly when accounting for local variation in habitat or mosquito control efforts, and may provide real-time indicators of WNV or other mosquito-borne disease risks during the summer.

Increased risk of endemic mosquito-borne diseases in Canada due to climate change

There are currently over 80 species of mosquito endemic in Canada-although only a few of these carry pathogens that can cause disease in humans. West Nile virus, Eastern equine encephalitis virus and the California serogroup viruses (including the Jamestown Canyon and snowshoe hare viruses) are mosquito-borne viruses that have been found to cause human infections in North America, including in Canada. Over the last 20 years, the incidence of most of these endemic mosquito-borne diseases (MBD) has increased approximately 10% in Canada, due in large part to climate change. It is anticipated that both the mosquito lifecycle and virus transmission patterns will be affected by climate change, resulting in an increase in both the range and local abundance of several important mosquito species. Laboratory studies and mathematical modelling suggest that increased ambient temperatures, changes in precipitation and extreme weather events associated with climate change will likely continue to drive mosquito vector and MBD range expansion, increasing the duration of transmission seasons and leading to MBD-related epidemics. Furthermore, Canada's endemic MBDs have complex transmission cycles, involving multiple reservoir hosts (birds and mammals), multiple pathogens and multiple mosquito species-all of which may be sensitive to climate and other environmental changes, and making forecasting of potential emerging trends difficult. These expected climate-induced changes in mosquitoes and MBDs underline the need for continued (and expanded) surveillance and research to ensure timely and accurate evaluation of the risks to the public health of Canadians.

Modeling Arboviral Infection in Mice Lacking the Interferon Alpha/Beta Receptor

Arboviruses are arthropod-borne viruses that exhibit worldwide distribution and are a constant threat, not only for public health but also for wildlife, domestic animals, and even plants. To study disease pathogenesis and to develop efficient and safe therapies, the use of an appropriate animal model is a critical concern. Adult mice with gene knockouts of the interferon α/β (IFN-α/β) receptor (IFNAR(-/-)) have been described as a model of arbovirus infections. Studies with the natural hosts of these viruses are limited by financial and ethical issues, and in some cases, the need to have facilities with a biosafety level 3 with sufficient space to accommodate large animals. Moreover, the number of animals in the experiments must provide results with statistical significance. Recent advances in animal models in the last decade among other gaps in knowledge have contributed to the better understanding of arbovirus infections. A tremendous advantage of the IFNAR(-/-) mouse model is the availability of a wide variety of reagents that can be used to study many aspects of the immune response to the virus. Although extrapolation of findings in mice to natural hosts must be done with care due to differences in the biology between mouse and humans, experimental infections of IFNAR(-/-) mice with several studied arboviruses closely mimics hallmarks of these viruses in their natural host. Therefore, IFNAR(-/-) mice are a good model to facilitate studies on arbovirus transmission, pathogenesis, virulence, and the protective efficacy of new vaccines. In this review article, the most important arboviruses that have been studied using the IFNAR(-/-) mouse model will be reviewed.

Type I interferon receptor knockout mice as models for infection of highly pathogenic viruses with outbreak potential

Due to their inability to generate a complete immune response, mice knockout for type I interferon (IFN) receptors (Ifnar^–/–) are more susceptible to viral infections, and are thus commonly used for pathogenesis studies. This mouse model has been used to study many diseases caused by highly pathogenic viruses from many families, including the Flaviviridae, Filoviridae, Arenaviridae, Bunyaviridae, Henipaviridae, and Togaviridae. In this review, we summarize the findings from these animal studies, and discuss the pros and cons of using this model versus other known methods for studying pathogenesis in animals.

The Immune Responses of the Animal Hosts of West Nile Virus: A Comparison of Insects, Birds, and Mammals

Vector-borne diseases, including arboviruses, pose a serious threat to public health worldwide. Arboviruses of the flavivirus genus, such as Zika virus (ZIKV), dengue virus, yellow fever virus (YFV), and West Nile virus (WNV), are transmitted to humans from insect vectors and can cause serious disease. In 2017, over 2,000 reported cases of WNV virus infection occurred in the United States, with two-thirds of cases classified as neuroinvasive. WNV transmission cycles through two different animal populations: birds and mosquitoes. Mammals, particularly humans and horses, can become infected through mosquito bites and represent dead-end hosts of WNV infection. Because WNV can infect diverse species, research on this arbovirus has investigated the host response in mosquitoes, birds, humans, and horses. With the growing geographical range of the WNV mosquito vector and increased human exposure, improved surveillance and treatment of the infection will enhance public health in areas where WNV is endemic. In this review, we survey the bionomics of mosquito species involved in Nearctic WNV transmission. Subsequently, we describe the known immune response pathways that counter WNV infection in insects, birds, and mammals, as well as the mechanisms known to curb viral infection. Moreover, we discuss the bacterium Wolbachia and its involvement in reducing flavivirus titer in insects. Finally, we highlight the similarities of the known immune pathways and identify potential targets for future studies aimed at improving antiviral therapeutic and vaccination design.

Impact of Climate and Environmental Factors on West Nile Virus Circulation in Iran

BACKGROUND

Geographic distribution of West Nile virus (WNV) is heterogeneous in Iran by a high circulation in the southern-western areas. The objective of our study was to determine environmental and climatic factors associated with the risk of WNV equine seropositivity in Iran.

METHODS

Serological data were obtained from a serosurvey conducted in equine population in 260 districts in Iran. The climate and environmental parameters included in the models were distance to the nearest wetland area, type of stable, Normalized Difference Vegetation Index (NDVI), annual mean temperature, humidity and precipitation.

RESULTS

The important risk factors included annual mean temperature, distance to wetlands, local and seasonal NDVI differences. The effect of local NDVI differences in spring was particularly notable. This was a normalized difference of average NDVI between two areas: a 5 km radius area centered on the stable and the 5-10 km surrounding area.

CONCLUSION

The model indicated that local NDVI's contrast during spring is a major risk factor of the transmission of West-Nile virus in Iran. This so-called oasis effect consistent with the seasonal production of vegetation in spring, and is associated to the attractiveness of the local NDVI environment for WNV vectors and hosts.

Projection of Climate Change Influences on U.S. West Nile Virus Vectors

While estimates of the impact of climate change on health are necessary for health care planners and climate change policy makers, models to produce quantitative estimates remain scarce. We describe a freely available dynamic simulation model parameterized for three West Nile virus vectors, which provides an effective tool for studying vector-borne disease risk due to climate change. The Dynamic Mosquito Simulation Model is parameterized with species specific temperature-dependent development and mortality rates. Using downscaled daily weather data, we estimate mosquito population dynamics under current and projected future climate scenarios for multiple locations across the country. Trends in mosquito abundance were variable by location, however, an extension of the vector activity periods, and by extension disease risk, was almost uniformly observed. Importantly, mid-summer decreases in abundance may be off-set by shorter extrinsic incubation periods resulting in a greater proportion of infective mosquitoes. Quantitative descriptions of the effect of temperature on the virus and mosquito are critical to developing models of future disease risk.

Climate Change in the North American Arctic: A One Health Perspective

Climate change is expected to increase the prevalence of acute and chronic diseases among human and animal populations within the Arctic and subarctic latitudes of North America. Warmer temperatures are expected to increase disease risks from food-borne pathogens, water-borne diseases, and vector-borne zoonoses in human and animal populations of Arctic landscapes. Existing high levels of mercury and persistent organic pollutant chemicals circulating within terrestrial and aquatic ecosystems in Arctic latitudes are a major concern for the reproductive health of humans and other mammals, and climate warming will accelerate the mobilization and biological amplification of toxic environmental contaminants. The adverse health impacts of Arctic warming will be especially important for wildlife populations and indigenous peoples dependent upon subsistence food resources from wild plants and animals. Additional research is needed to identify and monitor changes in the prevalence of zoonotic pathogens in humans, domestic dogs, and wildlife species of critical subsistence, cultural, and economic importance to Arctic peoples. The long-term effects of climate warming in the Arctic cannot be adequately predicted or mitigated without a comprehensive understanding of the interactive and synergistic effects between environmental contaminants and pathogens in the health of wildlife and human communities in Arctic ecosystems. The complexity and magnitude of the documented impacts of climate change on Arctic ecosystems, and the intimacy of connections between their human and wildlife communities, makes this region an appropriate area for development of One Health approaches to identify and mitigate the effects of climate warming at the community, ecosystem, and landscape scales.

Major emerging vector-borne zoonotic diseases of public health importance in Canada

In Canada, the emergence of vector-borne diseases may occur via international movement and subsequent establishment of vectors and pathogens, or via northward spread from endemic areas in the USA. Re-emergence of endemic vector-borne diseases may occur due to climate-driven changes to their geographic range and ecology. Lyme disease, West Nile virus (WNV), and other vector-borne diseases were identified as priority emerging non-enteric zoonoses in Canada in a prioritization exercise conducted by public health stakeholders in 2013. We review and present the state of knowledge on the public health importance of these high priority emerging vector-borne diseases in Canada. Lyme disease is emerging in Canada due to range expansion of the tick vector, which also signals concern for the emergence of human granulocytic anaplasmosis, babesiosis, and Powassan virus. WNV has been established in Canada since 2001, with epidemics of varying intensity in following years linked to climatic drivers. Eastern equine encephalitis virus, Jamestown Canyon virus, snowshoe hare virus, and Cache Valley virus are other mosquito-borne viruses endemic to Canada with the potential for human health impact. Increased surveillance for emerging pathogens and vectors and coordinated efforts among sectors and jurisdictions will aid in early detection and timely public health response.

Climate Change and Health: Transcending Silos to Find Solutions

BACKGROUND

Climate change has myriad implications for the health of humans, our ecosystems, and the ecological processes that sustain them. Projections of rising greenhouse gas emissions suggest increasing direct and indirect burden of infectious and noninfectious disease, effects on food and water security, and other societal disruptions. As the effects of climate change cannot be isolated from social and ecological determinants of disease that will mitigate or exacerbate forecasted health outcomes, multidisciplinary collaboration is critically needed.

OBJECTIVES

The aim of this article was to review the links between climate change and its upstream drivers (ie, processes leading to greenhouse gas emissions) and health outcomes, and identify existing opportunities to leverage more integrated global health and climate actions to prevent, prepare for, and respond to anthropogenic pressures.

METHODS

We conducted a literature review of current and projected health outcomes associated with climate change, drawing on findings and our collective expertise to review opportunities for adaptation and mitigation across disciplines.

FINDINGS

Health outcomes related to climate change affect a wide range of stakeholders, providing ready collaborative opportunities for interventions, which can be differentiated by addressing the upstream drivers leading to climate change or the downstream effects of climate change itself.

CONCLUSIONS

Although health professionals are challenged with risks from climate change and its drivers, the adverse health outcomes cannot be resolved by the public health community alone. A phase change in global health is needed to move from a passive responder in partnership with other societal sectors to drive innovative alternatives. It is essential for global health to step outside of its traditional boundaries to engage with other stakeholders to develop policy and practical solutions to mitigate disease burden of climate change and its drivers; this will also yield compound benefits that help address other health, environmental, and societal challenges.

Climate change impacts on West Nile virus transmission in a global context

West Nile virus (WNV), the most widely distributed virus of the encephalitic flaviviruses, is a vector-borne pathogen of global importance. The transmission cycle exists in rural and urban areas where the virus infects birds, humans, horses and other mammals. Multiple factors impact the transmission and distribution of WNV, related to the dynamics and interactions between pathogen, vector, vertebrate hosts and environment. Hence, among other drivers, weather conditions have direct and indirect influences on vector competence (the ability to acquire, maintain and transmit the virus), on the vector population dynamic and on the virus replication rate within the mosquito, which are mostly weather dependent. The importance of climatic factors (temperature, precipitation, relative humidity and winds) as drivers in WNV epidemiology is increasing under conditions of climate change. Indeed, recent changes in climatic conditions, particularly increased ambient temperature and fluctuations in rainfall amounts, contributed to the maintenance (endemization process) of WNV in various locations in southern Europe, western Asia, the eastern Mediterranean, the Canadian Prairies, parts of the USA and Australia. As predictions show that the current trends are expected to continue, for better preparedness, any assessment of future transmission of WNV should take into consideration the impacts of climate change.

Environmental predictors of West Nile fever risk in Europe

Background

West Nile virus (WNV) is a mosquito-borne pathogen of global public health importance. Transmission of WNV is determined by abiotic and biotic factors. The objective of this study was to examine environmental variables as predictors of WNV risk in Europe and neighboring countries, considering the anomalies of remotely sensed water and vegetation indices and of temperature at the locations of West Nile fever (WNF) outbreaks reported in humans between 2002 and 2013.

Methods

The status of infection by WNV in relationship to environmental and climatic risk factors was analyzed at the district level using logistic regression models. Temperature, remotely sensed Normalized Difference Vegetation Index (NDVI) and Modified Normalized Difference Water Index (MNDWI) anomalies, as well as population, birds’ migratory routes, and presence of wetlands were considered as explanatory variables.

Results

The anomalies of temperature in July, of MNDWI in early June, the presence of wetlands, the location under migratory routes, and the occurrence of a WNF outbreak the previous year were identified as risk factors. The best statistical model according to the Akaike Information Criterion was used to map WNF risk areas in 2012 and 2013. Model validations showed a good level of prediction: area under Receiver Operator Characteristic curve = 0.854 (95% Confidence Interval 0.850-0.856) for internal validation and 0.819 (95% Confidence Interval 0.814-0.823) (2012) and 0.853 (95% Confidence Interval 0.850-0.855) (2013) for external validations, respectively.

Conclusions

WNF incidence is increasing in Europe and WNV is expanding into new areas where it had never been observed before. Our model can be used to direct surveillance activities and public health interventions for the upcoming WNF season.

West Nile virus in Canada: ever-changing, but here to stay

The incidence of West Nile virus (WNv) has waxed and waned in Canada over the past 12 years, but it is unlikely to disappear. Climate change models, which suggest warming temperatures and changing patterns of precipitation, predict an expansion of geographic range for WNv in some regions of Canada, such as the Prairie provinces. Such projected changes in WNv distribution might also be accompanied by genetic changes in the virus and/or the range of bird and insect host species it infects. To address this risk, emphasis should be placed on preventing exposure to infected mosquitoes, conducting high-quality surveillance of WNv and WNv disease, controlling mosquito vectors, and promoting public and professional education.

Factors influencing mortality of Lesser Scaup (Aythya affinis) ducklings during a West Nile virus outbreak

Temporal variation in exposure and (or) susceptibility to disease-causing agents may result in changing disease risks for offspring of seasonally reproducing organisms. Although increases in disease risk and disease-related mortality have been observed during the course of the breeding cycle in some systems, the extent to which this is a generalized ecological pattern remains uncertain. We obtained data during an outbreak of West Nile virus (WNV) associated mortality in 50 semicaptive Lesser Scaup (Aythya affinis (Eyton, 1838)) ducklings and used known-fate survival models to assess whether daily survival rate (DSR) was related to age, hatch date, immunogenic challenge, vector abundance, and risk of WNV infection. Ducklings produced late in the breeding cycle had lower survival probabilities, relative to earlier conspecifics, but the best predictor of DSR was relative risk, suggesting that reduced survival of late-hatched individuals may have been related to increasing exposure to WNV-infected vectors.

Modeling monthly variation of Culex tarsalis (Diptera: Culicidae) abundance and West Nile Virus infection rate in the Canadian Prairies

The Canadian prairie provinces of Alberta, Saskatchewan, and Manitoba have generally reported the highest human incidence of West Nile virus (WNV) in Canada. In this study, environmental and biotic factors were used to predict numbers of Culex tarsalis Coquillett, which is the primary mosquito vector of WNV in this region, and prevalence of WNV infection in Cx. tarsalis in the Canadian prairies. The results showed that higher mean temperature and elevated time lagged mean temperature were associated with increased numbers of Cx. tarsalis and higher WNV infection rates. However, increasing precipitation was associated with higher abundance of Cx. tarsalis and lower WNV infection rate. In addition, this study found that increased temperature fluctuation and wetland land cover were associated with decreased infection rate in the Cx. tarsalis population. The resulting monthly models can be used to inform public health interventions by improving the predictions of population abundance of Cx. tarsalis and the transmission intensity of WNV in the Canadian prairies. Furthermore, these models can also be used to examine the potential effects of climate change on the vector population abundance and the distribution of WNV.