Climate and Dengue Transmission: Evidence and Implications

Climate change is one of the most important environmental changes populations will face in the coming decades. Understanding how it may affect human health and disease is complex and requires a thorough understanding of links between present climate and disease (Epstein 2005). Links between climate and diseases with various modes of transmission (vector-, water-, food-, soil-, and airborne) have been identified (Colwell and Patz 1998; Epstein 2001), with the strongest associations being between climate and mosquito-borne diseases (Ebi et al. 2005; Rogers and Randolph 2000; Small et al. 2003). Although widely held as the world’s most important arbovirus, only one review of potential climate change impacts on dengue virus (DENV) transmission has been published with a focus on tools currently used to establish climate–disease associations (Thai and Anders 2011). DENV is transmitted by Aedes genus mosquitoes, primarily Aedes aegypti and Aedes albopictus. Recent analysis indicates the that numbers of dengue fever (DF) cases may be as high as 400 million/year (Bhatt et al. 2013). Climate affects the DENV and vector populations both directly and indirectly (Gubler et al. 2001). Temperature influences vector development rates, mortality, and behavior (Christophers 1960; Rueda et al. 1990; Tun-Lin et al. 2000) and controls viral replication within the mosquito (Watts et al. 1987). Variability in precipitation influences habitat availability for Ae. aegypti and Ae. albopictus larvae and pupae. Temperature further interacts with rainfall as the chief regulator of evaporation, thereby also affecting the availability of water habitats. Indirectly, rainfall, temperature, and humidity influence land cover and land use, which can promote or impede the growth of vector populations. The incidence of DF has been associated with vegetation indices, tree cover, housing quality, and surrounding land cover (Troyo et al. 2009; Van Benthem et al. 2005). Climate change can also alter how humans interact with the land, altering its use and impacting mosquito population magnitude and species composition (Chang et al. 1997; Vanwambeke et al. 2007). Although empirical relationships have been identified between climate conditions, DF, and DENV vectors, causal relationships have not been firmly established, thus limiting our ability to assess intervention strategies. In order to evaluate the potential impacts of climate change and better prepare mitigation strategies, we examined the strength of the evidence supporting the complex relationships among Aedes mosquitoes, DENV, and weather and climate. We also explored the relative utility of statistical and process-based models and their ability to identify key associations between climate and disease and to predict and simulate DENV transmission under projected climate change conditions.