Yellow fever virus outbreak in Brazil under current and future climate

Introduction:Yellow fever(YF)is primarily transmitted by Haemagogus species of mosquitoes.Under climate change,mosquitoes and the pathogens that they carry are expected to develop faster,potentially impacting the case count and duration of YF outbreaks.The aim of this study was to determine how YF virus outbreaks in Brazil may change under future climate,using ensemble simulations from regional climate models under RCP4.5 and RCP8.5 scenarios for three time periods:2011-2040(short-term),2041-2070(mid-term),and 2071-2100(long-term).Methods:A compartmental model was developed to fit the 2017/18 YF outbreak data in Brazil using least squares optimization.To explore the impact of climate change,temperature-sensitive mosquito parameters were set to change over projected time periods using polynomial equations fitted to their relationship with temperature according to the average temperature for years 2011-2040,2041-2070,and 2071-2100 for climate change scenarios using RCP4.5 and RCP8.5,where RCP4.5/RCP8.5 corresponds to intermediate/high radiative forcing values and to moderate/higher warming trends.A sensitivity analysis was conducted to determine how the temperature-sensitive parameters impacted model results,and to determine how vaccination could play a role in reducing YF in Brazil.Results:Yellow fever case projections for Brazil from the models varied when climate change scenarios were applied,including the peak clinical case incidence,cumulative clinical case incidence,time to peak incidence,and the outbreak duration.Overall,a decrease in YF cases and outbreak duration was observed.Comparing the observed incidence in 2017/18 to the projected incidence in 2070-2100,for RCP4.5,the cumulative case incidence decreased from 184 to 161,and the outbreak duration decreased from 21 to 20 weeks.For RCP8.5,the peak case incidence decreased from 184 to 147,and the outbreak duration decreased from 21 to 17 weeks.The observed decrease was primarily due to temperature increasing beyond that suitable for Haemagogus mosquito survival.Conclusions:Climate change is anticipated to have an impact on mosquito-borne diseases.We found outbreaks of YF may reduce in intensity as temperatures increase in Brazil;however,temperature is not the only factor involved with disease transmission.Other factors must be explored to determine the attributable impact of climate change on mosquito-borne diseases.