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

北欧是气候变化的“熔炉”，拥有地球上变暖最快的海洋系统。有必要充分了解气候变化对该地区这一特定病原体群的作用，并对推动疾病传播的因素提供一个连贯的理解。这些知识可用于改进当前的风险评估工具（例如https://e3geoportal.ecdc.europa.eu/SitePages/Vibrio%20Map%20Viewer.aspx），也可用于制定相关的适应战略。一旦了解了气候变化的当前作用，就可以探索未来这些感染的许多情况。整个欧洲弧菌的流行病学和监测系统很差（例如，未在ECDC TESSY数据库中记录）。目标1的主要挑战之一将是利用我们与欧盟各监测中心的良好联系，系统地收集弧菌发病率数据。这些数据将通过对报告的弧菌暴发和病例报告的结构化文献检索加以补充。经核对及定位后，有关的环境资料（例如海表温度、降水、气温）将由ECMWF获得。除了与弧菌丰度有关外，后两者还可能与人类行为（如海浴）有关。将探索使用移动电话地理定位数据来评估热浪事件等“危险”时期的风险暴露。我们将探索一系列统计技术，从广义线性模型到广义加性混合模型，将发病率数据与天气联系起来。目标3将利用目标1的统计模型对与弧菌有关的人类疾病作出未来预测。基线预估将与使用CMIP5气候数据的未来预估进行比较。不确定性将通过一系列gcm的模拟来表示。弧菌未来的总体负担将取决于其他因素，如人口变化。预测将从全球数据来源（例如世界银行数据库）获得，如果有的话也将从更局部的来源获得。另一个巨大的未知因素是社会将如何适应这种不断变化的健康风险。波罗的海弧菌的早期预警系统很少，但我们将探讨这些系统（例如警告标志、文本警报）的可能功效。这将通过系统地审查有关干预措施，如水质警告标志来实现。这项工作的最终成果将是对整个欧洲未来可能出现的弧菌风险以及如何加以适应的综合评估。一个潜在的输出可能是波罗的海的高分辨率风险绘图工具，该工具建立在目前ECDC弧菌风险门户网站使用的数据基础上。这个令人兴奋的项目完全是跨学科的，结合了微生物学、气候科学、流行病学、社会科学和风险评估。

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.