Analyses of the Effects of Global Change on Human Health and Welfare and Human Systems Page: 47
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Analyses of the Effects of Global Change on Human Health and Welfare and Human Systems
may increase the geographic range and disease
burdens of Vibrio pathogens (e.g., Lipp et al.,
2002). For example, increasing prevalence and
diversity of Vibrio species has been noted in
northern Atlantic waters of the United States
coincident with warm water (Thompson et al.,
2004). Additionally, although most cases of V.
vulnificus infection are attributed to Gulf Coast
states, this species recently has been isolated
from northern waters in the United States
(Pfeffer et al., 2003; Randa et al., 2004).
The most striking example of an increased
range in pathogen distribution and incidence
was documented in 2004, when an outbreak of
shellfish-associated V. parahaemolyticus was
reported from Prince William Sound in Alaska
(McLaughlin et al., 2005). V parahaemolyticus
had never been isolated from Alaskan shellfish
before and it was thought that Alaskan waters
were too cold to support the species (McLaughlin
et al., 2005). In the period preceding the July
2004 outbreak, water temperatures in the
harvesting area consistently exceeded 15 C
and the mean daily water temperatures were
significantly higher than in the prior six years
(McLaughlin et al., 2005). This outbreak
extended the northern range of oysters known to
contain V. parahaemolyticus and cause illness
by 1,000 km. Given the well-documented
association between increasing sea surface
temperatures and proliferation of many Vibrio
species, evidence suggests that increasing
global temperatures will lead to an increased
burden of disease associated with certain
Vibrio species in the United States, especially
V. vulnificus and V. parahaemolyticus.
Protozoan parasites, particularly
Cryptosporidium and Giardia, contribute
significantly to water-borne and to a lesser
extent food-borne disease burdens in the United
States. Both parasites are zoonotic and form
environmentally resistant infective stages, with
only 10-12 oocysts or cysts required to cause
disease. In 1998, 1.2 cases of cryptosporidiosis
per 100,000 people were reported in the
United States (Dietz and Roberts, 2000); the
immunocompromised are at particularly high
risk (Casman et al., 2001; King and Monis,
2006). Between 2003 and 2004, of the 30
reported outbreaks of gastroenteritis fromrecreational water, 78.6 percent were due to
Cryptosporidium and 14.3 percent were due
to Giardia (Dzuiban et al., 2006). Giardia has
historically been the most commonly diagnosed
parasite in the United States. Between 1992
and 1997 there were 9.5 cases of Giardia per
100,000 people (Furness et al., 2000). Both
Cryptosporidium and Giardia case reports
peak in late summer and early fall, particularly
among younger age groups (Dietz and Roberts,
2000; Furness et al., 2000). For both parasites,
peak rates of reported infection in Massachusetts
occurred approximately one month after the
annual temperature peak (Naumova et al., 2006).
The lagged association between peak annual
temperatures and peaks in reported cases in
late summer has been attributed to increased
exposure during the summer bathing season,
especially in the younger age groups, and to a
slight lag in reporting (Dietz and Roberts, 2000;
Furness et al., 2000; Casman et al., 2001). With
increasing global temperatures, an increase
in recreational use of water can be reasonably
expected and could lead to increased exposure
among certain groups, especially children.
Naegleria fowleri is a free-living
amboeboflagellate found in lakes and ponds
at warm temperatures, either naturally or in
thermally polluted bodies of water. While
relatively rare, infections are almost always
fatal (Lee et al., 2002). N. fowleri can be
detected in environmental waters at rates
up to 50 percent (Wellings et al., 1977) at
water temperatures above 25C (Cabanes et
al., 2001). Cases are consistently reported in
the United States. Between 1999 and 2000,
four cases (all fatal) were reported. While
N. fowleri continues to be a rare disease, it
remains more common in the United States
than elsewhere in the world (Marciano-Cabral
et al., 2003). Given its association with warm
water, elevated temperatures could increase
this pathogen's range.
Epidemiologically significant viruses for food
and water exposure include enteroviruses,
rotaviruses, hepatitis A virus, and norovirus.
Viruses account for 67 percent of food-borne
disease, and the vast majority of these are due
to norovirus (Mead et al., 1999). Rotavirus
accounts for a much smaller fraction of viral
food-borne disease (Mead et al., 1999), but isa significant cause of diarrheal disease among
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U.S. Climate Change Science Program and the Subcommittee on Global Change Research. Analyses of the Effects of Global Change on Human Health and Welfare and Human Systems, book, September 2008; Washington, DC, USA. (https://digital.library.unt.edu/ark:/67531/metadc12033/m1/59/: accessed May 6, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; .