Creepy Crawlies & Climate Change at the CDC
Climate change is forcing mosquitoes, ticks, fleas and the diseases they carry to new climates. The Center for Disease Control has the opportunity to use technology and improved operations to ensure that it's ready to handle whatever bugs may migrate north over the coming years.
Even if you’re a fan of tropical climates, you’ll likely agree that mosquitoes and ticks are an unpleasant side effect of warm temperatures. Unfortunately for bug magnets like me, climbing global temperatures mean that even Massachusetts will be seeing a lot more mosquitoes throughout the year. With these nasty biters come a host of vector-borne diseases like malaria, dengue fever, chikungunya and Zika. Government organizations like the Center for Disease Control have to start thinking about how they’ll prepare for increased outbreaks of arboviruses – infections spread between humans by insect hosts.
Extreme events like Hurricane Katrina also increase a population’s vulnerability to these diseases, so as climate change boosts the frequency of quakes and storms the CDC needs to be ready to get boots on the ground.
A good way to get a sense of what the CDC is up against is the recent spread of Zika to the US. While this disease wasn’t spread because of global warming, research shows that Zika-like infections are going to become more common as temperature-sensitive insects like mosquitoes, fleas and ticks spread to new geographic areas6. While the CDC is trying to react, they won’t have the full funding they’ve requested until at least next year because of political infighting8. This shows the need to improve preventative measures and their ability to rapidly address to new threats.
The CDC needs to be able to understand, then respond, to the changing patterns of these kinds of diseases as changing climates nudge disease carriers farther north.
Understand It: Increase Funding for Basic Science & Forecasting
The CDC is aware of climate change as an issue for public health, and has published several reports about initial preparations, but it currently lacks the data infrastructure to anticipate and quickly assess new threats. Right now the CDC doesn’t have great surveillance or predictive models to keep a pulse on where infections are. The CDC should arm itself with better monitoring tools so it can move quickly in the future.
Tech can be leveraged to get the CDC to this goal. Creating a mosquito counting app, or tick bite reporting tool will provide real-time information about where the bugs are in the country. Sites like Topcoder or Codechef could then be used to create better algorithms to analyze this data and create great predictive models.
Population Protection: Invest in Infrastructure
In parallel, the CDC should invest in more infectious disease-focused testing and response centers across the country. In 2015 a mere 14 local Vector Control departments participated in the CDC’s Performance Improvement Initiative3, a pretty scary stat in light of the growing number of Lyme and West Nile infections in the US. The CDC does have a laboratory response network of 150 laboratories, but current backlogs in Zika testing are making it hard for people to figure out if they’ve been infected5.
This doesn’t bode well for future larger outbreaks, so the group needs to figure out a system of local operational excellence that will allow them to respond to highly variable testing and patient volumes. Mosquito control in the US also depends on a patchwork quilt of local municipalities9. Centralizing resources, best practices and creating a formal response plan might help the decentralized government centers the CDC relies on do a better job in the future.
Personal Protection: Engage the Public
Arbovirus prevention also depends on individuals protecting themselves from bites and managing mosquito populations by keeping their property mosquito-free.
Media coverage of Zika in the US presents an opportunity to create an awareness campaign about the importance of managing insect populations and supporting preventative investments. While the CDC is working to improve its communication and community outreach as part of the 2016 Zika Response Plan, more general awareness about the threat of tropical diseases will be necessary in a warmer world.
Creative public awareness efforts could help change the conversation from reactive to preventative measures. Linking the current fear of Zika to climate change through advertising and media coverage might help people understand that their energy choices are likely to result in more bug troubles in the future. The CDC might also work with its foundation arm to create more viral fundraising campaigns – perhaps Mosquito-vember or a Halloween themed tick and flea costume competition.
Perhaps most importantly, the resulting public focus on infectious disease will help the CDC win the funding it needs to protect the population with improved forecasting, surveillance and testing infrastructure, and continue to build awareness of the link between climate change and scary infectious diseases.
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Sources
- Gubler DJ. Resurgent Vector-Borne Diseases as a Global Health Problem. Emerg Infect Dis. 1998, Sep 11/3/2016
- Beard, C.B., R.J. Eisen, C.M. Barker, J.F. Garofalo, M. Hahn, M. Hayden, A.J. Monaghan, N.H. Ogden, and P.J. Schramm, 2016: Ch. 5: Vectorborne Diseases. The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment. U.S. Global Change Research Program, Washington, DC, 129–156. http://dx.doi.org/10.7930/J0765C7V
- “Vector Control Program Performance Assessment and Improvement Initiative.” Vector Control Program Performance Assessment and Improvement Initiative. N.p., n.d. Web. 03 Nov. 2016.
- Keim, Mark. “Building Human Resilience: The Role of Public Health Preparedness and Response as an Adaptation to Climate Change”. American Journal of Preventative Medicine. Vol. 35 Issue. 5 Nov 2008. http://www.sciencedirect.com.ezp-prod1.hul.harvard.edu/science/article/pii/S0749379708006879
- Rabin, Roni Caryn. “Want a Zika Test? It’s Not Easy.” New York Times, 9/19/2016.
- Beard, Ben. “How Climate Influences the Infectious Disease Landscape.” CDC Grand Rounds. 12/16/2014. http://www.cdc.gov/cdcgrandrounds/pdf/gr-climate-change-1216.pdf
- Cunrui Huang, Pavla Vaneckova, Xiaoming Wang, Gerry FitzGerald, Yuming Guo, Shilu Tong. “Constraints and Barriers to Public Health Adaptation to Climate Change: A Review of the Literature.” American Journal of Preventive Medicine, February 2011.
- Fox, Maggie. “Zika Funds Not Going Anywhere Until Next Year, HHS Says.” NBC News, 10/18/2016. http://www.nbcnews.com/storyline/zika-virus-outbreak/zika-funds-not-going-anywhere-until-next-year-hhs-says-n668481
- McKenna, Maryn. “Disorganized Mosquito Control Will Make US Vulnerable to Zika.” National Geographic Blog, 02/29/2016. http://phenomena.nationalgeographic.com/2016/02/29/zika-mosquito-control/
- Andrew K. Githeko, Steve W. Lindsay, Ulisses E. Confalonieri, & Jonathan A. Patz. “Climate change and vector-borne diseases: a regional analysis.” Bulletin of the World Health Organization, 2000 78.
- Sonia Altizer, Richard S.Ostfeld, PieterT.J. Johnson, Susan Kutz, C.Drew Harvell. “Climate Change and Infectious Diseases: From Evidence to a Predictive Framework.” ScienceMag 2013. www.sciencemag.org/special/climate2013
Hi Tatiana – great post! I really like your idea of leveraging technology to build apps and other consumer-facing platforms that can help track infections and mosquito outbreaks real-time. Everyone loves to hate on mosquitos during the summer, so tying a “mosquito counting” app into general summer announcements about wearing sunscreen, etc. could be a pretty easy way to get the app out.
Your post reminded me of a tactic that some countries are using to combat Zika: building mosquito armies that have been infected with a different bacteria that reduces their ability to spread viruses among human populations. The CDC could also (with appropriate funding) look into developing low-cost and efficient processes to build these mosquito armies quickly in response to new infections that might come to the U.S. Now is the time to figure out how to develop these armies efficiently and quickly so that as infectious disease trends begin to change more in response to climate change, the CDC is ready.
(see Zika article here: http://www.bbc.com/news/health-37773274)
Thanks Tatiana, great article. Coming from a place of knowing next to nothing about the topic, I’d be curious about the relationship between climate change and the migration of species (esp. insects) specifically w/r/t the volatility of weather vs. the overall average increase in temperatures. Given that ‘more extreme’ weather is also part of the climate change program (more storms, more rapid fluctuations in weather, less predictability), are northern regions potentially granted a temporary reprieve due to things like flash freezes and lower minimum seasonal temperatures that the migratory species are not used to and are unable to endure?
Tatiana, very interesting choice of subject. Though a thought jumps out – I’m all for innovative solutions to tackle this problem, but it wouldn’t be altogether a bad idea to take a page out of the books of countries and companies that have been dealing with this issue for decades. Interestingly enough, I have not seen a mosquito repellant in the large departmental stores in the US. Quite frankly, that would be step one. Following that would be pumped up R&D in the same field to make better products on the same lines. The key is to get rid of the mosquitos, isn’t it?
Great post! As you point out, climate change will make it easier for certain organisms which carry infectious diseases to thrive in less common areas. I think the key point is that we need to consider outbreaks in a more global context, especially for diseases which can spread from person to person. Therefore, we need to consider the impact of diseases not only in the regions where mosquitoes thrive, but globally. To that extent I completely agree with you on the point about investing in infrastructure. I would expand that to say that we need to think about global infrastructure. In other words, how can we create systems which track infectious disease outbreaks and research on a global level to better protect and combat populations. Here are some interesting articles which touch on the need for a global pandemic response which links many of the related parties to create more effective responses to outbreaks.
“The Zika Virus: Pandemic Preparedness Is Needed Now!”
http://www.huffingtonpost.com/susan-blumenthal/the-zika-virus-pandemic-p_b_9959026.html
“The need for global R&D coordination for infectious diseases with epidemic potential”
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31152-7/fulltext?rss%3Dyes
This was a really great read Tatiana, thank you for sharing. Definitely one of the most unique and interesting ones out there, and a subject I hadn’t previously devoted any thought to!
If I’m not mistaken, the CDC’s Division of VectorBorne Diseases (DVBD) has partnered with several international governments in Latin America and the Caribbean (for Zika and Chikungunya) to provide subject matter knowledge and technical support during outbreaks. Do you think it would make sense for the CDC to assist more actively at the mitigatory stage itself by intervening to improve general conditions, disease identification and treatment at the regional sources of these VectorBorne Diseases outside of the United States? Perhaps this would serve as a powerful preventative mechanism given the CDC’s funding and technological expertise?