Page - 32 - in Biodiversity and Health in the Face of Climate Change

32 • Flooding and health Flood events are frequently associated with storms and landslips, which them- selves have high numbers of people directly affected, but there are also long-term and indirect impacts from events, such as increased exposure to disease (European Environment Agency 2017). There are numerous pathways through which health impacts are felt and they operate both during flood events and after them, frequently affecting people who have heightened sensitivity due to age or existing health sta- tus. Drowning, electrocution and other physical injury may lead to mortality during these events, as well as morbidity associated with injuries, illness from water-borne disease, carbon monoxide poisoning due to the use of generators and cardiovascular effects due the stress of being affected (Lowe et  al. 2013). Many of these morbidity factors are also associated with the period following flood events, which is sometimes long and exacerbated by displacement. Lack of power and water supply dispropor- tionately affects people with pre-existing illness and poor mobility and inhibits access to health and social care services, something that can be particularly impor- tant when essential medicines have been lost or contaminated (Fernandez et  al. 2002; Klinger et  al. 2014). • Emerging infections Infectious disease is inevitably influenced by human factors and mobility. However, redistributions of species through climatic change and climatic triggers are also recognised as having a key role in major events in history, such as the bubonic plague in Europe (Bonebrake et  al. 2018). Novel species assemblages are expected to be associated with new emergences in the future. See Müller et  al. (Chap. 4, this volume) for more on vector-borne diseases and climate change. • Impacts of extreme events on health services and social care In addition to differences in levels of demand for services, the services them- selves can be impacted, indirectly affecting physical health. Social, institutional and physical infrastructure systems are interconnected and impacts on one will affect how others are able to operate during heat waves, cold weather events and other climate-related hazards, for example affecting mobility/transport, storage/distribu- tion of medicines, the operation, reliability and efficiency of energy systems, avail- ability of fresh water and access to record systems (Curtis et  al. 2017). • Food- and water-borne disease and contamination There are known linkages between climate and the prevalence of food and water borne diseases. They include: campylobacter (seasonal, related to rainfall amounts/ timing and higher temperatures), salmonella (warmer temperatures and flooding, due to potential for contamination), listeria (humidity), vibrio (summer, brackish water), cryptosporidium (drinking/recreational water affected by heavy rain/flood- ing) and norovirus (winter, flooding/high rainfall) (European Environment Agency 2017). However, the likelihood of higher incidence rates depends on many other factors. For example, strong positive associations between elevated temperatures S. J. Lindley et al.