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Revista Portuguesa de Saúde Pública

versão impressa ISSN 0870-9025


ABRANTES, Patrícia  e  SILVEIRA, Henrique. Climate Change in Europe: Impact on human parasitic diseases. Rev. Port. Sau. Pub. [online]. 2009, vol.27, n.2, pp.71-86. ISSN 0870-9025.

The Earth’s climate is not constant and its natural changes obey to relatively well defined cycles. The abnormal increase that has recently been observed in temperature largely exceeds the natural climate changes from the last 1000 years. The most recent studies state that the causes of global warming are associated with the increase of anthropogenic emissions of greenhouse gases to the atmosphere. Future climate change scenarios indicate that the major impacts on Europe will be the increase of temperature, sea-level rise and higher frequency and intensity of extreme events, such as storms, heat waves, floods and droughts. In order to develop adaptation policies that allow an adequate prevention and minimize major climate change impacts it is fundamental to understand their impact on different sectors of society. Having in mind the importance to the human health sector, the aim of the present work was to review scientific literature in order to assess the impacts of climate change on human parasitic diseases in Europe. The main climate change impacts expected on health are associated with the occurrence of meteorological extreme events probably causing an increase of mortality, the intensification of air pollution with consequences on cardiorespiratory diseases, and the increase of infection diseases, especially water and vector-borne diseases. On the present work we focused on parasitic diseases that are estimated to suffer a more significant climate impact: Cryptosporidiosis, Malaria and Leishmaniasis. Following intense rainfall events and floods the risk of waterborne disease is estimated to increase mainly by Cryptosporidiosis outbreaks. Nevertheless, the good current sewage and public water supply conditions in Europe are expected to remain waterborne diseases at low risk. The risk of vectorborne diseases is also expected to increase due to vector geographic distribution changes and longer transmission seasons. The major concerns in Europe are focused on the potential re-introduction of Malaria on Eastern Europe, the introduction of Dengue vector on South of Europe, namely on Portugal, the increase of infection by Leishmania and on the increase of tick-borne diseases, like European Encephalite and Lyme disease. Due to a history of endemism and recent re-introduction in some Eastern Europe countries, Malaria is becoming a concern in Europe. It is expected that the Malaria risk of transmission increases on Eastern Europe and that «airport» Malaria cases increase on Western Europe. Due to current endemism situation of Visceral Leishmaniasis in the Mediterranean Region and global warming, the current limits of vector distribution and of the disease are expected to extend to North of Europe. Furthermore, this might be aggravated by the fact that Leishmaniasis is an opportunist infection among HIV patients. In Portugal it is estimated that air temperature will be the major determinant of endemic parasitic diseases whereas of non-endemic ones it will be the introduction of infected vectors. The current risk of Malaria transmission in Portugal is very low, and it is not expected to change in the near future, unless there would be a focal introduction of infected vectors. Leishmaniasis current risk of transmission in Portugal is medium. As both significant increase in days with favorable temperatures to vector survival and possible expansion of vector distribution in Portugal are expected, the risk of contracting Leishmaniasis may become higher in the country. Although the advances on reducing greenhouse gases emission achieved with Kyoto Protocol, this protocol will have low efficiency in avoiding the temperature increase of the next 50 years. Thus the development of adaptation policies to attenuate the negative impacts of climate change on human health is a major demand.

Palavras-chave : climate change; Europe; health; parasitic diseases; Malaria; Leishmaniose; Criptosporidiose.

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