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Health Effect of Climatic Change: Malaysian Senarios. Dr Rozlan Ishak Environmental Health Unit Disease Control Division Ministry of Health Malaysia. Situations 50 years ago. Malaria was rampant in Malaysia 460,000 cases a year High mortality and morbidity
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Health Effect of Climatic Change: Malaysian Senarios Dr Rozlan Ishak Environmental Health Unit Disease Control Division Ministry of Health Malaysia
Situations 50 years ago • Malaria was rampant in Malaysia • 460,000 cases a year • High mortality and morbidity • Every parts of the country were under malaria • Even the Island of Penang has malaria • Some urban areas were free from malaria
Health problems • Water supply was inadequate. • Hygiene and sanitation was poor • Latrines were lacking in most parts of the country. • Bucket latrines was the style of the day. • Infectious disease such as cholera, typhoid, dysentery, worms infestation were very common. • Dengue is not a problem!
Mosquito borne diseases 50 years later
Water Borne Diseases 50 years later
Climate ChangeFacts ! Global Warming 2100
Climate change and health: pathway from driving forces, through exposures to potential health impact. Source: Climate Change and Human Health – Risks and Reponses. Summary (WHO, 2003)
Biologic response to changes in climate • Global warming and wider fluctuation in weather help to spread diseases • Temperatures – affect growth, development and survival of microbes and the vectors • Weather affects the timing and intensity of disease outbreaks (McMichael et al, 2003)
Biologic response to changes in climate: Infectious diseases • Warmer environment and mosquitoes • Boost rate of reproduction • Increase the number of blood meal • Prolongs their breeding season • Shorten the maturation period of microbes they carry
Heavy downpours • Drive rodents from burrows: risk of zoonotic diseases • Create mosquito breeding sites • Faster fungal growth in houses • Flush pathogens and chemicals into waterways • Milwaukee’s cryptosporidiosis outbreak in 1993 • Katrina’s flood 2005: water-borne pathogens and toxins spread. • Johor flood 2007 and leptospirosis
Common communicabale diseases sensitive to climate (WHO, 2004) • Climate is the primary factor in epidemic Cholera, Malaria • Climate plays significant role • Meningococcal meningitis, leishmaniasis, dengue, Japanese encephalitis, Rift valley fever, Ross river virus, St. Louis encephalitis, Murray valley fever
Infection & Climate: Potential impact on endemic diseases in Malaysia
Temperature, vectorial capacity of Ann. maculatus and projected number of malaria cases (Ambu et al. 2003)
Rainfall and dengue outbreak in Malaysia • Modification of Mogi et al. 1990 model • Study the threshold of rainfall actually required to trigger an outbreak • Dengue incidence and rainfall data in 1986-1997 • Model indicated relatively fewer raining days are required for high transmission • Heavy rain flushes off breeding habitats
What is our plans? Thank you rozlan@dph.gov.my