Climate Change and Human Health Direct Health Impacts Climate-Induced Extreme Weather Events Climate-induced extreme weather events such as heavy rainfall and various types of floods and droughts affect health of populations by contributing to changes in mosquito abundance as well as contamination of water sources with faecal matter. Notwithstanding the fact that catastrophic flood events can lead to deaths and injuries, and respiratory and diarrhoeal diseases. Droughts also cause food shortages and in turn, to widespread famine and starvation of communities (Table 5). Indirect Health Impacts Table 6 presents the climate-sensitive vector-borne diseases. It can be observed that malaria has the highest likelihood of incidence with climate change. Malaria is caused by a parasite that is transmitted by the bite of P. falciparum mosquitoes. Other diseases that are transmitted by mosquitoes are dengue fever, yellow fever, and filariasis. Since mosquitoes are the vectors of most of the climate-sensitive vector-borne diseases, it is suggested that climate sensitivity of mosquitoes and the transmission link of diseases brought about by this vector can be studied. Table 7 presents the list of communicable diseases that have climate-epidemic relationship. Cholera and malaria show the highest association of disease outbreak with changes in climate. This was also reiterated in the study of Xu, et al in 2014.24 Data on Climate-Related Diseases Incidences in the Philippines Figure 4 shows the link between dengue cases and temperature change in the Philippines. Based on the graph, it is observed that as temperature increases, the number of cases of dengue also increases. Figure 5 shows the link between malaria cases and temperature change. Similarly, the number of cases of malaria also increases with temperature increase. Table 7. List of Communicable Diseases with Climate-Epidemic Relationship Disease Global Burden (1000 DALYs) Transmission Distribution Climate Epidemic Link Influenza 94 603 (all respiratory infections- only a fraction due to influenza) 61 966 (including diarrhoeal diseases) Air borne Worldwide Decreases in temperature (winter) associated with epidemics. A range of human-related factors is more significant. Food and waterborne Africa, Asia, Russian Federation, South America Malaria 46 486 Bite of female Anopheles mosquitoes Endemic in >100 tropics and subtropics countries and some temperature areas Meningococcal meningitis Dengue 6 192 (all meningitis) Air borne Worldwide 616 Bite of female Aedes mosquitoes Africa, Europe, South America, Southeast Asia, Western Pacific St. Louis Encephalitis NA North and South America Rift Valley fever Unquantified Bite of female Culex and Aedes mosquitoes Bite of female culicine mosquitoes Ross River virus Unquantified Bite of female culicine mosquitoes Australia and Pacific islands Murray Valley fever Unquantified Bite of female Culex mosquitoes Australia Increases in sea and air temperatures as well as El Niño events associated with epidemics. Sanitation and human behaviour are also important. Changes in temperatures and rainfall associated with epidemics. Many other locally relevant factors including vector characteristics, immunity, population movements, drug resistance, environmental changes, etc. Increases in temperature and decreases in humidity associated with epidemics. High temperature, humidity, and rainfall associated with epidemics in some areas. Non-climatic factors also have an important impact. High temperature and heavy rain associated with epidemic. Reservoir animal factors are also important. Heavy rains associated with onset of epidemic. Cold weather associated with end of epidemic. Reservoir animal factors are also important. High temperature and heavy precipitation associated with onset of epidemic. Host immune factors and reservoir animals are also important factors. Heavy rains and below average atmospheric pressure associated with epidemics. Cholera Sub-Saharan Africa Strength of temporal climate sensitivity ++ +++++ +++++ +++ +++ +++ +++ +++ +++ + Climate link is very weak ++ Climate plays a moderate role +++ Climate plays a significant role ++++ Climate is an important factor +++++ Climate is the primary factor in determining at least some epidemics, and the strength of the association between climate and disease outbreaks has been assessed on the basis of published quantitative (statistical) rather than anecdotal evidence. Adapted from Kuhn et al, 2005 25 VOL. 50 NO. 2 2016 ACTA MEDICA PHILIPPINA 95

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