Editing IPCC:AR6/WGII/Chapter-13 (section)

==== 13.7.1.3 Climate-Sensitive Infectious Diseases ====

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Figure 13.23 summarises the observed and projected changes in climatic suitability and assesses the risk for selected climate-sensitive infectious diseases in Europe.

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[[File:a90b43f80eb36cefd30a7846613d5648 IPCC_AR6_WGII_Figure_13_023.png]]

'''Figure 13.23 |''' '''Assessment of climate-sensitive infectious diseases.''' The assessment considers the main drivers of hazard (climate-impact drivers, pathogens and vectors), vulnerability (lack of safeguards and a predisposition to these hazards) and exposure (humans to be affected by these pathogens and vectors), the direction of change in climatic suitability (i.e., temperature, precipitation, relative humidity, extreme weather events) of observed changes and at 1.5°C and 3°C GWL, and the overall infectious disease risks across Europe (Chapters 7.3, 7.4; [[#Lindgren--2012|Lindgren et al., 2012]] ; [[#Semenza--2021|Semenza and Paz, 2021]] ). The assessment does not consider incidence of disease infections through autochthonous transmission (Table SM13.18).

Among the tick-borne diseases, Lyme disease is the most prevalent disease in Europe. There has been a temperature-dependent range expansion of ticks that is projected to expand further north in Sweden, Norway and the Russian Arctic ( [[#Jaenson--2012|Jaenson et al., 2012]] ; [[#Jore--2014|Jore et al., 2014]] ; [[#Tokarevich--2017|Tokarevich et al., 2017]] ; [[#Waits--2018|Waits et al., 2018]] ), and to higher elevations in Austria and the Czech Republic ( ''medium confidence'' ) ( [[#Daniel--2003|Daniel et al., 2003]] ; [[#Heinz--2015|Heinz et al., 2015]] ). A potential habitat expansion of these ticks of 3.8% across Europe, relative to 1990–2010, is projected for 2°C GWL ( [[#Porretta--2013|Porretta et al., 2013]] ; [[#Boeckmann--2014|Boeckmann and Joyner, 2014]] ). In contrast, there are projected habitat contractions for these ticks in SEU due to unfavourable climatic conditions ( [[#Semenza--2018|Semenza and Suk, 2018]] ).

The Asian tiger mosquito ( ''Aedes albopictus'' ) is present in many European countries and can transmit dengue, chikungunya and zika ( [[#Liu-Helmersson--2016|Liu-Helmersson et al., 2016]] ; [[#Tjaden--2017|Tjaden et al., 2017]] ; [[#Messina--2019|Messina et al., 2019]] ). There is a moderate climatic suitability projected for chikungunya transmission, notably across France, Spain and Germany, but also contractions particularly in Italy. Europe experienced an exceptionally early and intense transmission season of the West Nile virus in 2018, with elevated spring temperature abnormalities ( [[#Haussig--2018|Haussig et al., 2018]] ; [[#Marini--2020|Marini et al., 2020]] ). Projections for Europe show the West Nile virus risk to expand: by 2025, the risk is projected to increase in SEU and southern and eastern parts of WCE ( ''medium confidence'' ) ( [[#Semenza--2016|Semenza et al., 2016]] ). Although climatic suitability for malaria transmission in Europe is increasing and will lead to a northward spread of the occurrences of ''Anopheles'' vectors, the risk from malaria to human health in Europe remains low due to economic and social development as well as access to health care ( ''medium confidence'' ) ( [[#Sudre--2013|Sudre et al., 2013]] ; [[#Hertig--2019|Hertig, 2019]] ).

Water-borne diseases are also associated with changes in climate such as heavy precipitation events ( [[#Semenza--2020|Semenza, 2020]] ). Warming has been linked with elevated incidence of campylobacteriosis outbreaks in various European countries ( [[#Yun--2016|Yun et al., 2016]] ; [[#Lake--2019|Lake et al., 2019]] ). Marine bacteria, such as ''Vibrio'' , thrive under elevated sea surface temperature and low salinity such as that of the Baltic Sea. Under further warming, the number of months with risk of ''Vibrio'' transmission increases and the seasonal transmission window expands, thereby increasing the risk to human health in the future ( ''high confidence'' ) ( [[#Baker-Austin--2017|Baker-Austin et al., 2017]] ; [[#Semenza--2017|Semenza et al., 2017]] ).

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