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Responding to disease outbreaks in Europe
Editorial
Corbis
Global CO2 emissions: time to mitigate and adapt
For the IEA reports see http://www.iea.org For the Reyburn and colleagues’ study see Am J Trop Med Hyg 2011; 84: 862–869 For The Lancet Series on Health and Climate Change see http:// www.lancet.com/series/ health-and-climate-change For more on climate change see http://www.lancet.com/ climate-change
The latest statistics from the International Energy Authority (IEA) on global CO2 emissions should come as a shock. After a dip in global CO2 emissions with the recent economic downturn, they rebounded in 2010 to a record high of 30·6 Gigatonnes (Gt). This is only 1·4 Gt lower than the maximum annual level that the IEA have advised should be heeded by 2020 to avoid dangerous effects of climate change. If the present trend continues, this threshold will be crossed in 2012. Fatih Birol, Chief Economist at the IEA said that the data are a “wake up call”. But these words when applied to climate change seem to have an increasingly soporific effect—the public and politicians have ably demonstrated their ability to be unperturbed by such figures. The lack of an effective globally coordinated policy response means that the 2°C temperature-rise target agreed at the 2010 UN climate change talks in Cancun is likely to be missed. At this stage it would be foolish not to redouble efforts into strategies to adapt to the effects of climate change.
Predicting changes in disease occurrence due to change in climate is essential, and Rita Reyburn and colleagues’ study, published in the American Journal of Tropical Medicine and Hygiene is welcome. The researchers developed a model that uses climatic variables to predict cholera outbreaks. Such outbreaks are likely to become more frequent with global warming and robust models that governments can use to shape a response are a valuable tool. Cholera is only one of many diseases that will be affected by climate change, and predicting the effects of climate on disease should now be a priority for research funding. However, accurate prediction models are worth nothing by themselves. Governments around the world need to ensure that basic health-care needs are met and infrastructure is in place to rapidly deploy therapies in response to the changes in disease that climate change will bring. We can only hope that the policy responses are more effective in dealing with the outcomes of climate change than they have been with the causes. ■ The Lancet
Science Photo Library
Responding to disease outbreaks in Europe
See World Report page 1991
For more on the E coli outbreak see http://www.euro.who.int/en/ what-we-do/health-topics/ emergencies/internationalhealth-regulations/ehecoutbreak-in-germany
1978
The finger of blame for the serious outbreak of a new strain of enterohaemorrhagic Escherichia coli that has killed 22 people and made more than 2300 ill, mainly in Europe, has been pointed at several food sources. And, as of June 7, while the cause of the infection remains unclear, one thing is apparent: communication surrounding the outbreak has been haphazard at best, dismal at worst. On May 22, Germany first reported a substantial increase in patients with haemolytic uraemic syndrome and bloody diarrhoea caused by Shiga-toxin-producing E coli. 4 days later, health authorities in Hamburg (the outbreak’s epicentre) and Germany’s Robert Koch Institute said that a case-control study pointed to cucumbers, tomatoes, and leafy salads as possible culprits and they advised consumers to avoid these vegetables. On the same day, health authorities in Hamburg erroneously declared that cucumbers grown in Spain could be the source of the outbreak. Panic and confusion ensued, resulting in headlines about “killer cucumbers” and harsh decisions by some countries. Russia banned imports of fresh vegetables from the whole of the European Union on June 2. The United Arab Emirates and Qatar also issued import bans
for some European countries. Then, on June 5, agriculture officials in Germany’s northern state of Lower Saxony announced that locally grown bean sprouts could be the cause of the outbreak and advised Germans not to eat this vegetable. On June 7, however, Germany was unsure that bean sprouts were to blame. Coordination of the German public health response seems to have been utterly absent. But one should also ask: where was the European Centres of Disease Prevention and Control? Set up in 2005, the centre aims to work “in close collaboration with the Member States and the [European] Commission to promote the necessary coherence in the risk communication process on health threats”. From the public’s point of view, no visible collaboration seems to have taken place. The latest events in Germany point to a chronic predicament facing many European institutions. Although a European spirit of cooperation is welcome and apparent, its practice often falls far short of expectations. Once this immediate crisis subsides, there is a strong case for a European-wide review of national and continental responses to infectious disease outbreaks. Europe can do much better. ■ The Lancet www.thelancet.com Vol 377 June 11, 2011
Corbis
Global CO2 emissions: time to mitigate and adapt
For the IEA reports see http://www.iea.org For the Reyburn and colleagues’ study see Am J Trop Med Hyg 2011; 84: 862–869 For The Lancet Series on Health and Climate Change see http:// www.lancet.com/series/ health-and-climate-change For more on climate change see http://www.lancet.com/ climate-change
The latest statistics from the International Energy Authority (IEA) on global CO2 emissions should come as a shock. After a dip in global CO2 emissions with the recent economic downturn, they rebounded in 2010 to a record high of 30·6 Gigatonnes (Gt). This is only 1·4 Gt lower than the maximum annual level that the IEA have advised should be heeded by 2020 to avoid dangerous effects of climate change. If the present trend continues, this threshold will be crossed in 2012. Fatih Birol, Chief Economist at the IEA said that the data are a “wake up call”. But these words when applied to climate change seem to have an increasingly soporific effect—the public and politicians have ably demonstrated their ability to be unperturbed by such figures. The lack of an effective globally coordinated policy response means that the 2°C temperature-rise target agreed at the 2010 UN climate change talks in Cancun is likely to be missed. At this stage it would be foolish not to redouble efforts into strategies to adapt to the effects of climate change.
Predicting changes in disease occurrence due to change in climate is essential, and Rita Reyburn and colleagues’ study, published in the American Journal of Tropical Medicine and Hygiene is welcome. The researchers developed a model that uses climatic variables to predict cholera outbreaks. Such outbreaks are likely to become more frequent with global warming and robust models that governments can use to shape a response are a valuable tool. Cholera is only one of many diseases that will be affected by climate change, and predicting the effects of climate on disease should now be a priority for research funding. However, accurate prediction models are worth nothing by themselves. Governments around the world need to ensure that basic health-care needs are met and infrastructure is in place to rapidly deploy therapies in response to the changes in disease that climate change will bring. We can only hope that the policy responses are more effective in dealing with the outcomes of climate change than they have been with the causes. ■ The Lancet
Science Photo Library
Responding to disease outbreaks in Europe
See World Report page 1991
For more on the E coli outbreak see http://www.euro.who.int/en/ what-we-do/health-topics/ emergencies/internationalhealth-regulations/ehecoutbreak-in-germany
1978
The finger of blame for the serious outbreak of a new strain of enterohaemorrhagic Escherichia coli that has killed 22 people and made more than 2300 ill, mainly in Europe, has been pointed at several food sources. And, as of June 7, while the cause of the infection remains unclear, one thing is apparent: communication surrounding the outbreak has been haphazard at best, dismal at worst. On May 22, Germany first reported a substantial increase in patients with haemolytic uraemic syndrome and bloody diarrhoea caused by Shiga-toxin-producing E coli. 4 days later, health authorities in Hamburg (the outbreak’s epicentre) and Germany’s Robert Koch Institute said that a case-control study pointed to cucumbers, tomatoes, and leafy salads as possible culprits and they advised consumers to avoid these vegetables. On the same day, health authorities in Hamburg erroneously declared that cucumbers grown in Spain could be the source of the outbreak. Panic and confusion ensued, resulting in headlines about “killer cucumbers” and harsh decisions by some countries. Russia banned imports of fresh vegetables from the whole of the European Union on June 2. The United Arab Emirates and Qatar also issued import bans
for some European countries. Then, on June 5, agriculture officials in Germany’s northern state of Lower Saxony announced that locally grown bean sprouts could be the cause of the outbreak and advised Germans not to eat this vegetable. On June 7, however, Germany was unsure that bean sprouts were to blame. Coordination of the German public health response seems to have been utterly absent. But one should also ask: where was the European Centres of Disease Prevention and Control? Set up in 2005, the centre aims to work “in close collaboration with the Member States and the [European] Commission to promote the necessary coherence in the risk communication process on health threats”. From the public’s point of view, no visible collaboration seems to have taken place. The latest events in Germany point to a chronic predicament facing many European institutions. Although a European spirit of cooperation is welcome and apparent, its practice often falls far short of expectations. Once this immediate crisis subsides, there is a strong case for a European-wide review of national and continental responses to infectious disease outbreaks. Europe can do much better. ■ The Lancet www.thelancet.com Vol 377 June 11, 2011