The Eastern Mediterranean (EM) basin, a heavily populated area, is highly sensitive to climatic changes. The region, from the Iskenderun Bay in Turkey to the northeastern shoreline of the Sinai Peninsula, is unique in its climatic aspects, due to its location as the continental junction area between Europe, Africa, and Asia. As a result of this geographical position between different climatic influential areas, the region is highly sensitive to possible climate changes (IPCC, 2007). The millions of people along the EM are vulnerable to this warming trend in many aspects as water supply, crop yields, and human health.
One of the most disturbing impacts of the temperature increase is on human health in various complex ways: increased mortality and morbidity as a result of exposure to extreme heat; increased diseases and injuries due to more frequent and intense extreme weather events (floods, windstorms, droughts); increased diarrheal diseases and other food-and water-related diseases, among other health influences.
During the last decades, the summers in the EM became warmer (Zhang et al., 2005) with an increase in the frequency and the severity of heat waves. In the last 15 years, the region has been affected by the warmest weathers on record (Paz, 2006; Paz et al., 2007). Indeed, recent work by El-Zein et al. (2004) that investigated the linkage between mortality and air temperature variation in Greater Beirut, Lebanon, for the period between 1997 and 1999 showed that a rise of 1°C in temperature yielded a significant increase in mortality. These findings suggest that at regions with moderate to high temperatures such as the EM countries, heat-related mortality can be a significant public health concern.
Temperature increase may have important and far-reaching effects on infectious diseases, especially those transmitted by poikilothermic arthropods as mosquitoes and ticks. Climate change may affect the survival and reproduction of the pathogen or the vector, time of year and level of vector activity, and the rate of development and reproduction of the pathogen within the vector (Patz et al., 2003). Temperature-related changes in the life cycle dynamics of both the vector species and the pathogenic organisms would increase the potential transmission of vector-borne diseases. There are indications that the warming tendency in the EM is impacting the transmission of infectious diseases. For example, in a recent study Paz et al. (2007) investigated the linkage between local climate change and an ongoing outbreak of Vibrio vulnificus disease in Israel since 1996. The survival of this water-borne pathogen is dependent on salinity and temperature. Lag correlation analysis revealed significant correlations between temperature values and hospital admission dates. The authors speculated that an extreme rise in daily temperatures at the beginning of the summer might predict larger V. vulnificus populations in fish ponds water.
Another issue is the impact of warming on mosquitoes. Since many mosquitoes and the diseases they carry are sensitive to temperature increase, the potential transmission of many vector-borne diseases carried by mosquitoes, such as malaria, dengue fever, and West Nile virus (WNV), may be increased by the influence of global warming, since the temperatures are related to the life-cycle dynamics of both the vector species and the pathogenic organisms. Warming of the mosquito environment boosts their rates of reproduction and number of blood meals, prolongs their breeding season, and shortens the maturation period for the microbes they disperse (Pats et al., 2003; Epstein, 2005).
Accordingly, this chapter aims to demonstrate the linkage between temperature increase over the EM and West Nile virus outbreaks by focusing on a recent case study from Israel.
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