Global Warming and Public Health Robert M. Levin, MD Health Officer Ventura County April 7, 2008

Public Health Impacts of Global Warming Heat waves and deaths from hyperthermia Fresh water shortages (due to combined effects of global warming, overpopulation and water pollution) with wars fought over fresh water Air pollution related to greenhouse gases (increased disease and death due to heart attack, stroke, asthma, emphysema, lung cancer, allergy) Ozone depletion leading to increased cataracts, melanoma Extreme weather events (floods and storms) Water-borne and food-borne diseases (toxic algal blooms like red tide, survival of viral pathogens leading to shellfish poisoning, cholera) Vector-borne and rodent-borne diseases (mosquitoes, ticks, rodents) Elevated seas levels (population exodus, aquifers threatened in San Francisco and New Orleans) Crop failures and famine Economic and political stress may damage public health infrastructure

Will global warming by itself change the boundaries of the diseases we see? Malaria

The Little Ice Age Hunters in the Snow by the Flemish painter Pieter Bruegel February, 1565

Vector-borne Disease Disease in humans carried from another warm-blooded animal by an insect such as a mosquito, tick or sandfly.

Infectious Diseases Potentially Spread by Global Warming  Dengue fever  Malaria  Yellow fever  Chickungunya fever  Epidemic polyarthritis  West Nile fever  St. Louis encephalitis  Lyme disease  Ehrlichiosis  Plague  Loaiasis  Leishmaniasis  Kyasanur Forest disease  La Crosse encephalitis  Eastern equine encephalitis  Japanese encephalitis  Oropouche  Western equine encephalitis  Venezuelan equine encephalitis  Onchocerciasis

Example: The Complexity of Disease Spread - Dengue Fever  Vast difference in the amount of Dengue in Nuevo Laredo, Mexico and Laredo, Texas  Dengue Fever is called “breakbone fever”  Americans stay indoors and have air conditioning  Public places in Mexico are not likely to be air conditioned and are open to the elements

The Human Response Housing Housing Air conditioning Air conditioning Pesticides in the environment Pesticides in the environment Bug spray on people Bug spray on people Drainage Drainage Immunizations Immunizations Netting Netting Release predator insects and sterile mates Release predator insects and sterile mates

Leishmaniasis Skin lesion like bump or ulcer Heals spontaneously or smolders for years Destructive changes in nose or throat Disfiguring Other form is visceral leishmaniasis Fever, anemia, weakness, emaciation, enlarged liver, spleen, death

Leishmaniaisis Transmission

Leishmaniasis

Leishmaniasis in Germany

Global Warming and Public Health