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

2. 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

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

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

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

6. 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

7. 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

8. 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

9. 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

10. Leishmaniaisis Transmission

11. Leishmaniasis

12. Leishmaniasis in Germany

13. Global Warming and Public Health