{"id":165,"date":"2022-04-26T06:38:16","date_gmt":"2022-04-26T10:38:16","guid":{"rendered":"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/?post_type=chapter&#038;p=165"},"modified":"2023-04-18T22:09:28","modified_gmt":"2023-04-19T02:09:28","slug":"planetary-health-and-infectious-diseases","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/chapter\/planetary-health-and-infectious-diseases\/","title":{"raw":"Planetary Health and Infectious Diseases","rendered":"Planetary Health and Infectious Diseases"},"content":{"raw":"<h2>Authors:\u00a0<span class=\"NormalTextRun SpellingErrorV2Themed SCXW144125054 BCX8\">Tabarsi<\/span><span class=\"NormalTextRun SCXW144125054 BCX8\">,<\/span><span class=\"NormalTextRun SCXW144125054 BCX8\"> N., &amp; <\/span>Grynszpan, D.<\/h2>\r\n<div class=\"textbox\">\r\n\r\n<em>What's in this chapter?<\/em>\r\n<div style=\"font-weight: 400\">\r\n<div>\r\n<ul>\r\n \t<li data-leveltext=\"-\" data-font=\"Cambria\" data-listid=\"1\" data-list-defn-props=\"{&quot;335551671&quot;:14,&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Cambria&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;-&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"14\" data-aria-level=\"1\">What are Emerging Infectious Diseases (EIDs)?<\/li>\r\n<\/ul>\r\n<\/div>\r\n<div>\r\n<ul>\r\n \t<li data-leveltext=\"o\" data-font=\"Courier New\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:1440,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Courier New&quot;,&quot;469769242&quot;:[9675],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;o&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"1\" data-aria-level=\"2\">What is zoonosis?<\/li>\r\n<\/ul>\r\n<\/div>\r\n<div>\r\n<ul>\r\n \t<li data-leveltext=\"-\" data-font=\"Cambria\" data-listid=\"1\" data-list-defn-props=\"{&quot;335551671&quot;:14,&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Cambria&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;-&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"14\" data-aria-level=\"1\">What are the epidemiological considerations?<\/li>\r\n \t<li data-leveltext=\"-\" data-font=\"Cambria\" data-listid=\"1\" data-list-defn-props=\"{&quot;335551671&quot;:14,&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Cambria&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;-&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"14\" data-aria-level=\"1\">What is the relationship to human health? (acute and chronic)<\/li>\r\n<\/ul>\r\n<\/div>\r\n<div>\r\n<ul>\r\n \t<li data-leveltext=\"o\" data-font=\"Courier New\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:1440,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Courier New&quot;,&quot;469769242&quot;:[9675],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;o&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"2\" data-aria-level=\"2\">Physical, mental, and social implications<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n<div class=\"textbox textbox--learning-objectives\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\">Learner Outcomes<\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nAfter reading this chapter you should be able to:\r\n<div style=\"font-weight: 400\">\r\n<div>\r\n<ul>\r\n \t<li data-leveltext=\"-\" data-font=\"Cambria\" data-listid=\"1\" data-list-defn-props=\"{&quot;335551671&quot;:14,&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Cambria&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;-&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"14\" data-aria-level=\"1\">List key modalities in which the ecosystem and human infectious diseases are interconnected<\/li>\r\n \t<li data-leveltext=\"-\" data-font=\"Cambria\" data-listid=\"1\" data-list-defn-props=\"{&quot;335551671&quot;:14,&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Cambria&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;-&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"14\" data-aria-level=\"1\">Describe the impact that changes in the climate and the ecosystem can have on human infectious diseases<\/li>\r\n \t<li data-leveltext=\"-\" data-font=\"Cambria\" data-listid=\"1\" data-list-defn-props=\"{&quot;335551671&quot;:14,&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Cambria&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;-&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"14\" data-aria-level=\"1\">Explain the emergence of novel human infectious diseases from zoonoses<\/li>\r\n \t<li data-leveltext=\"-\" data-font=\"Cambria\" data-listid=\"1\" data-list-defn-props=\"{&quot;335551671&quot;:14,&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Cambria&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;-&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"14\" data-aria-level=\"1\">Recognize how physicians can apply knowledge of the relationship between planetary health and human infectious diseases to their clinical practice through case studies.<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n<div><\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<h1><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW201118995 BCX8\"><span class=\"NormalTextRun SCXW201118995 BCX8\">Effects of Climate on Infectious Diseases<\/span><\/span><span class=\"EOP SCXW201118995 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:480}\">\u00a0<\/span><\/h1>\r\n<div class=\"textbox textbox--key-takeaways\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\">Defining Zoonosis<\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nA zoonosis is an infectious disease, which has been transmitted from non-human animals to humans. Zoonotic pathogens can spread through direct contact between the animal and human or indirectly through water, food or other parts of the environment. (2)\r\n\r\n<\/div>\r\n<\/div>\r\n<span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW1396209 BCX8\"><span class=\"NormalTextRun SCXW1396209 BCX8\">The World Health Organization estimates that zoonoses<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\"> <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">account for one billion cases of illness and one million deaths annually worldwide (1). <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">Studies have found that 58% of all infectious diseases are <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">aggravated by climate change (3<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">). There are <\/span><span class=\"NormalTextRun AdvancedProofingIssueV2Themed SCXW1396209 BCX8\">numerous<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\"> <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">events related to<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\"> climate change <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">that <\/span><span class=\"NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW1396209 BCX8\">lead<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\"> to these <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">impacts<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">; warming, precipitation, floods, drought, storms, land cover change, ocean climate change, fires, heatwaves, and sea level have all been found to influence changes i<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">n infectious disease patterns (3<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">). <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">The <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">varied <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">pathways through which these events <\/span><span class=\"NormalTextRun AdvancedProofingIssueV2Themed SCXW1396209 BCX8\">modify<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\"> disease<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\"> trends<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\"> will be described further in this section.\u00a0<\/span><\/span><span class=\"EOP SCXW1396209 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:480}\">\u00a0<\/span>\r\n<h4><em><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW62523966 BCX8\"><span class=\"NormalTextRun SCXW62523966 BCX8\">Increased Exposure to Pathogens<\/span><\/span><\/em><\/h4>\r\n<\/div>\r\n<div>\r\n<div style=\"font-weight: 400\">\r\n\r\nChanges in climate resulting in warming and precipitation can bring pathogens in closer and more prolonged contact with humans (3). For example, in the case of vector-borne diseases such as those transmitted by mosquitos, ticks, and fleas, warmer temperatures across broader areas lead to an expanded range where they are able to survive and spread (3). In the US between 2004 and 2018 the number of illnesses from mosquito, tick, and flea bites more than doubled (4).\r\n\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n\r\nClimate changes can lead to changes in the geographic distribution of pathogens in other ways as well. Drought can cause mosquitoes and birds to concentrate over the remaining water bodies, increasing transmission of West Nile virus (3). Temperatures in the Arctic are rising at more than twice the speed of the rest of the world and anecdotal evidence of the impact on zoonoses is increasing. An outbreak of anthrax in the Arctic Circle was believed to have originated from an unearthed animal corps following a reduction in frost. Reductions in snow cover have caused voles to find shelter in human inhabitations, leading to outbreaks of Hantavirus and Alaskapox (3, 4).\r\n\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n\r\nChanges in human activity related to climate hazards may also increase exposure to pathogens. For instance, heatwaves lead to increased recreational water activity and have been associated with cases of waterborne illnesses such as Vibrio-associated infections and primary amoebic meningoencephalitis (3). Human migration is anticipated to substantially increase in coming decades due in part to climate change (5). This is expected to influence infectious diseases through several pathways including the introduction and spread of infections, as well as the exposure of migrants to endemic diseases to which they do not have immunity (5).\r\n<h4><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW47480062 BCX8\"><span class=\"NormalTextRun SCXW47480062 BCX8\">Differences in Pathogen and Host Strength<\/span><\/span><\/h4>\r\n<span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW55839314 BCX8\"><span class=\"NormalTextRun SCXW55839314 BCX8\">Climate change has the potential to lead to <\/span><span class=\"NormalTextRun AdvancedProofingIssueV2Themed SCXW55839314 BCX8\">a number of<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> factors that increase the survival ability of pathogens. For example, warmer climates can increase the transmission efficiency of the West Nile virus b<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">y<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> increasing mosquito reproduction, biting<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> rates, and viral replication<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">.<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> H<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">eat <\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">also <\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">upregulates gene expression of proteins affecting transmission, penetration, and host injury by <\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW55839314 BCX8\"><span class=\"NormalTextRun SCXW55839314 BCX8\">Vibrio <\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW55839314 BCX8\">spp<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> <\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW55839314 BCX8\"><span class=\"NormalTextRun SCXW55839314 BCX8\">bacteria<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">, which cause diarrheal <\/span><span class=\"NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW55839314 BCX8\">illnesses <\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW55839314 BCX8\"><span class=\"NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW55839314 BCX8\">.<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> <\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW55839314 BCX8\"><span class=\"NormalTextRun SCXW55839314 BCX8\">Warming and precipitation can also increase <\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">the <\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">food resources<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> of<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> rodent populations <\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">that<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> have been associated with <\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">infectious diseases such as <\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">plague and hantavirus (3<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">).\u00a0<\/span><\/span><span class=\"EOP SCXW55839314 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:480}\">\u00a0<\/span>\r\n\r\n<\/div>\r\n<\/div>\r\n<h4><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW248008314 BCX8\"><span class=\"NormalTextRun SCXW248008314 BCX8\">Susceptibility to Infections\u00a0<\/span><\/span><span class=\"EOP SCXW248008314 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:480}\">\u00a0<\/span><\/h4>\r\n<div style=\"font-weight: 400\">\r\n\r\nClimatic hazards can negatively impact the ability of humans to withstand pathogens. Malnutrition - resulting from a number of consequences of climate change including poor crops and damaged infrastructure \u2013 can negatively impact human immunity (3).\r\n\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n\r\n<span style=\"text-align: initial;font-size: 1em\">The impacts of air pollution related to climate change on humans\u2019 susceptibility to infectious diseases are also important to note. Climate change exacerbates air pollution through a number of routes including longer fire seasons, more airborne dust, and increased chemical rates in the atmosphere that influence ozone and fine particulate matter (PM2.5) formation (8). Exposure to PM2.5, NO2, carbon monoxide, and ozone have been linked in children to increased emergency room visits for respiratory infections (8). In adults, exposure to PM2.5 and NO2 has been linked to respiratory infections including increased incidence and severity of pneumonia, increased reporting of upper respiratory tract infections; chronic exposure has been associated with increased COVID-19 incidence and mortality, as well as tuberculosis transmission and progression (8).\u00a0\u00a0<\/span>\r\n<h4><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW237851476 BCX8\"><span class=\"NormalTextRun SCXW237851476 BCX8\">Impacts on Human Health<\/span><\/span><span class=\"EOP SCXW237851476 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:480}\">\u00a0<\/span><\/h4>\r\n<\/div>\r\n<div class=\"textbox textbox--key-takeaways\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\">Emerging Infectious diseases (EID)<\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nWHO defines an emerging infectious disease, or EID, as an infectious disease that has appeared in a population for the first time, or that may have existed previously but is rapidly increasing in incidence or geographic range.\u00a0Many EIDs are zoonoses or start off as zoonoses before spreading within the human population (9).\r\n\r\n<\/div>\r\n<\/div>\r\n<span class=\"WACImageGroupContainer SCXW198395088 BCX8\"><span class=\"WACImageContainer NoPadding AttachedToBeginning DragDrop SCXW198395088 BCX8\" role=\"presentation\"><\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW198395088 BCX8\"><span class=\"NormalTextRun SCXW198395088 BCX8\">There is increasing awareness of emerging infectious diseases, such as HIV\/AIDS in the 1980s or SARS and COVID-19 more recently. <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">The emergence of<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> novel human<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> infectious diseases<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">is the result of both changes in the geographic distribution of pathogens as well as genetic adap<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">tations in t<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">he microorganisms<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">, both of which can be direct or indirect consequences of climate and environmental change<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">.<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">Changes to ecosystems and to migration patterns can also result in<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> infectious diseases <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">spreading further around the globe<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> and create favorable conditions for the re-emergence of previously controlled pathogens Vector-borne infectious diseases<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">are particularly affected, as exemplified by the spread of West Nile virus and Lyme disease in North America<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> and the re-appearance of dengue outbreaks in southern Europe<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">. <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">This combination of factors leads to three expected impacts on infectious diseases in Cana<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">da, as summarized in Figure 1<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">. First, <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">there is an increased risk of introduction and <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">endemic transmission of infectious diseases from around the world. Second, a south-to-north spread of <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">some <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">diseases currently endemic to the United States<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">is <\/span><span class=\"NormalTextRun AdvancedProofingIssueV2Themed SCXW198395088 BCX8\">anticipated<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">. Finally, the re-emergence of Canada-endemic infectious diseases are expected<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> (11<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">).\u00a0<\/span><\/span><span class=\"EOP SCXW198395088 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:480}\">\u00a0<\/span>\r\n<div class=\"textbox textbox--key-takeaways\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\">Vector-borne infectious diseases<\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nVector-borne infectious diseases are those where the infectious pathogen is transmitted from one person or animal to another via the bite of an arthropod, such as a mosquito or tick.\r\n\r\n<\/div>\r\n<\/div>\r\n<img src=\"http:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig1.png\" alt=\"\" width=\"1280\" height=\"720\" class=\"alignnone size-full wp-image-1048\" \/>\r\n\r\nFigure 1. Impacts of climate change on infectious diseases in Canada (11).\r\n<h4>Integration Into Clinical Practice<\/h4>\r\nTo provide appropriate and timely patient care, physicians must be aware of how climate change is altering infectious disease epidemiology and adjust their differential diagnoses accordingly. For example, tick-borne illness has doubled from 2004 and 2016 with a corresponding geographic spread due in part to warmer temperatures that change habitat suitability for ticks. Lyme disease makes up 80% of these tick-borne illnesses (13). An anticipated lengthened tick season also means that infectious are expected to occur earlier in the spring and linger later into the fall (13, 14). Physicians working in areas without substantial rates of Lyme disease must continue to be vigilant for patients presenting with potentially associated symptoms to avoid a missed diagnosis.\r\n<div style=\"font-weight: 400\">\r\n<h4>Case Study \u2013 West Nile Virus<\/h4>\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n\r\nWest Nile Virus provides a useful example to illustrate the impacts of climate change at various stages of infectious disease transmission.\r\n\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n\r\nWest Nile Virus is caused by a Flaviviridae virus. Although most people infected with WNV remain asymptomatic, it can cause a rash and feverish illness. In a minority of cases, illness will develop further into serious neurological symptoms, paralysis or death. There are currently no vaccines and prevention against infection is based on protective behaviour and barrier clothing.\r\n\r\n<\/div>\r\n<img src=\"http:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig2.png\" alt=\"\" width=\"1280\" height=\"720\" class=\"alignnone size-full wp-image-1055\" \/>\r\n\r\nFigure 2. <span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun Highlight SCXW41622459 BCX8\"><span class=\"NormalTextRun SCXW41622459 BCX8\">Source: <\/span><span class=\"NormalTextRun SCXW41622459 BCX8\"><strong>Transmission Cycle of West Nile Virus<\/strong>. Contributed Illustration by Bryan Parker<\/span><span class=\"NormalTextRun SCXW41622459 BCX8\">. <\/span><span class=\"NormalTextRun SCXW41622459 BCX8\">From:\u202f<\/span><\/span><a class=\"Hyperlink SCXW41622459 BCX8\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK544246\/\" target=\"_blank\" rel=\"noreferrer noopener\"><span data-contrast=\"none\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun Highlight Underlined SCXW41622459 BCX8\"><span class=\"NormalTextRun SCXW41622459 BCX8\" data-ccp-charstyle=\"Hyperlink\">West Nile Virus<\/span><\/span><\/a><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun Highlight SCXW41622459 BCX8\"><span class=\"NormalTextRun SCXW41622459 BCX8\"> <\/span><span class=\"NormalTextRun SCXW41622459 BCX8\">\u00a9 2022, <\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW41622459 BCX8\">StatPearls<\/span><span class=\"NormalTextRun SCXW41622459 BCX8\"> Publishing LLC.<\/span><\/span><span class=\"EOP SCXW41622459 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:480}\">\u00a0<\/span>\r\n\r\n<span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW240054173 BCX8\"><span class=\"NormalTextRun SCXW240054173 BCX8\">Birds are the <\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW240054173 BCX8\"><span class=\"NormalTextRun SCXW240054173 BCX8\">reservoir<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> host<\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW240054173 BCX8\"><span class=\"NormalTextRun SCXW240054173 BCX8\"> for West Nile Virus, meaning that they <\/span><span class=\"NormalTextRun AdvancedProofingIssueV2Themed SCXW240054173 BCX8\">provide<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> the site for the virus to live, grow, and multiply.<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> Humans and pets (horses, dogs) are <\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW240054173 BCX8\"><span class=\"NormalTextRun SCXW240054173 BCX8\">accidental hosts<\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW240054173 BCX8\"><span class=\"NormalTextRun SCXW240054173 BCX8\"> for the virus, meaning that they can be infected<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> and develop disease,<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> but are not part of the natural <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">life <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">cycle <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">of<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> the virus<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">. The disease is vector-borne. M<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">osquitoes<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">, which are the <\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW240054173 BCX8\"><span class=\"NormalTextRun SCXW240054173 BCX8\">vector<\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW240054173 BCX8\"><span class=\"NormalTextRun SCXW240054173 BCX8\"> in this case, pick up the virus as<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">they <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">feed on infected birds<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> and <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">then spread <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">it<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> by biting <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">other birds, <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">people<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> or animals.<\/span><\/span><span class=\"EOP SCXW240054173 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:480}\">\u00a0<\/span>\r\n\r\n<img src=\"http:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig3-e1681868011676.png\" alt=\"\" width=\"740\" height=\"416\" class=\"alignnone size-full wp-image-1059\" \/>\r\n<div style=\"font-weight: 400\">\r\n\r\n<strong>Birds:<\/strong> Birds are the reservoir of West Nile Virus (15). Warmer than average winters and longer frost-free seasons can impact migration, breeding, and mortality of birds (10, 16). Additionally, droughts and water scarcity have been shown to bring birds and mosquitoes into closer proximity, increasing the cycling of the virus between them (16).\r\n\r\n<img src=\"http:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2022\/04\/Slide4.jpg\" alt=\"\" width=\"284\" height=\"256\" class=\"alignnone size-full wp-image-1063 aligncenter\" \/><strong style=\"text-align: initial;font-size: 1em\">Mosquitoes:<\/strong><span style=\"text-align: initial;font-size: 1em\"> Mosquitoes are the insect vector for West Nile Virus (10). Warmer temperatures will increase the geographic spread where mosquitoes are able to survive and breed. Additionally, while the West Nile Virus transmission season in Canada is typically May through September, warming is expected to increase the period where mosquitoes are able to survive. The transmission season can therefore be anticipated to start earlier and continue later into the fall. In the setting of drought, standing water can increase mosquito populations (15).<\/span>\r\n\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n\r\n<img src=\"http:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/Slide5.jpg\" alt=\"\" width=\"210\" height=\"218\" class=\"alignnone size-full wp-image-1066 aligncenter\" \/><strong style=\"text-align: initial;font-size: 1em\">Humans:<\/strong><span style=\"text-align: initial;font-size: 1em\"> Humans are incidental hosts for West Nile Virus. Climate change is expected to lead to human behaviours that bring them into closer proximity with mosquitoes that carry West Nile Virus (10). Physicians must be prepared to manage this increased risk. Assessments must include detailed travel histories, and a broad infectious disease differential should be maintained. Testing capacity of hospitals should be reviewed. Patients must be advised on precautionary measures such as wearing long pants and avoiding early-morning and late-evening exposure to vector insects (16).<\/span>\r\n\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n\r\n&nbsp;\r\n\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n\r\nConclusion\r\n\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n\r\nClimate change is expected to contribute to changes in infectious disease patterns including the emergence of new diseases and those appearing in areas where they had previously not been found. It is critical for physicians to be aware of these trends when caring for patients to avoid missed diagnoses and other poor outcomes.\r\n\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n\r\n&nbsp;\r\n\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n\r\n&nbsp;\r\n\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n\r\n&nbsp;\r\n\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n\r\n&nbsp;\r\n\r\n<\/div>\r\n<div style=\"font-weight: 400\">\r\n\r\nReferences\r\n\r\n<\/div>","rendered":"<h2>Authors:\u00a0<span class=\"NormalTextRun SpellingErrorV2Themed SCXW144125054 BCX8\">Tabarsi<\/span><span class=\"NormalTextRun SCXW144125054 BCX8\">,<\/span><span class=\"NormalTextRun SCXW144125054 BCX8\"> N., &amp; <\/span>Grynszpan, D.<\/h2>\n<div class=\"textbox\">\n<p><em>What&#8217;s in this chapter?<\/em><\/p>\n<div style=\"font-weight: 400\">\n<div>\n<ul>\n<li data-leveltext=\"-\" data-font=\"Cambria\" data-listid=\"1\" data-list-defn-props=\"{&quot;335551671&quot;:14,&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Cambria&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;-&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"14\" data-aria-level=\"1\">What are Emerging Infectious Diseases (EIDs)?<\/li>\n<\/ul>\n<\/div>\n<div>\n<ul>\n<li data-leveltext=\"o\" data-font=\"Courier New\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:1440,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Courier New&quot;,&quot;469769242&quot;:[9675],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;o&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"1\" data-aria-level=\"2\">What is zoonosis?<\/li>\n<\/ul>\n<\/div>\n<div>\n<ul>\n<li data-leveltext=\"-\" data-font=\"Cambria\" data-listid=\"1\" data-list-defn-props=\"{&quot;335551671&quot;:14,&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Cambria&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;-&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"14\" data-aria-level=\"1\">What are the epidemiological considerations?<\/li>\n<li data-leveltext=\"-\" data-font=\"Cambria\" data-listid=\"1\" data-list-defn-props=\"{&quot;335551671&quot;:14,&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Cambria&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;-&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"14\" data-aria-level=\"1\">What is the relationship to human health? (acute and chronic)<\/li>\n<\/ul>\n<\/div>\n<div>\n<ul>\n<li data-leveltext=\"o\" data-font=\"Courier New\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:1440,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Courier New&quot;,&quot;469769242&quot;:[9675],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;o&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"2\" data-aria-level=\"2\">Physical, mental, and social implications<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<div style=\"font-weight: 400\">\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\">Learner Outcomes<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<p>After reading this chapter you should be able to:<\/p>\n<div style=\"font-weight: 400\">\n<div>\n<ul>\n<li data-leveltext=\"-\" data-font=\"Cambria\" data-listid=\"1\" data-list-defn-props=\"{&quot;335551671&quot;:14,&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Cambria&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;-&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"14\" data-aria-level=\"1\">List key modalities in which the ecosystem and human infectious diseases are interconnected<\/li>\n<li data-leveltext=\"-\" data-font=\"Cambria\" data-listid=\"1\" data-list-defn-props=\"{&quot;335551671&quot;:14,&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Cambria&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;-&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"14\" data-aria-level=\"1\">Describe the impact that changes in the climate and the ecosystem can have on human infectious diseases<\/li>\n<li data-leveltext=\"-\" data-font=\"Cambria\" data-listid=\"1\" data-list-defn-props=\"{&quot;335551671&quot;:14,&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Cambria&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;-&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"14\" data-aria-level=\"1\">Explain the emergence of novel human infectious diseases from zoonoses<\/li>\n<li data-leveltext=\"-\" data-font=\"Cambria\" data-listid=\"1\" data-list-defn-props=\"{&quot;335551671&quot;:14,&quot;335552541&quot;:1,&quot;335559684&quot;:-2,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Cambria&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;-&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"14\" data-aria-level=\"1\">Recognize how physicians can apply knowledge of the relationship between planetary health and human infectious diseases to their clinical practice through case studies.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div style=\"font-weight: 400\">\n<div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<h1><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW201118995 BCX8\"><span class=\"NormalTextRun SCXW201118995 BCX8\">Effects of Climate on Infectious Diseases<\/span><\/span><span class=\"EOP SCXW201118995 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:480}\">\u00a0<\/span><\/h1>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\">Defining Zoonosis<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<p>A zoonosis is an infectious disease, which has been transmitted from non-human animals to humans. Zoonotic pathogens can spread through direct contact between the animal and human or indirectly through water, food or other parts of the environment. (2)<\/p>\n<\/div>\n<\/div>\n<p><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW1396209 BCX8\"><span class=\"NormalTextRun SCXW1396209 BCX8\">The World Health Organization estimates that zoonoses<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\"> <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">account for one billion cases of illness and one million deaths annually worldwide (1). <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">Studies have found that 58% of all infectious diseases are <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">aggravated by climate change (3<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">). There are <\/span><span class=\"NormalTextRun AdvancedProofingIssueV2Themed SCXW1396209 BCX8\">numerous<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\"> <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">events related to<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\"> climate change <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">that <\/span><span class=\"NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW1396209 BCX8\">lead<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\"> to these <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">impacts<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">; warming, precipitation, floods, drought, storms, land cover change, ocean climate change, fires, heatwaves, and sea level have all been found to influence changes i<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">n infectious disease patterns (3<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">). <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">The <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">varied <\/span><span class=\"NormalTextRun SCXW1396209 BCX8\">pathways through which these events <\/span><span class=\"NormalTextRun AdvancedProofingIssueV2Themed SCXW1396209 BCX8\">modify<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\"> disease<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\"> trends<\/span><span class=\"NormalTextRun SCXW1396209 BCX8\"> will be described further in this section.\u00a0<\/span><\/span><span class=\"EOP SCXW1396209 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:480}\">\u00a0<\/span><\/p>\n<h4><em><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW62523966 BCX8\"><span class=\"NormalTextRun SCXW62523966 BCX8\">Increased Exposure to Pathogens<\/span><\/span><\/em><\/h4>\n<\/div>\n<div>\n<div style=\"font-weight: 400\">\n<p>Changes in climate resulting in warming and precipitation can bring pathogens in closer and more prolonged contact with humans (3). For example, in the case of vector-borne diseases such as those transmitted by mosquitos, ticks, and fleas, warmer temperatures across broader areas lead to an expanded range where they are able to survive and spread (3). In the US between 2004 and 2018 the number of illnesses from mosquito, tick, and flea bites more than doubled (4).<\/p>\n<\/div>\n<div style=\"font-weight: 400\">\n<p>Climate changes can lead to changes in the geographic distribution of pathogens in other ways as well. Drought can cause mosquitoes and birds to concentrate over the remaining water bodies, increasing transmission of West Nile virus (3). Temperatures in the Arctic are rising at more than twice the speed of the rest of the world and anecdotal evidence of the impact on zoonoses is increasing. An outbreak of anthrax in the Arctic Circle was believed to have originated from an unearthed animal corps following a reduction in frost. Reductions in snow cover have caused voles to find shelter in human inhabitations, leading to outbreaks of Hantavirus and Alaskapox (3, 4).<\/p>\n<\/div>\n<div style=\"font-weight: 400\">\n<p>Changes in human activity related to climate hazards may also increase exposure to pathogens. For instance, heatwaves lead to increased recreational water activity and have been associated with cases of waterborne illnesses such as Vibrio-associated infections and primary amoebic meningoencephalitis (3). Human migration is anticipated to substantially increase in coming decades due in part to climate change (5). This is expected to influence infectious diseases through several pathways including the introduction and spread of infections, as well as the exposure of migrants to endemic diseases to which they do not have immunity (5).<\/p>\n<h4><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW47480062 BCX8\"><span class=\"NormalTextRun SCXW47480062 BCX8\">Differences in Pathogen and Host Strength<\/span><\/span><\/h4>\n<p><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW55839314 BCX8\"><span class=\"NormalTextRun SCXW55839314 BCX8\">Climate change has the potential to lead to <\/span><span class=\"NormalTextRun AdvancedProofingIssueV2Themed SCXW55839314 BCX8\">a number of<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> factors that increase the survival ability of pathogens. For example, warmer climates can increase the transmission efficiency of the West Nile virus b<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">y<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> increasing mosquito reproduction, biting<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> rates, and viral replication<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">.<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> H<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">eat <\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">also <\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">upregulates gene expression of proteins affecting transmission, penetration, and host injury by <\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW55839314 BCX8\"><span class=\"NormalTextRun SCXW55839314 BCX8\">Vibrio <\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW55839314 BCX8\">spp<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> <\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW55839314 BCX8\"><span class=\"NormalTextRun SCXW55839314 BCX8\">bacteria<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">, which cause diarrheal <\/span><span class=\"NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW55839314 BCX8\">illnesses <\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW55839314 BCX8\"><span class=\"NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW55839314 BCX8\">.<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> <\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW55839314 BCX8\"><span class=\"NormalTextRun SCXW55839314 BCX8\">Warming and precipitation can also increase <\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">the <\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">food resources<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> of<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> rodent populations <\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">that<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\"> have been associated with <\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">infectious diseases such as <\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">plague and hantavirus (3<\/span><span class=\"NormalTextRun SCXW55839314 BCX8\">).\u00a0<\/span><\/span><span class=\"EOP SCXW55839314 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:480}\">\u00a0<\/span><\/p>\n<\/div>\n<\/div>\n<h4><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW248008314 BCX8\"><span class=\"NormalTextRun SCXW248008314 BCX8\">Susceptibility to Infections\u00a0<\/span><\/span><span class=\"EOP SCXW248008314 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:480}\">\u00a0<\/span><\/h4>\n<div style=\"font-weight: 400\">\n<p>Climatic hazards can negatively impact the ability of humans to withstand pathogens. Malnutrition &#8211; resulting from a number of consequences of climate change including poor crops and damaged infrastructure \u2013 can negatively impact human immunity (3).<\/p>\n<\/div>\n<div style=\"font-weight: 400\">\n<p><span style=\"text-align: initial;font-size: 1em\">The impacts of air pollution related to climate change on humans\u2019 susceptibility to infectious diseases are also important to note. Climate change exacerbates air pollution through a number of routes including longer fire seasons, more airborne dust, and increased chemical rates in the atmosphere that influence ozone and fine particulate matter (PM2.5) formation (8). Exposure to PM2.5, NO2, carbon monoxide, and ozone have been linked in children to increased emergency room visits for respiratory infections (8). In adults, exposure to PM2.5 and NO2 has been linked to respiratory infections including increased incidence and severity of pneumonia, increased reporting of upper respiratory tract infections; chronic exposure has been associated with increased COVID-19 incidence and mortality, as well as tuberculosis transmission and progression (8).\u00a0\u00a0<\/span><\/p>\n<h4><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW237851476 BCX8\"><span class=\"NormalTextRun SCXW237851476 BCX8\">Impacts on Human Health<\/span><\/span><span class=\"EOP SCXW237851476 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:480}\">\u00a0<\/span><\/h4>\n<\/div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\">Emerging Infectious diseases (EID)<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<p>WHO defines an emerging infectious disease, or EID, as an infectious disease that has appeared in a population for the first time, or that may have existed previously but is rapidly increasing in incidence or geographic range.\u00a0Many EIDs are zoonoses or start off as zoonoses before spreading within the human population (9).<\/p>\n<\/div>\n<\/div>\n<p><span class=\"WACImageGroupContainer SCXW198395088 BCX8\"><span class=\"WACImageContainer NoPadding AttachedToBeginning DragDrop SCXW198395088 BCX8\" role=\"presentation\"><\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW198395088 BCX8\"><span class=\"NormalTextRun SCXW198395088 BCX8\">There is increasing awareness of emerging infectious diseases, such as HIV\/AIDS in the 1980s or SARS and COVID-19 more recently. <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">The emergence of<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> novel human<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> infectious diseases<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">is the result of both changes in the geographic distribution of pathogens as well as genetic adap<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">tations in t<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">he microorganisms<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">, both of which can be direct or indirect consequences of climate and environmental change<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">.<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">Changes to ecosystems and to migration patterns can also result in<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> infectious diseases <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">spreading further around the globe<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> and create favorable conditions for the re-emergence of previously controlled pathogens Vector-borne infectious diseases<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">are particularly affected, as exemplified by the spread of West Nile virus and Lyme disease in North America<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> and the re-appearance of dengue outbreaks in southern Europe<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">. <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">This combination of factors leads to three expected impacts on infectious diseases in Cana<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">da, as summarized in Figure 1<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">. First, <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">there is an increased risk of introduction and <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">endemic transmission of infectious diseases from around the world. Second, a south-to-north spread of <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">some <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">diseases currently endemic to the United States<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> <\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">is <\/span><span class=\"NormalTextRun AdvancedProofingIssueV2Themed SCXW198395088 BCX8\">anticipated<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">. Finally, the re-emergence of Canada-endemic infectious diseases are expected<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\"> (11<\/span><span class=\"NormalTextRun SCXW198395088 BCX8\">).\u00a0<\/span><\/span><span class=\"EOP SCXW198395088 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:480}\">\u00a0<\/span><\/p>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\">Vector-borne infectious diseases<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<p>Vector-borne infectious diseases are those where the infectious pathogen is transmitted from one person or animal to another via the bite of an arthropod, such as a mosquito or tick.<\/p>\n<\/div>\n<\/div>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig1.png\" alt=\"\" width=\"1280\" height=\"720\" class=\"alignnone size-full wp-image-1048\" srcset=\"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig1.png 1280w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig1-300x169.png 300w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig1-1024x576.png 1024w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig1-768x432.png 768w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig1-65x37.png 65w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig1-225x127.png 225w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig1-350x197.png 350w\" sizes=\"auto, (max-width: 1280px) 100vw, 1280px\" \/><\/p>\n<p>Figure 1. Impacts of climate change on infectious diseases in Canada (11).<\/p>\n<h4>Integration Into Clinical Practice<\/h4>\n<p>To provide appropriate and timely patient care, physicians must be aware of how climate change is altering infectious disease epidemiology and adjust their differential diagnoses accordingly. For example, tick-borne illness has doubled from 2004 and 2016 with a corresponding geographic spread due in part to warmer temperatures that change habitat suitability for ticks. Lyme disease makes up 80% of these tick-borne illnesses (13). An anticipated lengthened tick season also means that infectious are expected to occur earlier in the spring and linger later into the fall (13, 14). Physicians working in areas without substantial rates of Lyme disease must continue to be vigilant for patients presenting with potentially associated symptoms to avoid a missed diagnosis.<\/p>\n<div style=\"font-weight: 400\">\n<h4>Case Study \u2013 West Nile Virus<\/h4>\n<\/div>\n<div style=\"font-weight: 400\">\n<p>West Nile Virus provides a useful example to illustrate the impacts of climate change at various stages of infectious disease transmission.<\/p>\n<\/div>\n<div style=\"font-weight: 400\">\n<p>West Nile Virus is caused by a Flaviviridae virus. Although most people infected with WNV remain asymptomatic, it can cause a rash and feverish illness. In a minority of cases, illness will develop further into serious neurological symptoms, paralysis or death. There are currently no vaccines and prevention against infection is based on protective behaviour and barrier clothing.<\/p>\n<\/div>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig2.png\" alt=\"\" width=\"1280\" height=\"720\" class=\"alignnone size-full wp-image-1055\" srcset=\"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig2.png 1280w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig2-300x169.png 300w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig2-1024x576.png 1024w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig2-768x432.png 768w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig2-65x37.png 65w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig2-225x127.png 225w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig2-350x197.png 350w\" sizes=\"auto, (max-width: 1280px) 100vw, 1280px\" \/><\/p>\n<p>Figure 2. <span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun Highlight SCXW41622459 BCX8\"><span class=\"NormalTextRun SCXW41622459 BCX8\">Source: <\/span><span class=\"NormalTextRun SCXW41622459 BCX8\"><strong>Transmission Cycle of West Nile Virus<\/strong>. Contributed Illustration by Bryan Parker<\/span><span class=\"NormalTextRun SCXW41622459 BCX8\">. <\/span><span class=\"NormalTextRun SCXW41622459 BCX8\">From:\u202f<\/span><\/span><a class=\"Hyperlink SCXW41622459 BCX8\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK544246\/\" target=\"_blank\" rel=\"noreferrer noopener\"><span data-contrast=\"none\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun Highlight Underlined SCXW41622459 BCX8\"><span class=\"NormalTextRun SCXW41622459 BCX8\" data-ccp-charstyle=\"Hyperlink\">West Nile Virus<\/span><\/span><\/a><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun Highlight SCXW41622459 BCX8\"><span class=\"NormalTextRun SCXW41622459 BCX8\"> <\/span><span class=\"NormalTextRun SCXW41622459 BCX8\">\u00a9 2022, <\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW41622459 BCX8\">StatPearls<\/span><span class=\"NormalTextRun SCXW41622459 BCX8\"> Publishing LLC.<\/span><\/span><span class=\"EOP SCXW41622459 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:480}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW240054173 BCX8\"><span class=\"NormalTextRun SCXW240054173 BCX8\">Birds are the <\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW240054173 BCX8\"><span class=\"NormalTextRun SCXW240054173 BCX8\">reservoir<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> host<\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW240054173 BCX8\"><span class=\"NormalTextRun SCXW240054173 BCX8\"> for West Nile Virus, meaning that they <\/span><span class=\"NormalTextRun AdvancedProofingIssueV2Themed SCXW240054173 BCX8\">provide<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> the site for the virus to live, grow, and multiply.<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> Humans and pets (horses, dogs) are <\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW240054173 BCX8\"><span class=\"NormalTextRun SCXW240054173 BCX8\">accidental hosts<\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW240054173 BCX8\"><span class=\"NormalTextRun SCXW240054173 BCX8\"> for the virus, meaning that they can be infected<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> and develop disease,<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> but are not part of the natural <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">life <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">cycle <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">of<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> the virus<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">. The disease is vector-borne. M<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">osquitoes<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">, which are the <\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW240054173 BCX8\"><span class=\"NormalTextRun SCXW240054173 BCX8\">vector<\/span><\/span><span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW240054173 BCX8\"><span class=\"NormalTextRun SCXW240054173 BCX8\"> in this case, pick up the virus as<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">they <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">feed on infected birds<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> and <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">then spread <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">it<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> by biting <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">other birds, <\/span><span class=\"NormalTextRun SCXW240054173 BCX8\">people<\/span><span class=\"NormalTextRun SCXW240054173 BCX8\"> or animals.<\/span><\/span><span class=\"EOP SCXW240054173 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:480}\">\u00a0<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig3-e1681868011676.png\" alt=\"\" width=\"740\" height=\"416\" class=\"alignnone size-full wp-image-1059\" srcset=\"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig3-e1681868011676.png 740w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig3-e1681868011676-300x169.png 300w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig3-e1681868011676-65x37.png 65w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig3-e1681868011676-225x126.png 225w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/chap14_fig3-e1681868011676-350x197.png 350w\" sizes=\"auto, (max-width: 740px) 100vw, 740px\" \/><\/p>\n<div style=\"font-weight: 400\">\n<p><strong>Birds:<\/strong> Birds are the reservoir of West Nile Virus (15). Warmer than average winters and longer frost-free seasons can impact migration, breeding, and mortality of birds (10, 16). Additionally, droughts and water scarcity have been shown to bring birds and mosquitoes into closer proximity, increasing the cycling of the virus between them (16).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2022\/04\/Slide4.jpg\" alt=\"\" width=\"284\" height=\"256\" class=\"alignnone size-full wp-image-1063 aligncenter\" srcset=\"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2022\/04\/Slide4.jpg 284w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2022\/04\/Slide4-65x59.jpg 65w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2022\/04\/Slide4-225x203.jpg 225w\" sizes=\"auto, (max-width: 284px) 100vw, 284px\" \/><strong style=\"text-align: initial;font-size: 1em\">Mosquitoes:<\/strong><span style=\"text-align: initial;font-size: 1em\"> Mosquitoes are the insect vector for West Nile Virus (10). Warmer temperatures will increase the geographic spread where mosquitoes are able to survive and breed. Additionally, while the West Nile Virus transmission season in Canada is typically May through September, warming is expected to increase the period where mosquitoes are able to survive. The transmission season can therefore be anticipated to start earlier and continue later into the fall. In the setting of drought, standing water can increase mosquito populations (15).<\/span><\/p>\n<\/div>\n<div style=\"font-weight: 400\">\n<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/Slide5.jpg\" alt=\"\" width=\"210\" height=\"218\" class=\"alignnone size-full wp-image-1066 aligncenter\" srcset=\"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/Slide5.jpg 210w, https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-content\/uploads\/sites\/70\/2023\/04\/Slide5-65x67.jpg 65w\" sizes=\"auto, (max-width: 210px) 100vw, 210px\" \/><strong style=\"text-align: initial;font-size: 1em\">Humans:<\/strong><span style=\"text-align: initial;font-size: 1em\"> Humans are incidental hosts for West Nile Virus. Climate change is expected to lead to human behaviours that bring them into closer proximity with mosquitoes that carry West Nile Virus (10). Physicians must be prepared to manage this increased risk. Assessments must include detailed travel histories, and a broad infectious disease differential should be maintained. Testing capacity of hospitals should be reviewed. Patients must be advised on precautionary measures such as wearing long pants and avoiding early-morning and late-evening exposure to vector insects (16).<\/span><\/p>\n<\/div>\n<div style=\"font-weight: 400\">\n<p>&nbsp;<\/p>\n<\/div>\n<div style=\"font-weight: 400\">\n<p>Conclusion<\/p>\n<\/div>\n<div style=\"font-weight: 400\">\n<p>Climate change is expected to contribute to changes in infectious disease patterns including the emergence of new diseases and those appearing in areas where they had previously not been found. It is critical for physicians to be aware of these trends when caring for patients to avoid missed diagnoses and other poor outcomes.<\/p>\n<\/div>\n<div style=\"font-weight: 400\">\n<p>&nbsp;<\/p>\n<\/div>\n<div style=\"font-weight: 400\">\n<p>&nbsp;<\/p>\n<\/div>\n<div style=\"font-weight: 400\">\n<p>&nbsp;<\/p>\n<\/div>\n<div style=\"font-weight: 400\">\n<p>&nbsp;<\/p>\n<\/div>\n<div style=\"font-weight: 400\">\n<p>References<\/p>\n<\/div>\n","protected":false},"author":56,"menu_order":1,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-165","chapter","type-chapter","status-publish","hentry"],"part":625,"_links":{"self":[{"href":"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-json\/pressbooks\/v2\/chapters\/165","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-json\/wp\/v2\/users\/56"}],"version-history":[{"count":22,"href":"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-json\/pressbooks\/v2\/chapters\/165\/revisions"}],"predecessor-version":[{"id":1067,"href":"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-json\/pressbooks\/v2\/chapters\/165\/revisions\/1067"}],"part":[{"href":"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-json\/pressbooks\/v2\/parts\/625"}],"metadata":[{"href":"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-json\/pressbooks\/v2\/chapters\/165\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-json\/wp\/v2\/media?parent=165"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-json\/pressbooks\/v2\/chapter-type?post=165"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-json\/wp\/v2\/contributor?post=165"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.upei.ca\/planetaryhealth\/wp-json\/wp\/v2\/license?post=165"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}