date: Thu, 30 Jul 1998 10:14:35 +0000
from: Sari Kovats <sari.kovats@lshtm.ac.uk>
subject: Re: infectious disease, climate change
to: m.hulme@uea.ac.uk


Dear Mike,

I am sorry about this -- the document is now pasted in below. 

Sari

*************WELLCOME PROPOSAL**********************

1. Applicant: Anthony J McMichael
Co-applicant: Rosalind Stanwell-Smith (CDSC)
Co-applicant: Laura Rodrigues (LSHTM)

2. Institution: 	London School of Hygiene and Tropical Medicine, Keppel St, 
London 
			WC1E 7HT.

Source of institution's core funding: Higher Education Funding Council

3. Scientific Outline

Proposed start date: March 1999

Period requested: 24 months

Title: Assessment of the impact of recent climate change and climate 
variability on selected infectious diseases in Europe

Aims of the project (hypothesis to be tested and experimental objectives):

 Hypothesis: Changes in climate over the past two decades have affected 
the transmission, seasonality, or range of certain infectious diseases in 
Western Europe.

 Main objective: Given that changes in climate within Europe have occurred 
over the past two decades (with documented regional differences), to 
determine if there have been accompanying changes in selected infectious 
diseases (e.g. water- and food-borne infections, including Campylobacter and 
Cryptosporidium). Two closely-related objectives are: a) to further develop 
research methods to detect and characterise the impact of climate/weather 
on selected non-vector-borne infectious diseases in Europe; and b) in light of 
this research, and recent moves by European agencies to initiate surveillance 
of the potential health impacts of long-term climate change, to make 
appropriate recommendations.

Work which has led up to the project:

Prof. McMichael has played a leading role internationally in defining and 
developing the research strategies applicable to the assessment of current 
and future health impacts of climate change. Since 1993, he has chaired the 
scientific panel assessing this topic for the UN's Intergovernmental Panel on 
Climate Change. He has investigated the relationship between climate and 
malaria outbreaks in West Rajasthan, and, in a preliminary analysis with Dr 
Rodrigues, between weather events and cryptosporidiosis cases in the UK. Dr 
Rodrigues has extensive experience in developing research methods in the 
study of infectious diseases, and, in particular, food-borne and water-related 
diarrhoea in England. Dr Stanwell-Smith is an expert on surveillance data and 
has a particular interest in the surveillance of water-related diseases; she 
and Prof. McMichael are members of a recently-commissioned WHO Working 
Group on the early detection of health impacts of climate change in Europe. 

Experimental design and methods to be used in investigating the problem:

Global climate change (for which climate scientists have now adduced 
"discernible evidence") is a prime manifestation of world population growth, 
urbanisation, and increasing economic activity. Climate conditions and 
weather variations are important in the transmission of certain infectious 
diseases, and changes in climate can affect the seasonality and range of such 
diseases.

This study will use recent and ongoing infectious disease surveillance data to 
describe climate/health relationships and determine if these have been 
affected by recent changes in climate within Europe. From existing 
knowledge of how climatic factors (e.g. temperature) affect transmission, 
the potential future impacts of climate change on various tropical 
vector-borne disease patterns have been modelled by scientists elsewhere. 
However, there is a dearth of empirical evidence, particularly in 
temperate-zone countries, of how medium-term changes in climate might 
actually have begun to affect patterns of infection.

Design: The composite study will examine relationships between climate 
factors and infectious disease in the UK and other countries throughout 
Europe, including Scandinavia. Countries will be selected by the availability of 
data as well as to maximize contrasts in climates and rates of warming. Time 
series data of infectious disease cases will be obtained from national disease 
surveillance centres and regional networks. Appropriate geographical and 
temporal resolution will be used to aggregate data and link the datasets. 
Climate data will be obtained from the internationally prominent Climatic 
Research Unit, Univ. of East Anglia (Dr M Hulme). Observed warming and 
associated ecological impacts have been greatest at high latitudes, including 
Europe. Rainfall has increased at higher latitudes and spring is arriving earlier 
in Europe. Since climate change impacts would amplify, or add to, other 
ongoing trends that arise out of changes in human ecology and social 
behaviour, information will be obtained on confounding and interacting 
factors.


++++++++++++++++++++++++++
Sari Kovats
Research Fellow
Epidemiology Unit
Department of Epidemiology & Population Health
London School of Hygiene & Tropical Medicine
Keppel St
London WC1E 7HT
UK
Tel: +44 (0)171 927 2078
Fax: +44 (0)171 580 6897
email: s.kovats@lshtm.ac.uk
+++++++++++++++++++++++++++
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