Climate change and infectious diseases

The previous chapter considered how short-term variations in climatic conditions and extreme weather events can exert direct effects on human death rates, physical injury, mental health and other health outcomes. Changes in mean climatic conditions and climate variability also can affect human health via indirect pathways, particularly via changes in biological and ecological processes that influence infectious disease transmission and food yields. This chapter examines the influences of climatic factors on infectious diseases. For centuries humans have known that climatic conditions affect epidemic infections—since well before the basic notion of infectious agents was understood late in the nineteenth century. The Roman aristocracy took refuge in their hill resorts each summer to avoid malaria. South Asians learnt early that in high summer, strongly curried foods were less prone to induce diarrhoeal diseases. In the southern United States one of the most severe summertime outbreaks of yellow fever (viral disease transmitted by the Aedes aegypti mosquito) occurred in 1878, during one of the strongest El Niño episodes on record. The economic and human cost was enormous, with an estimated death toll of around 20000 people. In developed countries today it is well known that recurrent influenza epidemics occur in mid-winter. Infectious disease transmission should be viewed within an ecological framework. Infectious agents obtain the necessary nutrients and energy by parasitization of higher organisms. Most such infections are benign, and some are even beneficial to both host and microbe. Only a minority of infections that adversely affect the host’s biology are termed “infectious disease”. During the long processes of human cultural evolution; population dispersal around the world; and subsequent inter-population contact and conflict; several distinct transitions in human ecology and inter-population interactions have changed profoundly the patterns of infectious disease in human populations. Since the early emergence of agriculture and livestock herding around 10000 years ago, three great transitions in human/microbe relationships are readily recognizable (1):