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WHO/SDE/OEH/04.01
© World Health Organization 2004
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Using climate to predict disease outbreaks: a review

Using climate to predict infectious disease outbreaks cover

  Contents

Preface

This document was written as guidance for the Department of Communicable Diseases Surveillance and Response (CSR), the Department of Protection of the Human Environment (PHE), and the Roll Back Malaria Department (RBM) on the potential of early warning systems based on climate variations to enhance global surveillance and response to epidemic-prone diseases.

CSR has a unique mandate to lead international efforts to achieve global health security. Its strategy has three components: to improve preparedness of member states by strengthening national surveillance and response systems; to contain known risks; and to respond to unexpected health events. PHE aims to achieve safe, sustainable and health-enhancing human environments, protected from biological, chemical and physical hazards and secure from the adverse effects of global and local environmental threats. Founded in 1998, Roll Back Malaria aims to halve the world's malaria burden by 2010. Its four main technical strategies are: prompt access to treatment, especially for young children; prevention and control of malaria in pregnant women; vector control; and prevention and containment of epidemics.

Knowledge of the interactions between climate and health date back to the time of Aristotle, but our understanding of this subject has recently progressed rapidly as technology has become more advanced. At the same time the ability to forecast weather (in terms of both accuracy and lead-times) has greatly improved in recent years, especially with the use of remote sensing. The increased accuracy of climate predictions, and improving understanding of interactions between weather and infectious disease, has motivated attempts to develop models which predict changes in the incidence of epidemic-prone infectious diseases. Such models are designed to provide early warning of impending epidemics which, if accurate, would be invaluable for epidemic preparedness and prevention.

This document evaluates the current and future potential of climate-based disease early warning as a means of improving preparedness for, and response to, epidemics. Based on the history of Early Warning Systems (EWS) development to date, the authors develop a conceptual framework for constructing and evaluating climate-based EWS. They identify the climate-sensitive diseases of major public health importance and review the current state of the art in climate-based modelling of these diseases, as well as future requirements and recommendations.

This document lays the foundation for future development of EWS that capitalize on new knowledge about the interaction between climate and infectious diseases, as well as improved capacity for forecasting climate. No large scale EWS is yet in place but for some diseases, such as malaria and Rift Valley fever, early warnings based on climatic conditions are beginning to be used in selected locations to alert ministries of health to the potential for increased risk of outbreaks and to improve epidemic preparedness. However, the use of such models is just beginning, and experience with their use is limited.

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This document evaluates the current and future potential of climate-based disease early warning as a means of improving preparedness for, and response to, epidemics. Based on the history of EWS development to date, the authors develop a conceptual framework for constructing and evaluating climate-based EWS. They identify the climate-sensitive diseases of major public health importance and review the current state of the art in climate-based modelling of these diseases, as well as future requirements and recommendations.

This document lays the foundation for future development of EWS that capitalize on new knowledge about the interaction between climate and infectious diseases, as well as improved capacity for forecasting climate. No large scale EWS is yet in place but for some diseases, such as malaria and Rift Valley fever, early warnings based on climatic conditions are beginning to be used in selected locations to alert ministries of health to the potential for increased risk of outbreaks and to improve epidemic preparedness. However, the use of such models is just beginning, and experience with their use is limited.

  • Developing and strengthening disease surveillance systems to produce the high-quality, long-term data needed for model development and testing.
  • Developing standard terminology and criteria for evaluating the accuracy of such models.
  • Inclusion of non-climatic influences in the models.
  • Making the models relevant to particular response decisions and to the particular needs of policy-makers.
  • Cost effectiveness analyses.

A number of models are in the pipeline, although more work is required before climate-based models can realize their full potential. This includes:

This joint CSR, PHE and RBM publication was prepared with the understanding that climate-based EWS, when fully developed, do have the potential to provide increased lead-times in which to implement epidemic prevention and/or control activities. Therefore their development should be encouraged, and both positive and negative experience of using such systems should be documented. It is only with experience that such systems will become useful tools.

Guenael Rodier
Director
Department of Communicable Disease Surveillance and Response
World Health Organization
Margaret Chan
Director
Department of Protection of the Human Environment
World Health Organization
Fatoumata Nafo-Traoré
Director
Roll Back Malaria Department
World Health Organization

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