Abstract

Background:

This paper represents, to our knowledge, the first national-level (United States) estimate of the economic impacts of vibriosis cases as exacerbated by climate change. Vibriosis is an illness contracted through food- and waterborne exposures to various Vibrio species (e.g., nonV. cholerae O1 and O139 serotypes) found in estuarine and marine environments, including within aquatic life, such as shellfish and finfish.

Objectives:

The objective of this study was to project climate-induced changes in vibriosis and associated economic impacts in the United States related to changes in sea surface temperatures (SSTs).

Methods:

For our analysis to identify climate links to vibriosis incidence, we constructed three logistic regression models by Vibrio species, using vibriosis data sourced from the Cholera and Other Vibrio Illness Surveillance system and historical SSTs. We relied on previous estimates of the cost-per-case of vibriosis to estimate future total annual medical costs, lost income from productivity loss, and mortality-related indirect costs throughout the United States. We separately reported results for V. parahaemolyticus, V. vulnificus, V. alginolyticus, and “V. spp.,” given the different associated health burden of each.

Results:

By 2090, increases in SST are estimated to result in a 51% increase in cases annually relative to the baseline era (centered on 1995) under Representative Concentration Pathway (RCP) 4.5, and a 108% increase under RCP8.5. The cost of these illnesses is projected to reach $\$5.2\text{\hspace{0.17em}billion}$ annually under RCP4.5, and $\$7.3\text{\hspace{0.17em}billion}$ annually under RCP8.5, relative to $\$2.2\text{\hspace{0.17em}billion}$ in the baseline (2018 U.S. dollars), equivalent to 140% and 234% increases respectively.

Discussion:

Vibriosis incidence is likely to increase in the United States under moderate and unmitigated climate change scenarios through increases in SST, resulting in a substantial burden of morbidity and mortality, and costing billions of dollars. These costs are mostly attributable to deaths, primarily from exposure to V. vulnificus. Evidence suggests that other factors, including sea surface salinity, may contribute to further increases in vibriosis cases in some regions of the United States and should also be investigated. https://doi.org/10.1289/EHP9999a

中文翻译：

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检查美国气候变化与弧菌病之间的关系：21 世纪预计的健康和经济影响

摘要

背景：

据我们所知，本文代表了第一次国家级（美国）对因气候变化而加剧的弧菌病病例的经济影响的估计。弧菌病是一种通过食源性和水源性暴露于河口和海洋环境（包括贝类和有鳍鱼类等水生生物）中发现的各种弧菌（例如，非霍乱弧菌O1 和 O139 血清型）而感染的疾病。

目标：

本研究的目的是预测气候引起的弧菌病变化以及美国与海面温度 (SST) 变化相关的经济影响。

方法：

为了通过分析确定气候与弧菌病发病率的联系，我们使用来自霍乱和其他弧菌疾病监测系统和历史 SST 的弧菌病数据，按弧菌种类构建了三个逻辑回归模型。我们依靠先前对每例弧菌病成本的估计来估计未来每年的总医疗成本、生产力损失造成的收入损失以及全美与死亡率相关的间接成本。我们分别报告了副溶血性弧菌、创伤弧菌、溶藻弧菌和“弧菌”的结果。spp.”，鉴于每个人的相关健康负担不同。

结果：

到 2090 年，在代表性浓度途径 (RCP) 4.5 下，估计 SST 的增加将导致病例数相对于基线时代（以 1995 年为中心）每年增加 51%，在 RCP8.5 下增加 108%。这些疾病的费用预计将达到$\$5.2\text{\hspace{0.17em}十亿}$每年根据 RCP4.5，和$\$7.3\text{\hspace{0.17em}十亿}$每年根据 RCP8.5，相对于$\$2.2\text{\hspace{0.17em}十亿}$在基线（2018 美元）中，分别相当于 140% 和 234% 的增长。

讨论：

在适度和未缓解的气候变化情景下，通过增加 SST，美国的弧菌病发病率可能会增加，从而导致发病率和死亡率的沉重负担，并造成数十亿美元的损失。这些成本主要归因于死亡，主要是由于接触创伤弧菌。有证据表明，包括海面盐度在内的其他因素可能导致美国某些地区的弧菌病病例进一步增加，因此也应进行调查。https://doi.org/10.1289/EHP9999a