Global Warming Impact on Viral Diseases

Global Warming Impact on

Viral Diseases

Bruno Queirós (88480); Iria Freitas (88580); Carolina Pinto (88318); Sara Amorim (88436)
U.C.: Virologia
Docente: Daniela Ribeiro; Ana Rita Ferreira
Global Warming Impact on Viral Diseases

Introduction
Global Warming can be defined as a continuous increase in the surfaces’ temperature of the
Earth, mainly caused by the accumulation of atmospheric greenhouse gases derived from intense
human activities (1).
Over the years, there have been many discussions on the evolution and consequences of Global
Warming. It was established that a 2 ºC increase maximum should be considered the limit, in order to
avoid catastrophes worldwide. However, during the 21st century, various studies estimate the average
temperature of the Earth will rise between 1.8ºC and 4.0ºC. Therefore, it is possible to predict that the
consequences will arrive sooner than people expected them to (2)(3)(4).
Some of the major effects of this long-term rising temperature are climate changes, which
include longer periods of drought and heat waves, higher sea levels, loss of sea ice, shifted precipitation
patterns, faster wind, more frequent extreme weather events (EWEs), and an increased number,
duration and intensity of tropical storms (2)(3)(5)(6).
Several studies have concluded that some of these events can lead to a wide range of impacts
on plants, wildlife, and humans, especially when infectious diseases are involved, favoring their global
emergence and redistribution (7). Particularly, EWEs, such as hurricanes and floods, are highly
associated with outbreaks, whose timing and intensity are affected by changed daily-weather conditions
(6)(8)(9).
Despite the important role of all the pathogens in this matter, here we review some of the main
consequences that global warming brings to the transmission of viral diseases only, directly and
indirectly (10). And although all viruses, including plant (11), marine (12) and human viruses, play a
major role in managing the diversity and abundance of species(13), those that affect mainly human
health will be the priority in this monography.
The level of impact that climate changes have on the spread of viral diseases is closely related to
the mode of transmission of the various viruses. There are diseases which are usually transmitted
between humans only - anthroponoses - and others that are naturally transmitted from animals (the
reservoir) to humans - zoonoses. Interestingly, each one of these can spread through direct and indirect
contact, depending on whether they need a vector - such as blood-feeding arthropods (mosquitoes,
ticks, and fleas) - to transmit it to the host or not (Figure 1) (6)(14). It seems that the more variables
involved in the transmission of the disease, the greater the impact of climate changes. That is why
vector borne infectious diseases are the most sensitive ones, and have a special emphasis in several
studies (6)(9).
With these fundamental concepts in mind, in the next sections we are reviewing global warming
impacts on viruses, vectors and hosts, but never forgetting indirect factors that also influence viral
disease transmission.
Global Warming Impact on Viral Diseases

Figura 1 - Main transmission types of infectious diseases (15)

Impact of Global Warming in Viral Diseases

Climate changes due to global warming can influence spread of viral diseases as they affect
crucial factors for their survival, optimal growth, transport, and dissemination. The constant rising
temperature influences precipitation patterns, humidity levels and wind speed, affecting disease
transmission in a direct or indirect way. If they influence the survival, reproduction, and life cycle of
viruses and vectors, it is considered to be a direct impact, in contrast with the fact that if they affect the
habitat, environment or human behavior, it is an indirect one. Therefore, it is possible to consider not
only the quantity, but also the geographic and seasonal distributions of viruses, vectors and hosts that
can affect diseases’ propagation (6)(7)(16).

Global Warming and Virus

As all the other pathogens, viruses also have an ideal temperature range which allows them to
survive and develop properly, which means that either excessive heat or a temperature decrease may
compromise viral life cycle (7). Temperature is considered to be an intrinsic factor in virus stability (17),
as they are able to compromise the integrity of viral genomes (RNA or DNA) and the state of viral
proteins (16). Since RNA viruses are commonly less stable, they are the most affected ones. Delagneau,
J.-F. (1970) showed that, although supra-optimal temperatures intensify RNA polymerase’s activity,
genome’s translation is blocked, thus compromising the infection process (18). Vector-borne virus
extrinsic incubation period (EIP) - known as the viral replication and dissemination within the vector,
needed for it to become infectious - is also temperature-dependent (19)(20). Usually, proper higher
temperatures lead to a shortening of EIP, increasing instead the transmission potential, as it will be
mentioned later (20).
Global Warming Impact on Viral Diseases

It is important to highlight the fact that temperature and relative

humidity (RH) levels are closely related and interact to compromise the survival of some viruses, such as
air-borne, water-borne and vector-borne ones (16)(7). Contrary to temperature, RH is known as an
extrinsic factor (17), as it influences air-borne viruses’ transmission through aerosols (microscopic water
droplets). With low RH, aerosols can float, disperse and easily infect a host due to their loss of weight
and size throughout evaporation (21). RH effects will also depend on the type of viruses concerned. Low
RHs (20-30%) favor lipid enveloped viruses’ survival, such as influenza and coronaviruses (22)(23). In
contrast, adenoviruses and rhinoviruses, as they are non-lipid enveloped viruses, tend to endure higher
RHs (70–90%) (16)(24)(25)(26).

Human Influenza virus is one of the most common examples studied so far, whose transmission
has been proven to be temperature and humidity dependent (27). Lowen, A. C., et al (2007) was the first
to demonstrate that cold and dry conditions are advantageous for influenza survival, while recent
studies have deepened this concept (28). They suggest that 5°C and 20% - 35% RH, specifically, allow a
robust Influenza transmission (29). This may be due to the fact that, at low temperatures, protease
activity decreases and viral fusion within the cells to release the genome is inefficient; additionally,
droplets remain available in the air for longer periods of time at low RH. This means that infected
individuals, during cold and dry seasons, tend to increase the viral excretion of influenza, promoting its
spread (30). More recent studies revealed that, despite having its mRNA production intensified (31),
Influenza ribonucleoprotein complex’s exportation is inhibited by HSP70 (heat shock protein) at
excessively high temperatures (32), causing a blockage of viral replication (31). Besides, these climate
conditions also compromise viral replication processes by increasing the endosomal pH and reducing the
production of IL-6 (33). In theory, influenza virus would be easy to prevent and combat when human
populations were involved. Instead, seasonal influenza patterns vary a lot depending on the climate
zone - temperate, subtropical or tropical (29) - and the virus type - Influenza A or B (34).

Besides air-borne virus, vector-borne diseases can also be affected by temperature and
humidity. Thu. et al. (1998) reported that these two conditions were favorable for dengue’s propagation
in mosquitos (7).

Climate change also shifts the precipitation patterns. The alternance between drought and
heavy rainfall periods can influence the development of water-borne virus and potentiate their
dissemination (7). Rainy seasons can lead to flooding, which are currently known to be one of the main
causes of water-borne disease outbreaks, such as enterovirus and viral hepatitis (35)(36)(37). This is due
to the fact that heavy rain can resuspend pathogens from river sediments (38), mobilize them
horizontally from the soil to profound water bodies or suffer vertical transport, by surface runoff or soil
leakage, until they reach water courses (35). Droughts, on the other hand, usually lead to the
concentration of effluent viruses on reservoirs of drinking water (7)(36).

Lastly, increasing wind speed is a factor that influences mostly vectors, as it will be discussed
later, allowing them to reach hosts over long distances. However, it can also carry air-borne viruses
themselves through long-distances (7)(39).
Global Warming Impact on Viral Diseases

Global Warming and Vectors

Vectors are organisms that allow interaction of certain pathogens with hosts, playing a major
role in their transmission. Many of these organisms are ectothermic, which means that they do not have
the ability to thermoregulate themselves and, therefore, are easily affected by any change in
temperature. Even though the climatic impact has more drastic consequences on pathogens, infectious
diseases transmitted by vectors are the most affected by climate change (9)(40)(41).

Temperature may be the most impactful climate change with the most direct consequences on
vectors, manifesting itself mainly through more temperate winters and longer springs and autumns.
Recent data shows vector’s population growth by increased reproduction rates, as well as an increased
biting activity and a longer period of infectivity, following the rising temperature. On the other hand,
some vectors may have their infectivity limited, since pathogens cannot complete their EIP before their
vectors die. A more illustrative evidence was the outbreaks of dengue fever, Rift Valley fever, among
others, which were observed after El Nino. El-nino is an ocean-atmospheric phenomenon that occurs for
6 to 15 months every 4 years. Without going into detail, it consists of the atypical warming of the Pacific
Ocean, that consequently affects the atmospheric currents and causes years of drought (9)(41)(42).

Nevertheless, vectors can always resist and survive under adverse circumstances if they have
the capacity to seek and find refuge from extreme conditions and if that refuge offers good
opportunities for them to thrive. Accordingly, due to higher temperatures, there has been a shift in
vectors typical of regions lower in latitude, to higher latitude regions, amplifying their geographical
dominance and the distribution of diseases (41).

Of all vectors, temperature variations mainly affect mosquitos. For instance, currently, the most
worrying viral infectious diseases are mainly transmitted by two types of mosquito genus: Aedes and
Culex. Dengue, Zika, Chikungunya and Yellow fever are transmitted to humans by the same vector,
mosquito of genus Aedes. This mosquito flies best at temperatures between 15°C and 32°C, getting
stunted around 10°C. The urge to bite and fed is also bigger around 26°C to 35°C, dying in temperatures
higher than 40°C. Also Aedes aegypti larvae growth stops when the water from their breeding sites
exceeds 34 °C (41)(43). As for Culex pipiens, their development is possible between 8,4°C and 34,2°C,
however, 25°C is the most favorable temperature for their life cycle (44). This mosquito transmits viral
diseases such as West Nile virus (WNV), Saint Louis encephalitis virus (SLEV), Sindbis virus and Rift Valley
fever virus (RVFV). Central Macedonia exhibits all the necessities for transmission of WNV to humans.
However, in Europe, since 1960 there have been sporadic outbreaks, being one of the latest reports a
WNV case in Portugal, July 2010 (9).

In these two types of mosquitos, the female is accidentally responsible for the transmission of
diseases, since she obtains the blood nutrients to produce eggs by biting animals, such as birds, horses
or humans that can be infected. After this, the virus replicates in the epithelial cells of the mosquito's
intestine and through the basal lamina of the same cells, reaches the circulation and infects the vector's
salivary glands. When the EIP is completed, it can infect other hosts. Simultaneously, the female
Global Warming Impact on Viral Diseases

mosquito lays eggs in places capable of accumulating standing water, and after
four larva stages and one pupa stage, the newly formed adult emerges. The increase in transmission and
geographical areas of viral diseases transmitted by these vectors also depend on: the abundance of
mosquitos, the ability of the female to lay eggs in places capable of accumulating standing water, the
viruses’ replication rate in mosquito's epithelial cells; which are all influenced by climatic factors (45)
(46).

With the increasing temperatures, the adult female mosquito, feds of blood more frequently as
mentioned before, increasing the disease transmission; digest nutrients more quickly and produces
more eggs. Besides that, larval development of the mosquito accelerates. As mentioned above during
temperature influence on viruses, another consequence of this climate variable is the shortening of EIP
within the mosquito, which reduces the time needed for the mosquito to become an infectious
vector(43)(47).

Ticks can be great vectors as well. Due to higher temperatures in winter, therefore a milder
season, they have suffered some changes in their survival and reproduction rates, being able to increase
their coverage area, especially to more northern regions (41).

Precipitation is another environmental factor that should be evaluated. It can either increase or
decrease vector’s development, however, in most cases, when the temperature rises and it rains, it is
possible to observe a greater, and faster development. Precipitation can increase the rodent population
and expel them from their shelters, however it can negatively affect the growth of larvae, if their
breeding sites are flooded, washing out the mosquito eggs from the standing water reservoirs(47). On
the other hand, in case of drought or low precipitation, either an increase or decrease in the
development of vectors can also be observed. For instance, vectors that reproduce in clean, stagnant
water have fewer breeding sites available, but with the decrease in the flow of streams, rivers, etc.,
small pools of putrid water may be formed favoring the reproduction of some other vectors (9).

When it comes to other climate changes, even though their impact is not as direct and strong, it
is also necessary to address humidity and wind. As for humidity, evidence suggests that it affects the
survival and activity of mosquitos, shortening their life span and / or forcing them to move to atypical
areas, where they are not common to be found. Also, in these conditions the egg hatch rates increase
too. In addition, low levels of humidity and high temperatures are adverse for ticks and fleas, limiting
their ability of pathogens transmission. On another topic, the strong wind reduces the mosquitos' ability
and opportunities to bite, but increases the distance of their flight, expand their spatial distribution (7)
(43).

Global Warming and Hosts

Climate change can also affect the host's susceptibility. In humans’ particular case, infections can
be propitiated by alterations in the immune system caused by increase of UV radiation, but also, on a
Global Warming Impact on Viral Diseases

bigger scale, by the malnutrition that can arise with the environmental impact
in agriculture and in the contamination of the water reserves (9).

In addition to host’s susceptibility to infection, global warming can also affect the transmission
between hosts, like in the case of HIV in mother-to-child transmission (MTCT). There are various factors
that increase the risk of HIV infection in infants during the pregnancy, labor, delivery and breastfeeding,
but the most relevant of these are whether a woman receives and adheres to antiretroviral treatment,
since it is used to preserve maternal health and to prevent MTCT, and the increase of intake of breast
milk by the infants. Thus, this can lead to a higher amount of HIV virus that the infant is exposed to (48)
(49).

Regarding airborne infections such as Influenza, it is believed that temperature and humidity can affect
the host as much as the virus, augmenting its susceptibility to acquire the infection. Cold and dry air
affect the functionality of nasal epithelium and alter the mucociliary properties, inhibiting clearance
through a slower cellular metabolism, which reduce ciliary movements, mucous production and limit
phagocytosis. These conditions leave the lower respiratory tract more vulnerable to viral agents (50)
(29).

Moreover, an experimental study demonstrated that infected mice, when exposed to a high
ambient temperature of 36ºC, had an impaired adaptive immune response against the infection. They
failed to stimulate inflammasome-dependent cytokine secretion and respiratory dendritic cell migration
to lymph nodes. Additionally, heat-exposed mice also decreased their food intake and increased
autophagy in lung tissue. It was also shown a severely impaired virus specific CD8 T cells and antibody
responses following the infection. With the information of this study, we can conclude that outside
temperature, together with the consequent compromised nutritional status, controls the virus specific
adaptive immune responses (51).

Climatic Phenomena
Climate changes are being observed in the atmosphere, the ocean and, simultaneously with
anthropogenic economic exploitation, they also have negative impacts in the cryosphere by loss of ice
mass, affecting the permafrost. The permafrost serves as a natural reservoir of organic matter from
other eras, such as eggs or seeds, but it retains microorganisms too, like viruses, for instance. This layer
of the cryosphere can contain up to 108 cells/g, these cells being microbes that are dormant but
possibly able to be revived and set free. As proof, it was found a virus from the Geminiviridae family
preserved in 700-year-old caribou feces. This virus was well preserved and still presented infectivity
after all this time, however, it infects contemporary plants (Nicotiana benthamiana), that are not their
natural host.
Global Warming Impact on Viral Diseases

This raises the possibility of viruses set free from permafrost, posing a threat of infection to new
hosts such as humans. For this to occur the pathogen needs to adapt to the new host. Firstly, it begins
with an accidental infection, as the virus is exposed to different conditions from their former
environment and their level of virulence is unpredictable. Once infected successfully, the virus is still not
well adapted to the host so it will undergo some evolutionary changes, initially small alterations to adapt
and, over time, they will suffer other variations that allow them to reach an optimal virulence.

It is also important to have in mind that, even though these modifications occur, it does not
mean the virus will be more dangerous. For example, if a 1918 influenza virus re-emerged, most people
could be immune to it as current human flu viruses, which humans are acquainted to, are in part derived
from it. Therefore, ancient microbes coming once again to life are not necessarily something negative. In
addition, they can even be useful to create a bank of genes that subsequently can be used for
biomedical research, developing new vaccines, antibiotic drugs, and even cancer-fighting drugs.

Thus, there is a spatial movement of pathogens but, overtime, pathogens moving through time
can pose dangerous threats to the world as we know it (52).

As it was said earlier, long-term climate variations can lead to an increase of weather disasters’
frequency and intensity. Even though devastating floods, droughts, storms and hurricanes are hard to
predict and occur in very specific regions, historical evidence supports that these events are often
followed by infectious disease outbreaks (6)(53).
There may be a direct impact on vector populations. For example, floods, most common and well
documented natural disasters worldwide (54), can wash vectors away, but as standing water pools
become available breeding sites for mosquitos, it becomes clear that their propagation will increase (6).
In other scenarios, hurricanes can dramatically destroy their habitats, forcing them to migrate to other
places where they normally wouldn't be found and, consequently, placing new populations at risk (55).
These occurrences together with lack of vaccination and the population impacts of EWEs, such as social
chaos, excessive migration, crowding in emergency shelters, insufficient sanitary facilities, disruption of
healthcare services due to damage, under-nutrition, starvation and unavailability of safe drinking water,
can considerably increase the spread of opportunistic viral diseases (6)(53)(55).

Conclusion
In this review, we summarize what is known about the positive and negative impact of global
warming on the spread of viral infectious diseases.
Mild changes in the temperature, precipitation, and humidity, can influence the spread of viral
diseases directly affecting viruses, influencing their survival and replication rate, or indirectly, through
vectors, also affecting their survival, feeding, or even changing the timing of their life cycle. As for
hosts, there is a tendency to be more susceptible to infection and facilitate the transmission between
Global Warming Impact on Viral Diseases

themselves. Therefore, it is likely that diseases transmitted by vectors,

between hosts and/or spread by water or air, will become a major concern globally.
On the other hand, in case of more striking environmental events, such as heat waves, floods,
droughts, among others, there is contradictory information. These events seem to lead to a higher
incidence of viral diseases and a greater geographical coverage of vectors. However, the opposite can
also be true, generating a strong instability and imbalance between ecosystems that can lead to a
massive decrease in the vector's population. generating a strong instability and imbalance between
ecosystems that can lead to a massive decrease in the vector's population.
Ultimately, it seems that each place on earth will be affected by global warming differently, and,
therefore, viral diseases can increase in some areas and decrease in others. Thus, there should be more
research on this topic, to better predict the future patterns of these diseases. If each country has a
better understanding of what's to come, preventive measures can be taken, such as preparing
professionals in various areas or educating and alerting the population in order to avoid the emergence
or re-emergence of viral diseases and preventing, thereafter, a devastating impact on the population.

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