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

北方代表着气候变化的“熔炉”--包含着地球上升温最快的海洋系统。有必要充分了解气候变化对该地区这一特定病原体群体的作用，并对推动疾病传播的因素有一个统一的认识。这一知识可用于改进现有的风险评估工具（如https：//e3geoportal.ecdc.europa.eu/SitePages/Vibrio%20Map%20Viewer.aspx），也可用于制定相关的适应战略。一旦对气候变化的当前作用的理解是确定的，那么这些感染在未来的情况下，可以探讨。弧菌的流行病学和监测系统是穷人在整个欧洲（例如，未记录在ECDC TESSY数据库）。目标1的主要挑战之一是利用我们与欧盟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进行补充。在核对和地理定位之后，将从欧洲中期天气预报中心获得相关的环境数据（例如海面温度、降水量、气温）。除了与弧菌丰度有关外，后者2也可能与人类行为（例如海水浴）有关。将探索使用移动的电话地理定位数据来评估热浪事件等“风险”期间的风险暴露。我们将探索一系列统计技术，从广义线性模型到广义相加混合模型，将发病率数据与天气联系起来。目标3将利用目标1中的统计模型来预测未来与弧菌相关的人类疾病。基线预测将与使用CMIP 5气候数据的未来预测进行比较。将通过一系列大气环流模型的模拟来表示不确定性。弧菌的总体未来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（如世界银行数据库）以及更多的地方性来源（如有）获得。另一个巨大的未知数是社会将如何适应这种不断变化的健康风险。在波罗的海，弧菌的早期预警系统很少，但我们将探讨这些（例如警告标志，文本警报）的可能功效，如果这些系统被实施。这将通过系统审查水质警告标志等相关干预措施来实现。这项工作的最终成果将是对整个欧洲未来可能的弧菌风险以及如何适应这一风险进行综合评估。一个潜在的产出可能是一个高分辨率的波罗的海风险绘图工具，该工具建立在目前用于经合组织弧菌风险门户网站的数据基础上，这一令人兴奋的项目是完全跨学科的，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.