Climate change and human health in the Eastern Mediterranean and Middle East: Literature review, research priorities and policy suggestions.

Human health is linked to climatic factors in complex ways, and climate change can have profound direct and indirect impacts on the health status of any given region. Susceptibility to climate change is modulated by biological, ecological and socio-political factors such as age, gender, geographic location, socio-economic status, occupation, health status and housing conditions, among other. In the Eastern Mediterranean and Middle East (EMME), climatic factors known to affect human health include extreme heat, water shortages and air pollution. Furthermore, the epidemiology of vector-borne diseases (VBDs) and the health consequences of population displacement are also influenced by climate change in this region. To inform future policies for adaptation and mitigation measures, and based on an extensive review of the available knowledge, we recommend several research priorities for the region. These include the generation of more empirical evidence on exposure-response functions involving climate change and specific health outcomes, the development of appropriate methodologies to evaluate the physical and psychological effects of climate change on vulnerable populations, determining how climate change alters the ecological determinants of human health, improving our understanding of the effects of long-term exposure to heat stress and air pollution, and evaluating the interactions between adaptation and mitigation strategies. Because national boundaries do not limit most climate-related factors expected to impact human health, we propose that adaptation/mitigation policies must have a regional scope, and therefore require collaborative efforts among EMME nations. Policy suggestions include a decisive region-wide decarbonisation, the integration of environmentally driven morbidity and mortality data throughout the region, advancing the development and widespread use of affordable technologies for the production and management of drinking water by non-traditional means, the development of comprehensive strategies to improve the health status of displaced populations, and fostering regional networks for monitoring and controlling the spread of infectious diseases and disease vectors.

Transboundary determinants of avian zoonotic infectious diseases: challenges for strengthening research capacity and connecting surveillance networks.

As the climate changes, global systems have become increasingly unstable and unpredictable. This is particularly true for many disease systems, including subtypes of highly pathogenic avian influenzas (HPAIs) that are circulating the world. Ecological patterns once thought stable are changing, bringing new populations and organisms into contact with one another. Wild birds continue to be hosts and reservoirs for numerous zoonotic pathogens, and strains of HPAI and other pathogens have been introduced into new regions via migrating birds and transboundary trade of wild birds. With these expanding environmental changes, it is even more crucial that regions or counties that previously did not have surveillance programs develop the appropriate skills to sample wild birds and add to the understanding of pathogens in migratory and breeding birds through research. For example, little is known about wild bird infectious diseases and migration along the Mediterranean and Black Sea Flyway (MBSF), which connects Europe, Asia, and Africa. Focusing on avian influenza and the microbiome in migratory wild birds along the MBSF, this project seeks to understand the determinants of transboundary disease propagation and coinfection in regions that are connected by this flyway. Through the creation of a threat reduction network for avian diseases (Avian Zoonotic Disease Network, AZDN) in three countries along the MBSF (Georgia, Ukraine, and Jordan), this project is strengthening capacities for disease diagnostics; microbiomes; ecoimmunology; field biosafety; proper wildlife capture and handling; experimental design; statistical analysis; and vector sampling and biology. Here, we cover what is required to build a wild bird infectious disease research and surveillance program, which includes learning skills in proper bird capture and handling; biosafety and biosecurity; permits; next generation sequencing; leading-edge bioinformatics and statistical analyses; and vector and environmental sampling. Creating connected networks for avian influenzas and other pathogen surveillance will increase coordination and strengthen biosurveillance globally in wild birds.

Distribution of bat species in Western Asia: Occurrence records from the Western Asia Bat Research Network (WAB-Net) project.

Background: Western Asia represents a mixing pot of diverse bat species with distributions spanning across other geographic regions. Yet, relative to other regions, there is a significant gap in coordinated bat research in Western Asia, thereby resulting in a relatively limited number of curated occurrence records. New information: The Western Asia Bat Research Network (WAB-Net) project was created to strengthen research capacity and knowledge of the diversity and distribution of bat species in a little-studied region, as well as to collect data to characterise the diversity and prevalence of coronaviruses in diverse bat species. Over a four-year period (2018-2022), we documented 4,278 individual records for 41 bat species using a cross-sectional survey approach at 50 sites in seven Western Asian countries, specifically Armenia, Azerbaijan, Georgia, Jordan, Oman, Pakistan and Turkiye. At each site, we captured, on average, 90 individual bats (range: 9-131) over multiple consecutive nights and used standardised methods to collect demographic and morphological data from captured individuals. We additionally completed a systematic evaluation of environmental characterisation and human-bat interactions at all 50 sites. Here, we report individual occurrence records and site conditions from this multi-country, multi-year sampling effort.

Unconventional P-35S sequence identified in genetically modified maize.

The Cauliflower Mosaic Virus 35S promoter sequence, CaMV P-35S, is one of several commonly used genetic targets to detect genetically modified maize and is found in most GMOs. In this research we report the finding of an alternative P-35S sequence and its incidence in GM maize marketed in Jordan. The primer pair normally used to amplify a 123 bp DNA fragment of the CaMV P-35S promoter in GMOs also amplified a previously undetected alternative sequence of CaMV P-35S in GM maize samples which we term V3. The amplified V3 sequence comprises 386 base pairs and was not found in the standard wild-type maize, MON810 and MON 863 GM maize. The identified GM maize samples carrying the V3 sequence were found free of CaMV when compared with CaMV infected brown mustard sample. The data of sequence alignment analysis of the V3 genetic element showed 90% similarity with the matching P-35S sequence of the cauliflower mosaic virus isolate CabbB-JI and 99% similarity with matching P-35S sequences found in several binary plant vectors, of which the binary vector locus JQ693018 is one example. The current study showed an increase of 44% in the incidence of the identified 386 bp sequence in GM maize sold in Jordan's markets during the period 2009 and 2012.

The Prevalence of Aflatoxinogenic Aspergillus parasiticus in Jordan.

Aflatoxins are potent carcinogens and produced by almost all Aspergillus parasiticus isolates and about 35% of Aspergillus flavus isolates. Chemical methods are used for detection of aflatoxins in food and feed. These methods cannot detect aflatoxinogenic fungi in samples, which contain undetectable amounts of aflatoxins. The objective of this research work was to ascertain the importance of molecular and microbiological methods in detection of aflatoxinogenic fungus A. parasiticus in food and feed samples in Jordan. Specific media for the detection of aflatoxins showed the prevalence of A. parasiticus (6-22%) in contaminated food and feed samples. HPLC method confirmed the presence of aflatoxins B1, B2, G1, and G2 in food sample contaminated with A. parasiticus. Primer set OmtBII-F and OmtBII-R amplified DNA fragment of 611 base pairs from genomic DNA of aflatoxinogenic A. parasiticus isolated from food and feed samples but could not amplify DNA fragment of nonaflatoxinogenic A. flavus. The results of this study showed the prevalence of aflatoxinogenic A. parasiticus in food and feed samples in Jordan and give further evidence of suitability of microbiological and molecular methods in detection of aflatoxins, which are reliable low-cost approach to determine food and feed biosafety.