Is it safe to go into the sea? Climate change and vibrio bacteria

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Northern Europe represents the "crucible" of climate change - containing the fastest warming marine systems on Earth. There is a need to fully understand the role of climate change on this particular group of pathogens in this region and provide a cohesive understanding of factors driving disease transmission. This knowledge can used to improve current risk assessment tools (e.g. https://e3geoportal.ecdc.europa.eu/SitePages/Vibrio%20Map%20Viewer.aspx), but also in the development of relevant adaptation strategies. Once an understanding of the current role of climate change is determined then a number of scenarios for these infections in the future can be explored.Systems of epidemiology and surveillance for Vibrios are poor across Europe (e.g. unrecorded on the ECDC TESSY database). One of the key challenges for Aim 1 will be the systematic collection of vibrio incidence data taking advantage of our excellent links with surveillance centres across the EU. These data will be supplemented with structured literature searches for reported vibrio outbreaks and case reports. After collation and geolocation, relevant environmental data (e.g. sea surface temperature, precipitation, air temperature) will be obtained from ECMWF. As well as being associated with vibrio abundance, the latter 2 may also be associated with human behavior (e.g. sea bathing). The use of mobile phone geolocation data will be explored to assess risk exposure during "at risk" periods such as heatwave events. We will explore a range of statistical techniques, ranging from generalized linear models to generalized additive mixed models, to relate incidence data to weather.Aim 3 will utilize the statistical models from aim 1 to generate future projections for human illnesses associated with vibrios. Baseline projections will be compared to future projections using climate data from CMIP5. Uncertainty will be represented through simulations from a range of GCMs. The overall future burden of vibrios will depend upon other factors such as demographic change. Projections will be obtained from global data sources (e.g. World Bank Databank) as well as more localized sources if available. Another large unknown is how societies will adapt to this changing health risk. There are few early warning systems for vibrios in the Baltic, but we will explore the likely efficacy of these (e.g. warning signs, text alerts) should such systems be implemented. This will be achieved through a systematic review of related interventions such as water quality warning signs. The final output of the work will be an integrated assessment of the likely future vibrio risk across Europe and how this can be adapted to. A potential output could be a high resolution risk mapping tool for the Baltic that builds on data currently used for the ECDC Vibrio risk portal.This exciting project is wholly interdisciplinary and combines microbiology, climate sciences, epidemiology, social science and risk assessment.