Tracing the future of epidemics: Coincident niche distribution of host animals and disease incidence revealed climate-correlated risk shifts of main zoonotic diseases in China

Climate has critical roles in the origin, pathogenesis and transmission of infectious zoonotic diseases. However, large-scale epidemiologic trend and specific response pattern of zoonotic diseases under future climate scenarios are poorly understood. Here, we projected the distribution shifts of transmission risks of main zoonotic diseases under climate change in China. First, we shaped the global habitat distribution of main host animals for three representative zoonotic diseases (2, 6, and 12 hosts for dengue, hemorrhagic fever, and plague, respectively) with 253,049 occurrence records using maximum entropy (Maxent) modeling. Meanwhile, we predicted the risk distribution of the above three diseases with 197,098 disease incidence records from 2004 to 2017 in China using an integrated Maxent modeling approach. The comparative analysis showed that there exist highly coincident niche distributions between habitat distribution of hosts and risk distribution of diseases, indicating that the integrated Maxent modeling is accurate and effective for predicting the potential risk of zoonotic diseases. On this basis, we further projected the current and future transmission risks of 11 main zoonotic diseases under four representative concentration pathways (RCPs) (RCP2.6, RCP4.5, RCP6.0, and RCP8.5) in 2050 and 2070 in China using the above integrated Maxent modeling with 1,001,416 disease incidence records. We found that Central China, Southeast China, and South China are concentrated regions with high transmission risks for main zoonotic diseases. More specifically, zoonotic diseases had diverse shift patterns of transmission risks including increase, decrease, and unstable. Further correlation analysis indicated that these patterns of shifts were highly correlated with global warming and precipitation increase. Our results revealed how specific zoonotic diseases respond in a changing climate, thereby calling for effective administration and prevention strategies. Furthermore, these results will shed light on guiding future epidemiologic prediction of emerging infectious diseases under global climate change.     

Climate change and health with an emphasis on interactions with ultraviolet radiation: a review

Climate change is increasingly recognized as a major risk to human health, and health concerns are assuming more importance in international debates on mitigation and adaptation strategies. Health consequences of climate change will occur through direct and indirect routes, and as a result of interactions with other environmental exposures. Heatwaves will become more common and are associated with higher mortality particularly in the elderly and those with pre‐existing cardiovascular and respiratory illnesses. Warmer ambient temperatures will result in more dehydration episodes and increased risks of renal disease and, through effects on pollen seasons, there may be an increase in allergic disease such as asthma and hayfever. Other adverse effects including on air quality, food safety and security and an expanding distribution of some infectious diseases, including vector‐borne diseases, are postulated. A related but separate environmental exposure is that of ultraviolet radiation (UVR). Interactions between climate change and stratospheric ozone (and the causes of ozone depletion) will cause changes to levels of ambient UVR in the future and warmer temperatures are likely to change sun exposure behaviour. Co‐occurring effects on aquatic and terrestrial ecosystems have potential consequences for food safety, quality and supply. Climate change‐related exposures are likely to affect the incidence and distribution of diseases usually considered as caused by UVR exposure; and changes in UVR exposure will modulate the climate change effects on human health. For example, in some regions warmer temperatures due to climate change will encourage more outdoor behaviour, with likely consequences for increasing skin cancer incidence. Although many of the health outcomes of both climate change and the interaction of climate change and UVR exposure are somewhat speculative, there are risks to over‐ or under‐estimations of health risks if synergistic and antagonistic effects of co‐occurring environmental changes are not considered.     

Climate changes, environment and infection: facts, scenarios and growing awareness from the public health community within Europe

Climate change is a current global concern and, despite continuing controversy about the extent and importance of causes and of its effects, it seems likely that it will affect the incidence and prevalence of both residual and imported infections in Europe. Climate affects mainly the range of infectious diseases, whereas weather affects the timing and intensity of outbreaks. Climate change scenarios include a change distribution of infectious diseases with warming and changes in outbreaks associated with weather extremes. The largest health impact from climate change for Europe doesn’t come from vector borne infectious diseases. This does not mean that these types of health impacts will not arise in Europe. The ranges of several vector-borne diseases or their vectors are already changing in altitude due to warming. In addition, more intense weather events create conditions conductive to outbreaks of infectious diseases: Heavy rains leave insect breeding sites, drive rodents from burrows, and contaminate clean water systems. The incidence of mosquito-borne parasitic and viral diseases, are among those diseases most sensitive to climate. Climate change affect disease transmission by shifting the vector’s geographic range and by shortening the pathogen incubation period. climate-related increases in temperature in sea surface and level would lead to higher incidence of waterborne infectious and toxin-related illnesses, such as cholera and seafood intoxication. Climate changes all around the world with impact in Europe are demonstrated by the fact that recent cases of cholera have been imported to Europe from Kenya, where spreading epidemic has been linked to the El Niño phenomenon, originated from the Pacific Ocean. Human migration and damage to health infrastructures from aberrant climate changes could indirectly contribute to disease transmission. Human susceptibility to infections might be further compounded by alterations in the human immune system caused by increased exposure to ultraviolet radiation and malnutrition due to alterations in agricultural products. Different kind of incidents in Europe with extreme weather events demonstrated effects on public health. The recent outbreak of the insect-borne Chikungunya virus in Italy in 2007 is an example of the kind of new health threat that the EU must be vigilant to confront. In addition, health effects of flooding, have been related to an excess cases of leptospirosis and campylobacter enteritis. Such examples have been demonstrated reported after flooding in the Czech Republic. Similarly, an increase of cryptosporidiosis in the United Kingdom has been related to flooding. Changing vector distributions associated with tickborne encephalitis and malaria have also been dempostrated in EU. A recently reported case of malaria in Italy in June 2008, suspected to be indigenously acquired, has shown how easily malaria could be reintroduced into several countries in the region. Another case of malaria in Greece in May 2010 affecting a young man living in a forestry region was claimed at KEELPNO-the Greek Center for disease control. Would this latest case be considered closely related to the one from Italy? If yes, then Public Health Services should elaborate plans to affront possible tickborne diseases. Heat waves are important causes of mortality on mortality are important. The deaths seen in France in 2003 from a heat wave are projected to be repeated, as heat waves become more severe. However, heat waves impacts on the transmission and severity of infectious diseases have not been elucidated. Finally scientific challenges include the elucudation of climate changes and extreme weather condition impact on infection transmission and outcome, human immune system changes and infection response, outbreak scenarios, animal and plant health and public health preparedness. European action plans to affront climate changes related health and infection problems are developed by the EU Commission at different levels and jointly by different DGs. In a few words within the EU the following points on human, animal and plant health are considered a priority: * Strengthening cooperation between the services of these three branches of health (human, animals, plants); * Developing action plans in the event of extreme weather conditions, in order to be better prepared and to react in the best way; * Gathering more reliable information on the risks of climate change whilst maintaining international cooperation, in particular with the WHO, as cooperation beyond that between Member States will be required to be more effective; * Providing additional effort to identify the most effective measures; * Improving the surveillance and the control of the animal diseases. The European Commission has decided to consider climate change, and the consequences it has on health, with greater importance whilst being aware that it is at the root of numerous diseases.     

The book reopened on infectious diseases

Emerging infectious diseases represent a major challenge to human health worldwide. The risk of evolving new infectious pathogens has been intensifying due to urbanization, demographic changes, air travel, inappropriate use of antibiotics, and climate change. These pathogens can affect humans from urban centers to the remotest corners of the globe. Far from being a scourge of the past, infectious diseases are relevant for the world today.     

Trends in notifiable infectious diseases in China: implications for surveillance and population health policy

This study aimed to analyse trends in notifiable infectious diseases in China, in their historical context. Both English and Chinese literature was searched and diseases were categorised according to the type of disease or transmission route. Temporal trends of morbidity and mortality rates were calculated for eight major infectious diseases types. Strong government commitment to public health responses and improvements in quality of life has led to the eradication or containment of a wide range of infectious diseases in China. The overall infectious diseases burden experienced a dramatic drop during 1975-1995, but since then, it reverted and maintained a gradual upward trend to date. Most notifiable diseases are contained at a low endemic level; however, local small-scale outbreaks remain common. Tuberculosis, as a bacterial infection, has re-emerged since the 1990s and has become prevalent in the country. Sexually transmitted infections are in a rapid, exponential growth phase, spreading from core groups to the general population. Together human immunodeficiency virus (HIV), they account for 39% of all death cases due to infectious diseases in China in 2008. Zoonotic infections, such as severe acute respiratory syndrome (SARS), rabies and influenza, pose constant threats to Chinese residents and remain the most deadly disease type among the infected individuals. Therefore, second-generation surveillance of behavioural risks or vectors associated with pathogen transmission should be scaled up. It is necessary to implement public health interventions that target HIV and relevant coinfections, address transmission associated with highly mobile populations, and reduce the risk of cross-species transmission of zoonotic pathogens.     

The Effect of Meteorological Variables on the Transmission of Hand,Foot and Mouth Disease in Four Major Cities of Shanxi Province,China: A Time Series Data Analysis (2009-2013)

Increased incidence of hand, foot and mouth disease (HFMD) has been recognized as a critical challenge to communicable disease control and public health response. This study aimed to quantify the association between climate variation and notified cases of HFMD in selected cities of Shanxi Province, and to provide evidence for disease control and prevention. Meteorological variables and HFMD cases data in 4 major cities (Datong, Taiyuan, Changzhi and Yuncheng) of Shanxi province, China, were obtained from the China Meteorology Administration and China CDC respectively over the period 1 January 2009 to 31 December 2013. Correlations analyses and Seasonal Autoregressive Integrated Moving Average (SARIMA) models were used to identify and quantify the relationship between the meteorological variables and HFMD. HFMD incidence varied seasonally with the majority of cases in the 4 cities occurring from May to July. Temperatures could play important roles in the incidence of HFMD in these regions. The SARIMA models indicate that a 1° C rise in average, maximum and minimum temperatures may lead to a similar relative increase in the number of cases in the 4 cities. The lag times for the effects of temperatures were identified in Taiyuan, Changzhi and Yuncheng. The numbers of cases were positively associated with average and minimum temperatures at a lag of 1 week in Taiyuan, Changzhi and Yuncheng, and with maximum temperature at a lag of 2 weeks in Yuncheng. Positive association between the temperature and HFMD has been identified from the 4 cities in Shanxi Province, although the role of weather variables on the transmission of HFMD varied in the 4 cities. Relevant prevention measures and public health action are required to reduce future risks of climate change with consideration of local climatic conditions.     

Assessing the Effects of Climate Change on Waterborne Microorganisms: Implications for EU and U.S. Water Policy

Despite advances in water treatment, outbreaks of waterborne diseases still occur in developed regions including the United States and Europe Union (EU). Water quality impairments attributable to elevated concentrations of fecal indicator bacteria, and associated with health risk, are also very common. Research suggests that the impact of such microorganisms on public health may be intensified by the effects of climate change. At present, the major regulatory frameworks in these regions (i.e., the US Clean Water Act [CWA] and the EU Water Framework Directive [WFD]), do not explicitly address risks posed by climate change. This article reviews existing U.S. and EU water quality regulatory legislation for robustness to climate change and suggests watershed modeling approaches to inform additional pollution control measures given the likely impacts on microbial fate and transport. Comprehensive analysis of future climate and water quality scenarios may only be achievable through the use of watershed-scale models. Unless adaptation measures are generated and incorporated into water policy, the potential threat posed to humans from exposure to waterborne pathogens may be amplified. Such adaptation measures will assist in achieving the aims of the EU WFD and US CWA and minimize impacts of climate change on microbial water quality.     

气候变化对传染病爆发流行的影响研究进展

全球气候变化已影响到传染病发生、传播与变化的各个环节,从病原体及其携带者、传播途径和人体自身抵抗力等方面直接或间接影响传染病的发病趋势,从而对人类健康造成了巨大的威胁。所以加强对气候变化与传染病间关系、预测预报研究,对进一步认识、预防和控制传染病的爆发流行具有重要意义。本文首先阐述了全球气候变化对生物物种的地理分布和人类健康的影响,气候变化改变了生物物种的地理分布范围,增加了某些物种的潜在分布区域,并造成生物物侯期的改变;同时,极端气候事件成为导致种群数量波动的一个重要驱动力。气候变化对人类健康有直接和间接影响,它使得传染病发病率增加、传染病分布范围扩大、人群对疾病易感性增强。文章重点评述了气候变化对疟疾、登革热、霍乱、流行性乙型脑炎、流感、SARS、肠道传染病、鼠疫、血吸虫病等常见传染病流行机制和传播过程的影响研究进展。评述了传染病和气象因子关系分析中常用的定性和定量分析方法,传统的研究多以定性分析为主,方法较单一;目前,利用流行病学资料与同期的气象因子进行单因素相关分析、多元回归分析是常用的研究方法;主成分回归分析、逐步判别分析、灰色关联分析法、RS和GIS等方法近年来逐渐得到应用;数学建模、实验室生物学仿真实验方法是今后需强化的方向。提出了该研究领域国内外研究普遍存在和亟待解决的问题,针对目前的研究现状和存在的问题,提出了未来的研究重点和发展方向。     

提高医院传染病管理的实践

目的：总结解放军第302医院在防控传染病方面所践采取的措施,提高医院传染病管理相关工作。方法：完善传染病管理组织,明确责任;认真落实传染病管理相关制度;加强相关知识培训,强化医护人员责任意识,提高能动性、自觉性。总结分析以上相关措施实施后,2005年-2010年期间传染病报告情况。结果：2005年-2010年每年传染病疫情报告卡填写完整率逐渐提高,医院传染病报告漏报率呈逐年下降趋势,近两年呈现填写完整无漏报的情况。结论：提高医院传染病管理的相关措施的实施,使医护人员对的传染病防控意识有所提高,做到早发现、早报告、早隔离、早治疗,降低传染病传播风险,有效减少了医院交叉感染的发生,保障人们的生命健康和社会的发展稳定。     

Climate change and vector-borne diseases: what are the implications for public health research and policy?

Vector-borne diseases continue to contribute significantly to the global burden of disease, and cause epidemics that disrupt health security and cause wider socioeconomic impacts around the world. All are sensitive in different ways to weather and climate conditions, so that the ongoing trends of increasing temperature and more variable weather threaten to undermine recent global progress against these diseases. Here, we review the current state of the global public health effort to address this challenge, and outline related initiatives by the World Health Organization (WHO) and its partners. Much of the debate to date has centred on attribution of past changes in disease rates to climate change, and the use of scenario-based models to project future changes in risk for specific diseases. While these can give useful indications, the unavoidable uncertainty in such analyses, and contingency on other socioeconomic and public health determinants in the past or future, limit their utility as decision-support tools. For operational health agencies, the most pressing need is the strengthening of current disease control efforts to bring down current disease rates and manage short-term climate risks, which will, in turn, increase resilience to long-term climate change. The WHO and partner agencies are working through a range of programmes to (i) ensure political support and financial investment in preventive and curative interventions to bring down current disease burdens; (ii) promote a comprehensive approach to climate risk management; (iii) support applied research, through definition of global and regional research agendas, and targeted research initiatives on priority diseases and population groups.     

Seasonality and the dynamics of infectious diseases

Seasonal variations in temperature, rainfall and resource availability are ubiquitous and can exert strong pressures on population dynamics. Infectious diseases provide some of the best-studied examples of the role of seasonality in shaping population fluctuations. In this paper, we review examples from human and wildlife disease systems to illustrate the challenges inherent in understanding the mechanisms and impacts of seasonal environmental drivers. Empirical evidence points to several biologically distinct mechanisms by which seasonality can impact host–pathogen interactions, including seasonal changes in host social behaviour and contact rates, variation in encounters with infective stages in the environment, annual pulses of host births and deaths and changes in host immune defences. Mathematical models and field observations show that the strength and mechanisms of seasonality can alter the spread and persistence of infectious diseases, and that population-level responses can range from simple annual cycles to more complex multiyear fluctuations. From an applied perspective, understanding the timing and causes of seasonality offers important insights into how parasite–host systems operate, how and when parasite control measures should be applied, and how disease risks will respond to anthropogenic climate change and altered patterns of seasonality. Finally, by focusing on well-studied examples of infectious diseases, we hope to highlight general insights that are relevant to other ecological interactions.     

Climate change and local public health in the United States: preparedness, programs and perceptions of local public health department directors

While climate change is inherently a global problem, its public health impacts will be experienced most acutely at the local and regional level, with some jurisdictions likely to be more burdened than others. The public health infrastructure in the U.S. is organized largely as an interlocking set of public agencies at the federal, state and local level, with lead responsibility for each city or county often residing at the local level. To understand how directors of local public health departments view and are responding to climate change as a public health issue, we conducted a telephone survey with 133 randomly selected local health department directors, representing a 61% response rate. A majority of respondents perceived climate change to be a problem in their jurisdiction, a problem they viewed as likely to become more common or severe over the next 20 years. Only a small minority of respondents, however, had yet made climate change adaptation or prevention a top priority for their health department. This discrepancy between problem recognition and programmatic responses may be due, in part, to several factors: most respondents felt personnel in their health department--and other key stakeholders in their community--had a lack of knowledge about climate change; relatively few respondents felt their own health department, their state health department, or the Centers for Disease Control and Prevention had the necessary expertise to help them create an effective mitigation or adaptation plan for their jurisdiction; and most respondents felt that their health department needed additional funding, staff and staff training to respond effectively to climate change. These data make clear that climate change adaptation and prevention are not currently major activities at most health departments, and that most, if not all, local health departments will require assistance in making this transition. We conclude by making the case that, through their words and actions, local health departments and their staff can and should play a role in alerting members of their community about the prospect of public health impacts from climate change in their jurisdiction.     

Climate Change and Health Research in the Eastern Mediterranean Region

Anthropologically induced climate change, caused by an increased concentration of greenhouse gases in the atmosphere, is an emerging threat to human health. Consequences of climate change may affect the prevalence of various diseases and environmental and social maladies that affect population health. In this article, we reviewed the literature on climate change and health in the Eastern Mediterranean Region. This region already faces numerous humanitarian crises, from conflicts to natural hazards and a high burden of disease. Climate change is likely to aggravate these emergencies, necessitating a strengthening of health systems and capacities in the region. However, the existing literature on climate change from the region is sparse and informational gaps stand in the way of regional preparedness and adaptation. Further research is needed to assess climatic changes and related health impacts in the Eastern Mediterranean Region. Such knowledge will allow countries to identify preparedness vulnerabilities, evaluate capacity to adapt to climate change, and develop adaptation strategies to allay the health impacts of climate change.     

Climate Change-related Health Impacts in the Hindu Kush–Himalayas

Our goal was to identify the climate change-related health risks and vulnerable populations specific to the mountainous regions of the Hindu Kush–Himalayas. We reviewed published information of the likely health consequences of climate change in mountain regions, especially the findings of a workshop for countries in the Hindu Kush–Himalaya region, organized by the World Health Organization, World Meteorological Organization, United Nations Environment Programme, and United Nations Development Programme. The main climate-related risks in the Hindu Kush–Himalaya region include the expansion of vector-borne diseases as pathogens take advantage of new habitats in altitudes that were formerly unsuitable. Diarrheal diseases could become more prevalent with changes in freshwater quality and availability. More extreme rainfall events are likely to increase the number of floods and landslides with consequent death and injuries. A unique risk is sudden floods from high glacier lakes, which cause substantial destruction and loss of life. Because glaciers are the main source of freshwater for upland regions and downstream countries, the long-term reduction in annual glacier snowmelt is expected to heighten existing water insecurity in these areas. Climate change also is bringing some benefits to mountain populations, including milder winters and longer growing seasons. Populations in mountain regions have unique combinations of vulnerabilities to climate change. The extent of the health impacts experienced will depend on the effectiveness of public health efforts to identify and implement low-cost preparedness and response measures, and on the speed at which emissions of greenhouse gas emissions can be reduced.     

Risk Factors for Infectious Diseases in Backyard Poultry Farms in the Poyang Lake Area,China

Emergence and transmission of infectious diseases have an enormous impact on the poultry industry and present a serious threat to the health of humans and wild birds. Noncommercial poultry operations, such as backyard poultry facilities in China, are potential sources of virus exchange between commercial poultry and wild birds. It is particularly critical in wetland areas where backyard poultry have close contact with commercial poultry and migratory birds, therefore increasing the risk of contracting infectious diseases. To evaluate the transmission risks, a cross-sectional study was undertaken in the Poyang Lake area, China, involving 309 residents in the backyard poultry farms in three counties (Region A, B, and C) of Jiangxi Province. We examined the backyard poultry population, poultry species, presence of poultry deaths from infectious diseases, food sources, and biosecurity practices. Region B ranked highest for biosecurity while region C ranked lowest. The risks of infectious diseases were assessed by adjusted odds ratio based on multivariate logistic regression analysis. Potential risk factors in the three regions of the study site were compared. In Region A, significant factor was contact of poultry with wild birds (OR: 6.573, 95% CI: 2.148–20.115, P=0.001). In Region B, the most significant factor was contact of poultry with neighboring backyard waterfowls (OR: 3.967, 95% CI: 1.555–10.122, P=0.004). In Region C, significant factors were poultry purchase from local live bird markets (OR: 3.740, 95% CI: 1.243–11.255, P=0.019), and contact of poultry with wild birds (OR: 3.379, 95% CI: 1.058–10.791, P=0.040). In summary, backyard poultry was significantly affected by neighboring commercial poultry and close contact with wild birds. The results are expected to improve our understanding of the transmission risks of infectious diseases in a typical backyard poultry environment in rural China, and address the need to improve local farming practices and take preventive measures.     

新形势下的传染病医院医疗应急后勤保障工作

传染病因其不可预测性和突发性,已经成为人类生存的大敌。随着气候的变化和环境的破坏,新老传染病（SARS、甲型H1N1流感、禽流感、TB等）相继出现及复燃,人民的健康不时受到威胁,传染病医院肩负着防治疾病的重任并面临巨大挑战。因此如何做好医疗应急后勤保障工作是当今新形势下传染病医院工作的重中之重。     

Public Health Risk Assessment Linked to Climatic and Ecological Change

Disturbances of climatic and ecological systems can present risks to human health, which are becoming more evident from health studies linked to climate variability, landuse change and global climate change. Waterborne disease agents, such as Giardia cysts and Cryposporidium oocysts have been positively correlated with rainfall. El Niño-related extreme weather conditions can have a significant impact on vector- and water-borne diseases. The linkages between weather, terrestrial ecology and human health have been discovered for some diseases, such as rodent-borne hantavirus. Marine ecology also plays a role in determining human health risks, such as from cholera, and other enteric pathogens. Deforestation and ensuing changes in landuse, human settlement, commercial development, road construction, and water control systems singly, and in combination have been accompanied by increases in or emergence of diseases like malaria and schistosomiasis in some regions of the world. Long-term climate change may increase the frequency of heat waves and potentially air pollution episodes, increase the number of extreme weather events, cause coastal flooding and salination of fresh water aquifers, and displace coastal settlements. Ultimately, a two-pronged approach (empirical and modeling studies) is required to better understand these linkages between climato-logical and ecological change as determinants of disease.     

The impact of economic crises on communicable disease transmission and control: a systematic review of the evidence

There is concern among public health professionals that the current economic downturn, initiated by the financial crisis that started in 2007, could precipitate the transmission of infectious diseases while also limiting capacity for control. Although studies have reviewed the potential effects of economic downturns on overall health, to our knowledge such an analysis has yet to be done focusing on infectious diseases. We performed a systematic literature review of studies examining changes in infectious disease burden subsequent to periods of crisis. The review identified 230 studies of which 37 met our inclusion criteria. Of these, 30 found evidence of worse infectious disease outcomes during recession, often resulting from higher rates of infectious contact under poorer living circumstances, worsened access to therapy, or poorer retention in treatment. The remaining studies found either reductions in infectious disease or no significant effect. Using the paradigm of the "SIR" (susceptible-infected-recovered) model of infectious disease transmission, we examined the implications of these findings for infectious disease transmission and control. Key susceptible groups include infants and the elderly. We identified certain high-risk groups, including migrants, homeless persons, and prison populations, as particularly vulnerable conduits of epidemics during situations of economic duress. We also observed that the long-term impacts of crises on infectious disease are not inevitable: considerable evidence suggests that the magnitude of effect depends critically on budgetary responses by governments. Like other emergencies and natural disasters, preparedness for financial crises should include consideration of consequences for communicable disease control.     

Impact of Climate Variability on Infectious Disease in West Africa

The importance of infectious disease as a determinant (as well as an outcome) of poverty has recently become a prominent argument for international and national investment in the control of infectious disease, as can be seen in the recently articulated United Nations (UN) Millennium Development Goals (MDGs). Climate variability and land use change have an enormous impact on health in West Africa, and may yet undermine the potential for achieving the MDGs, in certain economic-ecological zones. However, their underlying role in determining the burden of disease in the region on a yearly or decadal basis has never been systematically studied. In order to improve our understanding of the future impacts of climate change, it may be more effective to start by investigating the impact of inter-annual climate variability, and short-term shifts in climate (e.g., decadal), on disease transmission dynamics. This information may inform both current and future policy decisions with regard to prediction, prevention, and management of adverse climate-related health outcomes. This article reviews current knowledge of changes in the epidemiology of infectious diseases associated with climate variability in West Africa over the last 40 years. Selected examples are considered from bacterial (meningococcal meningitis), protozoan (malaria), and filarial (onchocerciasis and lymphatic filariasis) infections where spatial and temporal disease patterns have been directly influenced by seasonal, inter-annual, or decadal changes in climate.The views expressed herein are those of the authors and do not necessarily reflect the views of the National Oceanic and Atmospheric Administration (NOAA) or any of its sub-agencies.     

同一健康理念下中国野生动物源疫病监测及响应体系发展对策

现代人类新发传染病中, 有60.3%是人兽共患病, 其中71.8%源于野生动物。野生动物是许多病原体的贮存库, 对人类和饲养动物会产生潜在的生物安全威胁。目前, 中国针对饲养动物疫病的监测检测系统和法律法规较为健全, 但针对野生动物的疫源疫病监测仍比较薄弱。根据“One Health”的理念, 野生动物疫源疫病的有效监测与相应防治措施的落实, 不仅可以为人兽共患病的大规模流行做出预警并降低其几率, 同时也为野生动物种群的健康提供了保障。本研究通过国际案例的比较分析, 提出有效的野生动物疫源疫病监测系统特征。同时, 通过对我国现有监测体系的研究分析, 结合利益相关方访谈以及实地调查, 提出了完善现有系统的主要措施建议。建议包括: (1)推进不同政府部门间的资源互通, 提高国家疫病监测体系应对跨学科、跨领域问题的综合能力; (2)针对人及饲养动物与野生动物接触频繁的生产生活方式, 应建立重点监测管理和响应机制; (3)提高对科学技术的重视, 包括建立野生动物疫病参考实验室、提升相关工作人员的技术能力等, 保障科学的监测方案和检测方法; (4)建立基于公众和现有监测资源的信息上报、汇总系统, 提升野生动物疫病监测的公众参与度和信息透明度。