“Global Climate Change and Extreme Weather Events: Understanding the Potential Contributions to the Emergence, Reemergence and Spread of Infectious Disease”
Influences of Migration and Population Mobility Institute of Medicine Monaco Hotel, Washington DC December 3-4, 2007
Douglas W. MacPherson MD, MSc(CTM), FRCPC Migration Health Consultants Inc. / McMaster University
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What is this presentation about? Human contribution to global climate change and extreme weather events: Related to mobility • People • Goods • Conveyances
Linking climate change and extreme weather events to: Adaptation • Mobility • Diversity of human health determinants • Prevalence gaps in disease
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New Orleans Repeats Mistakes as It Rebuilds
Many Houses Built in Areas Katrina Flooded Are Not on Raised Foundations By Peter Whoriskey, Washington Post Staff Writer. Thursday, January 4, 2007; Page A01
"It's terrifying: We're doing the same things we have in the past but expecting different results," said Robert G. Bea, a professor of civil engineering at the University of California at Berkeley and a former New Orleans resident who served as a member of the National Science Foundation panel that studied the city's levees.
Unlike many homes being rebuilt in the New Orleans area, this one is being put on a raised foundation. (By Ellis Lucia -- Timespicayune)
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Multiple layers of linkages: Human contribution to global climate change:
Related to mobility • People
Linking climate change and extreme weather events to:
Adaptation • Mobility
• Goods
• Diversity of human health determinants
• Conveyances
• Prevalence gaps in disease
Migration Health Consultants Inc. / McMaster University
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Global Climate Change and Infectious Diseases
Migration Health Consultants Inc. / http://www.who.int/globalchange/climate/en/ McMaster University
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Global Climate Change and Infectious Diseases
The human component of adaptation through mobility: Socio-economics Genetics & biology Behaviour Environmental
Migration Health Consultants Inc. / http://www.who.int/globalchange/climate/en/ McMaster University
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Global Climate Change and Infectious Diseases
The human contribution to climate change through mobility: People, Goods, Conveyances and the significance for infectious diseases Migration Health Consultants Inc. / http://www.who.int/globalchange/climate/en/ McMaster University
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History – Population Flows National Geographic News. Journey of Man
http://news.nationalgeographic.com/news/2002/12/photogalleries/journey_of_man/photo2.html
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What is the evidence? • Population mobility • Infectious diseases and • Global climate change and Extreme weather events
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Magnitude of International Mobility Annually: • 802 million international arrivals (2006) • 200 million permanent residents outside of their country of birth • 32.9 million persons of concern (UNHCR) • 50,000 smuggled and trafficked persons • 15,000 unaccompanied/separated children Migration Health Consultants Inc. / McMaster University
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Population Flows – Currently Major Migration Flows: 1960-75
Major Migration Flows: 1990s
4 x increase in volume as compared to 1960-75 Source: Population Action International 1994
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Source: Populati on Action Intern ational 1994
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International Arrivals 1950-2005
–
Magnitudes (people by destination) 900 800 700 600 Millions of 500 People 400 300 200 100 0
World Africa Americas Asia/Pacific Europe ME Asia 1950
1960
1970
1980
1990
2000
2005
Year
WTO data.
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Diversity of International Mobility
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What is the evidence? •
The contribution to climate change by greenhouse gases generated by fossil fuels and other human made gases – with a component of transportation (of goods and people by conveyances).
•
The extension of the boundaries of infectious disease zones by contiguous extension of ecological zones supporting vector or nonvector transmission of infectious diseases.
. . . Will not be addressed. Migration Health Consultants Inc. / McMaster University
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What is the evidence - 1? 1. The establishment of new zones of endemic
infectious diseases, or the “skip” pattern of diseases, introduced by mobile populations or importation of goods. 2. The precipitous and forced movement of people due to extreme and sudden weather events that result in new ecological niches that support infectious diseases.
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What is the evidence - 2? 3. The slowly evolving ecological impacts of environmental change that either force or attract population movement and the classical determinants of health. 4. The temporary movement of populations from low prevalence to higher infectious disease prevalence zones for humanitarian, business or recreational purposes.
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The establishment of new zones of endemic infectious diseases Examples: • Plague in India • Falciparum malaria in India • Cholera in Peru • SARS in Asia and Canada • Avian influenza • WNv • Lyme Disease Migration Health Consultants Inc. / McMaster University
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FDA lifts 2-week-old ban on most spinach after outbreak Only specific brands will now carry warning Lisa Leff, The Associated Press October 1, 2006
The recent outbreak is the 20th connected to leafy green vegetables - lettuce or spinach - since 1995, half of them linked to farms in central California's Salinas Valley. Investigators don't yet know how the greens linked to the current outbreak became tainted, and may never know for sure, Acheson said. Migration Health Consultants Inc. / McMaster University
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Peanut Butter Brand Is Recalled In China 10:52 AM, February 26th 2007
Inspectors in Beijing are recalling peanut butter imported from the United States that may be contaminated with salmonella. The state-run news agency Xinhua reported on the recall of 156 cases of "Peter Pan" and "Great Value" peanut butter. China's Ministry of Health was reportedly notified by the World Health Organization about the possibility of contamination. Migration Health Consultants Inc. / McMaster University
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Regional Origins of Immigrants to the United States, Selected Years Source: Immigration and Naturalization Service, 1998 Statistical Yearbook.
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The precipitous and forced movement of people Examples: • Water and food borne diseases • Vector borne diseases • Skin sepsis • “local” organisms: • Vibrio sp. • ARO Migration Health Consultants Inc. / McMaster University
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Water, food ... and then strippers 'There must be, like, 750,000 men in town . . . How can I not make money?‘ Rosie Dimanno. New Orleans. Oct. 2, 2005. 08:20 AM
So critical is the carnal business to the city's economy that even Mayor Ray Nagin dropped by a strip joint the other day, to see how things were shakin' (though he didn't go inside). The bacchanalia of the Big Easy is . . . why more than a few would like to see the whole metropolis re- invented, sanitized.
Bourbon St.’s relatively upscale Déjà Vu strip club, where the plan is “to show our appreciation for all the volunteer firefighters and the troops who came to our rescue.” LUCAS
OLENIUK/TORONTO STAR Migration Health Consultants Inc. / McMaster University
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The slowly evolving ecological impacts of environmental change Examples: Desertification / Migration Refugee Claimants: • TB in Europe, USA, & Canada • HIV/AIDS in Europe & Canada – adult & paediatric • Syphilis in Canada Migration Health Consultants Inc. / McMaster University
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African migrants 'left in desert' Friday, 7 October 2005, 15:03 GMT 16:03 UK
An aid agency says it has found more than 500 migrants abandoned in the Moroccan desert after being expelled from Spain's North African enclaves.
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The temporary movement of populations from low prevalence to higher infectious disease prevalence Examples: Predominately “sun destinations”/high prevalence • Malaria: risk in sub-Saharan Africa • Leptospirosis – Eco-tourism, Asia • STI’s/MDR: everywhere • Skin infections: leishmanisis, ARO Migration Health Consultants Inc. / McMaster University
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Figure 1 Malaria imported into the UK: 1977-2004 * CDR Weekly Current Issue: Volume 15 Number 22. Published on: 3 June 2005
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Figure 1 Malaria imported into the UK: 1977-2004 * CDR Weekly Current Issue: Volume 15 Number 22. Published on: 3 June 2005 Et h n ic it y, wh e re s ta te d White Britis h Othe r white Bla c k Afric a n Bla c k Ca ribbe a n Othe r bla c k India n s ub c o ntine nt S o uthe a s t As ia n Othe r As ia n
No o f c as e s 124 27 547 16 8
Re a s o n fo r t ra v e l Ne w e ntra nt to UK Vis iting frie nds a nd re la tive s UK c itize n living a bro a d Civilia n s e a /a ir
111 Britis h fo rc e s 3 9
Bus ine s s Fo re ign s tude nt in UK
Othe r e thnic ity 4 Ho lida y Fo re ign C a t e g o rie s – n o t o n vis ito r s t a n d a rd s u rv e illa n c e Childre n f o rm * vis iting Afric a n de s c e nt * 365 pa re nts As ia n de s c e nt Othe r * 71 Ethnic ity no t No t s ta te d Migration Health Consultants Inc. / s ta te d 331 To t a l
McMaster 16 16University To t a l
No o f c as e s 101
522 25 0 10 59 26 93 76
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Ottawa advises travellers to see a doctor about flu precautions Canadian Press Published: Saturday, November 26, 2005
OTTAWA -- Canadians planning to travel to countries affected by avian flu, including parts of Asia and eastern Europe, should consider seeing their doctor to discuss precautions, says the Public Health Agency of Canada. Migration Health Consultants Inc. / McMaster University
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By NEIL SYSON JULIE MOULT and NICK PARKER September 14, 2006 AIDS timebomb Everson Banda lured women for sex sessions at his holiday campsite caravan. The African asylum seeker — who was in Britain illegally and nicknamed himself Ace — bedded scores of women trippers and 13 co-workers in three seasons at the resort.
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Climate Change, Infectious Diseases and Mobility - A Complicated Issue • Population mobility – demographics/biometrics • Prevalence gaps of disease • Processes associated with migration – Regulated: immigration, refugees, humanitarian, travel – Unregulated: refugee claimants, smuggled/trafficked – Push/pull factors; including environmental
• Population and Public Health • Perceptions of Risk Migration Health Consultants Inc. / McMaster University
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So, . . .
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Global Climate Change and Extreme Weather Events: Infectious Diseases Knowledge
Complex
• creation • sharing
Threat to Risk • identification • assessment • management • harm • benefit Complicated Migration Health Consultants Inc. / McMaster University
Informed policy decision making
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Cargo plane crashes in Winnipeg, killing pilot Fri. Oct. 7 2005 6:35 AM ET CTV.ca News Staff
Although a Federal Express plane that crashed in Winnipeg Thursday was carrying potentially dangerous viruses. But this is the second accident involving potentially dangerous viruses in less than a year. In March a FedEx van carrying Ebola, hepatitis and tuberculosis was side-swiped in traffic. Migration Health Consultants Inc. / McMaster University
The Cessna 208 was flying from Winnipeg to Thunder Bay, Ont., when it went down.
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Thank You
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