CLIMATE CHANGES

AND NEW EMERGING

DISEASES
Disampaikan Oleh :
Enny Nugraheni, dr, M. Biomed
Ilmu Kedokteran Komunitas 2016
Enviromental Medicine
Climate change and New emerging diseases are closely
related to the Environmental Medicine (EM)
EM is a discipline in diagnosing and caring for people
exposed to chemical and physical hazards at homes,
communities, workplaces through such media
contaminated soil, water, and air. (IOM, 1988)
Environment and Health

straw that broke the camels

back. (William Crook)
Definition of Climate change
The term "climate
change" is not referred
to all changes in the
earth's climate,
Earth's climate is never
static,
Imply a larger scale
change
Hand in hand with the
term global warming
 The Earth's climate is
fueled by the Sun.
Sun's energy, called solar
radiation absorbed
>reflected back
Human activities release
pollutants trap the Suns
energy (greenhouse effect)
The result global
warming global climate
change.
(EPA,1995)
Greenhouse Gas Emissions
non-reusable energy caused increased gas emissions into
the atmosphere.
Carbon dioxide (CO2), the worst greenhouse gas with a
76% distribution in earths atmosphere
methane (CH4), at 13%,
nitrous oxide (N2O), at 6% and
fluorocarbons (HCFC, HFC, PFC). running at 5%

(Hopwood, N. and Cohen, J.2009)

Mitigation
Climate change is a natural occurrence,
all part of nature + man made,
preventable to decrease the rate of change
small changes to our daily lives can reduce emission
levels and if enough of us make these changes, then we
can help -slow down global climate change save our
planet
Adaptation
the adoption of new behaviors that will help people cope
with environmental change
adaption strategies,
selecting farm animals with limited water or foliage requirements,
growing short season crops or drought and pest resistant crops,
changing irrigation techniques to reduce water requirements.
land reclamation and climate proofing

(National Adaptation Program of Action to Climate Change (2004)

Potential Impacts on Human Health

Increased global temperature,

rising sea levels, and
precipitation changes, with more extremes in weather,
expected to have ill effects on public health.
Increased morbidity, mortality, and displacement

(Mc Mitchel, 2006)

Rosemary Stephen, Elements: Environmental Health Intelligence
(2009)
Climate change and inequality
Storms will be more intense and flooding more common.
Higher temperatures will lead to heat-related illnesses.
Changes in rainfall amounts will lead to disruptions in the
global food supply.
Organisms that transmit viruses and other pathogens will
be able to infect people in larger geographic ranges.
Air pollution will trigger more respiratory diseases.
Climate change and inequality
Altering the basic human needs of food, clean water,
clean air, and shelter is likely to result in civil conflict.
Expected to have disproportionate effects on people.
Less access to health care will likely suffer more.
very young or very old are usually less able to cope with sudden
changes.
without wealth will be less able to respond to rapidly changing living
condition
Climate change and disease vectors
climate change is causing changes in
rainfall, temperature, humidity, air direction
effect on terrestrial and marine ecosystems
proliferation of disease vectors such as Aedes aegypti, malaria and
others.
behavioral factors and community participation is still
lacking
population growth and increased mobility of population
improved means of transportation
---- led to the spread of dengue virus more easily and
more widely.
Can we stop the change?
changes in surface temperature, rainfall, and sea level
are largely irreversible for more than 1,000 years after
carbon dioxide (CO2) emissions are completely stopped
increases in CO2 that occur in this century lock in a
sea level rise that would slowly follow in the next 1,000
years
(Solomon S, 2009)
Climate change and disease vectors
In 2009 the province of Jakarta was a province with the
highest incidence rate DHF (313 cases per 100,000
population),
NTT province with the lowest incidence rate DHF (8 cases
per 100,000 population).
There are 11 (33%) provinces, including in high-risk areas
(> 55 cases per 100,000 population),
Jakarta and East Kalimantan province always has been in
five provinces with the highest IR.
Jakarta always has the highest IR each year.

(Kemenkes, 2010)
Jakarta, High Incidence rate and rainfall
The influence of population density,
High population mobility and a better transportation
facilities than other areas,
so the spread of the virus becomes more easily and more
widely.
East Kalimantan (?)
not too densely populated, (12 people/km2 vs DKI Jakarta 13,344
people/km2).
the high rainfall year round and
the existence of the biological environment that caused mosquitoes
to breed more easily.
Rainfall and DHF
Availability of water in the media will cause mosquito eggs
to hatch and after 10-12 days will turn into a mosquito.
Mosquito bit with dengue virus then in 4-7 days and then
will be symptoms of dengue fever.
The time required from start to the rainy season until the
occurrence of dengue incidence is about 3 weeks
increased rainfall -decreased incidence of DHF in 7
provinces
(Thammapalo S et al, 2005)
Rainfall and DHF
RI not directly affects the breeding of mosquitoes, but the effect
on the ideal rainfall.
The ideal rainfall meaning that rain water not to cause flooding
and stagnant water in a container / media into the breeding
places of mosquitoes that are safe and relatively clean (for
example basins in bamboo fences, trees, tin cans, old tires,
roof or gutters home ).

The incident of DHF increase when;

the intensity of rainfall among 1500 mm to 3670 mm.
the temperature is between 220 C to 270C,
the humidity is at 85% to 87%.
indicates that the incidence of DHF is so responsive when
changes of temperature and humidity

Nurma Yussanti, 2005)

Emerging Diseases
Any newly discovered pathogen, diseases that have
spread to new or additional locations or different hosts, or
that have increased in occurrence.
Many of the recent emerging diseases of humans are
zoonotic diseases
diseases of animals that can be transmitted to humans
increasing the potential risk for individuals in close contact with
animals.
Influencing factors;
Naturally occurring (e.g., weather patterns, vectors, or wildlife) or
accidental (e.g., import, human activities)
Can be prevented by taking the proper precautions and
preparedness actions.
Emerging and Re emerging Zoonoses
Zoonoses; The diseases and infections which are
naturally transmitted between vertebrate animals and man
(WHO, 1959)
Emerging and re-emerging zoonoses: zoonotic diseases
caused either by totally new or partially new agents, or by
micro-organisms previously known, but now occuring in
places or in species where the disease was previously
unknown (WHO, 1992)
Emerging and re emerging Zoonoses
49% of the human pathogens are zoonotic
9% are emerging pathogens - 73% are zoonotic
Major factors;
Human demographic and behaviour
Technology and Industry
Economic development and land use
International Travel and commerce
Microbial adaptation and change
Breakdown of public health measures
Bioterorism
Emerging & Re-emerging diseases in
Indonesia

Indonesia is one of hotspot emerging diseases

Severe Acute Respiratory Syndrome (SARS)
Influenza A H5N1
Pandemic influenza A H1N1

(Coker et al; 2011)

Emerging & Re-emerging diseases in
Indonesia
Reemerging threat in areas of previous effective control;
Chikungunya (2010)
Dengue Fever
Rabies
HIV/AIDS
Leptospirosis
Tuberculosis

(Coker et al; 2011)