A European Public Health Perspective on Climate Change: The Infectious Disease Challenge

In light of the recent Bali accord and the publication of the IPPC report, potential implications of climate change for communicable diseases in Europe must be considered. Here we discuss zoonoses, emerging, vector-, rodent-, water-, food-, and air-borne infectious diseases in light of a changing climate in Europe. Based on an extensive literature review and a survey of all European public health departments we present an assessment of the infectious disease threats by individual member states. Borreliosis is anticipated to advance further into northern latitudes and tick-borne encephalitis into higher altitudes. The recent outbreak of Chikungunya in Italy that affected over 240 individuals illustrates the potential for additional epidemics in regions that are endemic for a vector (aedes albopictus) competent to transmit tropical diseases including dengue. Nevertheless, climatic conditions alone are considered to be insufficient for diseases such as malaria to (re)-establish endemicity in Europe, as other factors such as land use and housing conditions are major determinants of disease.

A framework is presented to proactively address impending climate change-related public health challenges. These include: linking epidemic intelligence and infectious disease surveillance data with data from meteorology, entomology, remote sensing, environmental monitoring, etc. The strategic development of a comprehensive evidence base is warranted in Europe, connecting available data sets from different disciplines in order to proactively respond to the emerging challenges of globalization and changing climates.