Extreme precipitation, exacerbated by anthropogenic climate change, drove Peru's record-breaking 2023 dengue outbreak.

Anthropogenic forcing is increasing the likelihood and severity of certain extreme weather events, which may catalyze outbreaks of climate-sensitive infectious diseases. Extreme precipitation events can promote the spread of mosquito-borne illnesses by creating vector habitat, destroying infrastructure, and impeding vector control. Here, we focus on Cyclone Yaku, which caused heavy rainfall in northwestern Peru from March 7th - 20th, 2023 and was followed by the worst dengue outbreak in Peru's history.

Zika virus knowledge and vaccine acceptance among undergraduate students in Guayaquil, Ecuador.

Purpose: Zika virus (ZIKV) was declared a Public Health Emergency of International Concern (PHEIC) in 2016. Concerns surrounding the effects of ZIKV persist today and several vaccine candidates are currently in various stages of development worldwide. There is limited research on ZIKV vaccine acceptability worldwide, and little research specific to Latin American countries.

Climate predicts geographic and temporal variation in mosquito-borne disease dynamics on two continents.

Climate drives population dynamics through multiple mechanisms, which can lead to seemingly context-dependent effects of climate on natural populations. For climate-sensitive diseases, such as dengue, chikungunya, and Zika, climate appears to have opposing effects in different contexts. Here we show that a model, parameterized with laboratory measured climate-driven mosquito physiology, captures three key epidemic characteristics across ecologically and culturally distinct settings in Ecuador and Kenya: the number, timing, and duration of outbreaks.

Building resilience to mosquito-borne diseases in the Caribbean.

Small island developing states in the Caribbean are among the most vulnerable countries on the planet to climate variability and climate change. In the last 3 decades, the Caribbean region has undergone frequent and intense heat waves, storms, floods, and droughts. This has had a detrimental impact on population health and well-being, including an increase in infectious disease outbreaks.

Medically Attended Outpatient Coronavirus Infections in Ecuadorean Children During the 20 Months Preceding Countrywide Lockdown Related to the SARS-CoV-2 Pandemic of 2020.

Background: Human coronaviruses (HCoVs) cause respiratory tract infections during childhood manifesting as common colds, bronchiolitis, croup and pneumonia. In temperate geographies, HCoV activity peaks between December and March. The epidemiology and manifestations of HCoV infections have not been previously reported from Ecuador.

Spatiotemporal Tools for Emerging and Endemic Disease Hotspots in Small Areas: An Analysis of Dengue and Chikungunya in Barbados, 2013-2016.

Dengue fever and other febrile mosquito-borne diseases place considerable health and economic burdens on small island nations in the Caribbean. Here, we used two methods of cluster detection to find potential hotspots of transmission of dengue and chikungunya in Barbados, and to assess the impact of input surveillance data and methodology on observed patterns of risk. Using Moran's I and spatial scan statistics, we analyzed the geospatial and temporal distribution of disease cases and rates across Barbados for dengue fever in 2013-2016, and a chikungunya outbreak in 2014.

Co-developing climate services for public health: Stakeholder needs and perceptions for the prevention and control of Aedes-transmitted diseases in the Caribbean.

Background: Small island developing states (SIDS) in the Caribbean region are challenged with managing the health outcomes of a changing climate. Health and climate sectors have partnered to co-develop climate services to improve the management of emerging arboviral diseases such as dengue fever, for example, through the development of climate-driven early warning systems. The objective of this study was to identify health and climate stakeholder perceptions and needs in the Caribbean, with respect to the development of climate services for arboviruses.

A participatory community case study of periurban coastal flood vulnerability in southern Ecuador.

Background: Populations in coastal cities are exposed to increasing risk of flooding, resulting in rising damages to health and assets. Adaptation measures, such as early warning systems for floods (EWSFs), have the potential to reduce the risk and impact of flood events when tailored to reflect the local social-ecological context and needs. Community perceptions and experiences play a critical role in risk management, since perceptions influence people's behaviors in response to EWSFs and other interventions.

Seasonal and geographic variation in insecticide resistance in Aedes aegypti in southern Ecuador.

Insecticide resistance (IR) can undermine efforts to control vectors of public health importance. Aedes aegypti is the main vector of resurging diseases in the Americas such as yellow fever and dengue, and recently emerging chikungunya and Zika fever, which have caused unprecedented epidemics in the region. Vector control remains the primary intervention to prevent outbreaks of Aedes-transmitted diseases.

Socio-Ecological Factors Associated with Dengue Risk and Presence in the Galápagos Islands, Ecuador.

Dengue fever is an emerging infectious disease in the Galápagos Islands of Ecuador, with the first cases reported in 2002 and subsequent periodic outbreaks. We report results of a 2014 pilot study conducted in Puerto Ayora (PA) on Santa Cruz Island, and Puerto Baquerizo Moreno (PB) on San Cristobal Island. To assess the socio-ecological risk factors associated with dengue and mosquito vector presence at the household level, we conducted 100 household surveys (50 on each island) in neighborhoods with prior reported dengue cases.

Climate services for health: predicting the evolution of the 2016 dengue season in Machala, Ecuador.

Background: El Niño and its effect on local meteorological conditions potentially influences interannual variability in dengue transmission in southern coastal Ecuador. El Oro province is a key dengue surveillance site, due to the high burden of dengue, seasonal transmission, co-circulation of all four dengue serotypes, and the recent introduction of chikungunya and Zika. In this study, we used climate forecasts to predict the evolution of the 2016 dengue season in the city of Machala, following one of the strongest El Niño events on record.

The Social and Spatial Ecology of Dengue Presence and Burden during an Outbreak in Guayaquil, Ecuador, 2012.

Dengue fever, a mosquito-borne arbovirus, is a major public health concern in Ecuador. In this study, we aimed to describe the spatial distribution of dengue risk and identify local social-ecological factors associated with an outbreak of dengue fever in the city of Guayaquil, Ecuador. We examined georeferenced dengue cases ( = 4248) and block-level census data variables to identify social-ecological risk factors associated with the presence/absence and burden of dengue in Guayaquil in 2012.

Zika Virus Outbreak, Barbados, 2015-2016.

Barbados is a Caribbean island country of approximately 285,000 people, with a thriving tourism industry. In 2015, Zika spread rapidly throughout the Americas, and its proliferation through the Caribbean islands followed suit. Barbados reported its first confirmed autochthonous Zika transmission to the Pan American Health Organization in January 2016, a month before the global public health emergency was declared.

The Burden of Dengue Fever and Chikungunya in Southern Coastal Ecuador: Epidemiology, Clinical Presentation, and Phylogenetics from the First Two Years of a Prospective Study.

Here, we report the findings from the first 2 years (2014-2015) of an arbovirus surveillance study conducted in Machala, Ecuador, a dengue-endemic region. Patients with suspected dengue virus (DENV) infections (index cases, = 324) were referred from five Ministry of Health clinical sites. A subset of DENV-positive index cases ( = 44) were selected, and individuals from the index household and four neighboring homes within 200 m were recruited ( = 400).

Social-ecological factors and preventive actions decrease the risk of dengue infection at the household-level: Results from a prospective dengue surveillance study in Machala, Ecuador.

Background: In Ecuador, dengue virus (DENV) infections transmitted by the Aedes aegypti mosquito are among the greatest public health concerns in urban coastal communities. Community- and household-level vector control is the principal means of controlling disease outbreaks. This study aimed to assess the impact of knowledge, attitudes, and practices (KAPs) and social-ecological factors on the presence or absence of DENV infections in the household.

Outbreak of Zika Virus Infections, Dominica, 2016.

In February 2016, the World Health Organization declared the pandemic of Zika virus a public health emergency. On March 4, 2016, Dominica reported its first autochthonous Zika virus disease case; subsequently, 1,263 cases were reported. We describe the outbreak through November 2016, when the last known case was reported.

Climate Variability, Vulnerability, and Natural Disasters: A Case Study of Zika Virus in Manabi, Ecuador Following the 2016 Earthquake.

Climate change presents complex and wide-reaching threats to human health. A variable and changing climate can amplify and unmask ecological and socio-political weaknesses and increase the risk of adverse health outcomes in socially vulnerable regions. When natural disasters occur in such areas, underlying climatic conditions may amplify the public health crisis.

Declining Prevalence of Disease Vectors Under Climate Change.

More than half of the world population is at risk of vector-borne diseases including dengue fever, chikungunya, zika, yellow fever, leishmaniasis, chagas disease, and malaria, with highest incidences in tropical regions. In Ecuador, vector-borne diseases are present from coastal and Amazonian regions to the Andes Mountains; however, a detailed characterization of the distribution of their vectors has never been carried out. We estimate the distribution of 14 vectors of the above vector-borne diseases under present-day and future climates.

Knowledge, attitudes, and practices regarding dengue infection among public sector healthcare providers in Machala, Ecuador.

Background: Dengue fever is a rapidly emerging infection throughout the tropics and subtropics with extensive public health burden. Adequate training of healthcare providers is crucial to reducing infection incidence through patient education and collaboration with public health authorities. We examined how public sector healthcare providers in a dengue-endemic region of Ecuador view and manage dengue infections, with a focus on the 2009 World Health Organization (WHO) Dengue Guidelines.

Spatiotemporal clustering, climate periodicity, and social-ecological risk factors for dengue during an outbreak in Machala, Ecuador, in 2010.

Background: Dengue fever, a mosquito-borne viral disease, is a rapidly emerging public health problem in Ecuador and throughout the tropics. However, we have a limited understanding of the disease transmission dynamics in these regions. Previous studies in southern coastal Ecuador have demonstrated the potential to develop a dengue early warning system (EWS) that incorporates climate and non-climate information.

A social-ecological analysis of community perceptions of dengue fever and Aedes aegypti in Machala, Ecuador.

Background: The growing burden of dengue fever and the lack of a vaccine or specific medical treatment have increased the urgency of the public health sector to identify alternative management strategies. A prevailing trend in Latin America has been a shift towards decentralized vector control programs with integrated management strategies, requiring significant intersectoral coordination, community engagement, and knowledge of the local social-ecological system (SES). Community perceptions and responses are a critical component of this system, since perceptions shape actions, and thus govern behavioral responses and acceptance of shifts in policy and management.

Exploration of health risks related to air pollution and temperature in three Latin American cities.

This paper explores whether the health risks related to air pollution and temperature extremes are spatially and socioeconomically differentiated within three Latin American cities: Bogota, Colombia, Mexico City, Mexico, and Santiago, Chile. Based on a theoretical review of three relevant approaches to risk analysis (risk society, environmental justice, and urban vulnerability as impact), we hypothesize that health risks from exposure to air pollution and temperature in these cities do not necessarily depend on socio-economic inequalities. To test this hypothesis, we gathered, validated, and analyzed temperature, air pollution, mortality and socioeconomic vulnerability data from the three study cities.