title: A decision support tool to compare waterborne and foodborne infection and/or illness risks associated with climate change.
abstract: Climate change may impact waterborne and foodborne infectious disease, but to what extent is uncertain. Estimating climate-change-associated relative infection risks from exposure to viruses, bacteria, or parasites in water or food is critical for guiding adaptation measures. We present a computational tool for strategic decision making that describes the behavior of pathogens using location-specific input data under current and projected climate conditions. Pathogen-pathway combinations are available for exposure to norovirus, Campylobacter, Cryptosporidium, and noncholera Vibrio species via drinking water, bathing water, oysters, or chicken fillets. Infection risk outcomes generated by the tool under current climate conditions correspond with those published in the literature. The tool demonstrates that increasing temperatures lead to increasing risks for infection with Campylobacter from consuming raw/undercooked chicken fillet and for Vibrio from water exposure. Increasing frequencies of drought generally lead to an elevated infection risk of exposure to persistent pathogens such as norovirus and Cryptosporidium, but decreasing risk of exposure to rapidly inactivating pathogens, like Campylobacter. The opposite is the case with increasing annual precipitation; an upsurge of heavy rainfall events leads to more peaks in infection risks in all cases. The interdisciplinary tool presented here can be used to guide climate change adaptation strategies focused on infectious diseases.
authors.affiliation: National Institute of Public Health and the Environment, P.O. Box 1, 3720, BA, Bilthoven, the Netherlands.
authors.forename: Jack
authors.initials: J
authors.lastname: Schijven
authors.forename: Martijn
authors.initials: M
authors.lastname: Bouwknegt
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: de Roda Husman
authors.forename: Saskia
authors.initials: S
authors.lastname: Rutjes
authors.forename: Bertrand
authors.initials: B
authors.lastname: Sudre
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Suk
authors.forename: Jan C
authors.initials: JC
authors.lastname: Semenza
mesh_terms: D057231:Climate Change; D003141:Communicable Diseases / Q000453:epidemiology* / Q000209:etiology; D003661:Decision Support Techniques; D004196:Disease Outbreaks; D005517:Foodborne Diseases / Q000453:epidemiology*; D006801:Humans; D012307:Risk Factors; D014871:Water Microbiology
keywords: Climate change; epidemiology; food and waterborne diseases; quantitative microbial risk assessment