Heavy weather events, water quality and gastroenteritis in Norway.

Climate change will lead to more extreme weather events in Europe. In Norway, little is known about how this will affect drinking water quality and population's health due to waterborne diseases. The aim of our work was to generate new knowledge on the effect of extreme weather conditions and climate change on drinking water and waterborne disease. In this respect we studied the relationship between temperature, precipitation and runoff events, raw and treated water quality, and gastroenteritis consultations in Norway in 2006-2014 to anticipate the risk with changing climate conditions. The main findings are positive associations between extreme weather events and raw water quality, but only few with treated drinking water. Increase in maximum temperature was associated with an increase in risk of disease among all ages and 15-64 years olds for the whole year. Heavy rain and high runoff were associated with a decrease in risk of gastroenteritis for different age groups and time periods throughout the year. No evidence was found that increase in precipitation and runoff trigger increased gastroenteritis outbreaks. Large waterworks in Norway currently seem to manage extreme weather events in preventing waterborne disease. However, with more extreme weather in the future, this may change. Therefore, modelling future climate scenarios is necessary to assess the need for improved water treatment capacity in a future climate.

The warm summer of 2018 - increased mortality among older people? / Varm sommer 2018 ­ økt dødelighet blant eldre?

BACKGROUND: Heatwaves in Europe and the USA have been shown to cause excess mortality among older persons. The summer of 2018 was unusually hot in south-eastern Norway. The purpose of this study was to investigate whether more older persons died that summer compared with the average for the previous ten summers. MATERIAL AND METHOD: Temperature data from the Norwegian Meteorological Institute and mortality data for the summer of 2018 (June, July and August), divided into age groups and counties, were compared to the previous ten summers. RESULTS: For Norway as a whole, there was no increase in mortality among persons more than 75 years and 85 years of age in summer 2018. None of the counties in south-eastern Norway stood out as having elevated mortality for persons more than 75 years of age, apart from Vest-Agder county. Three counties, among them Aust-Agder, had somewhat lower mortality than expected. INTERPRETATION: We are unable to show any increase in mortality among older persons in summer 2018 compared with the average for the period 2008-17. Due to climate change and prognoses of more frequent heatwaves, mortality should nevertheless be monitored and public warning systems considered.

Association between heavy precipitation events and waterborne outbreaks in four Nordic countries, 1992-2012.

We conducted a matched case-control study to examine the association between heavy precipitation events and waterborne outbreaks (WBOs) by linking epidemiological registries and meteorological data between 1992 and 2012 in four Nordic countries. Heavy precipitation events were defined by above average (exceedance) daily rainfall during the preceding weeks using local references. We performed conditional logistic regression using the four previous years as the controls. Among WBOs with known onset date (n = 89), exceedance rainfall on two or more days was associated with occurrence of outbreak, OR = 3.06 (95% CI 1.38-6.78), compared to zero exceedance days. Stratified analyses revealed a significant association with single household water supplies, ground water as source and for outbreaks occurring during spring and summer. These findings were reproduced in analyses including all WBOs with known outbreak month (n = 186). The vulnerability of single households to WBOs associated with heavy precipitation events should be communicated to homeowners and implemented into future policy planning to reduce the risk of waterborne illness.

Prevalence of tick borne encephalitis virus in tick nymphs in relation to climatic factors on the southern coast of Norway.

BACKGROUND: Tick-borne encephalitis (TBE) is among the most important vector borne diseases of humans in Europe and is currently identified as a major health problem in many countries. TBE endemic zones have expanded over the past two decades, as well as the number of reported cases within endemic areas. Multiple factors are ascribed for the increased incidence of TBE, including climatic change. The number of TBE cases has also increased in Norway over the past decade, and the human cases cluster along the southern coast of Norway. In Norway the distribution and prevalence of TBE virus (TBEV) in tick populations is largely unknown. The objectives of this study were to estimate the TBEV prevalence in Ixodes ricinus from seven locations and to assess the relationship between the TBEV prevalence and site-specific climatic variables. METHODS: A total of 5630 questing nymphs were collected and analyzed in pools of ten. All pools were screened with an in-house real-time RT-PCR, and the positive pools were pyrosequenced. Two methods, minimum infection rate (MIR) and a frequentist method (EPP) for pooled prevalence estimations were calculated and compared. Climatic data were descriptively compared to the corresponding EPP of each location in order to explain variations in TBEV prevalence. RESULTS: The seven foci of TBEV had an estimated overall prevalence (EPP) in pools of nymphs combined, of 0.53% with 95% CI (0.35-0.75), with point prevalence ranging between 0.11%-1.22%. The sites with the highest point prevalences were within the municipalities which had the highest numbers of registered TBE cases. The results indicate that the location with highest point prevalence had the highest relative mean humidity and lowest mean saturation deficit and vice versa for the lowest EPP. CONCLUSION: Our study confirms the existence of TBEV endemic foci in Norway. These results are of importance to increase the awareness of TBEV infections in Norway and could be used for public information and recommendations of TBE vaccination. EPP is the method of choice for pooled prevalence calculations, since it provides estimated prevalences with confidence intervals. Our findings emphasise the possible importance of microclimatic conditions regarding the TBEV prevalence in ticks.

Hair-loss epizootic in moose (Alces alces) associated with massive deer ked (Lipoptena cervi) infestation.

Deer keds (Lipoptena cervi) are blood-sucking flies in the family Hippoboscidae; moose (Alces alces) are their main host in Scandinavia. There are no detailed reports of the negative impacts of deer keds on moose. In 2006 and 2007, hunters in southeastern Norway and midwestern Sweden found several moose cadavers with severe alopecia; numerous moose had extensive hair loss. Between February 2006 and June 2007, materials from 23 moose were submitted for laboratory examination and large numbers of deer keds were found in the coat of most animals. The body condition of the moose varied but was poor in animals with severe alopecia. The findings of enormous numbers of deer keds in the coat of the majority of the affected animals and a consistent histologic image (acute to chronic, multifocal to coalescing, eosinophilic to lymphocytic dermatitis), concurrent with the absence of any other lesions, trace element deficiencies, or dermal infections which are known to cause alopecia, suggest that the hair-loss epizootic was linked to massive infestations with deer keds. The emergence of this hair-loss syndrome implies that the dynamics between parasite and host have been disrupted by a currently unknown environmental or ecological factor. A high moose density, combined with extraordinarily mild weather June 2006-June 2007 and a particularly long period with the absence of night-frost in autumn of 2006, may have been ideal for deer ked development, survival, and optimal host acquisition.

Spatial patterns and dynamic responses of arctic food webs corroborate the exploitation ecosystems hypothesis (EEH).

According to the exploitation ecosystems hypothesis (EEH), productive terrestrial ecosystems are characterized by community-level trophic cascades, whereas unproductive ecosystems harbor food-limited grazers, which regulate community-level plant biomass. We tested this hypothesis along arctic-alpine productivity gradients at the Joatka field base, Finnmark, Norway. In unproductive habitats, mammalian predators were absent and plant biomass was constant, whereas herbivore biomass varied, reflecting the productivity of the habitat. In productive habitats, predatory mammals were persistently present and plant biomass varied in space, but herbivore biomass did not. Plant biomass of productive tundra scrublands declined by 40% when vegetation blocks were transferred to predation-free islands. Corresponding transfer to herbivore-free islands triggered an increase in plant biomass. Fertilization of an unproductive tundra heath resulted in a fourfold increase in rodent density and a corresponding increase in winter grazing activity, whereas the total aboveground plant biomass remained unchanged. These results corroborate the predictions of the EEH, implying that the endotherm community and the vegetation of the North European tundra behaves dynamically as if each trophic level consisted of a single population, in spite of local co-occurrence of >20 plant species representing different major taxonomic groups, growth forms, and defensive strategies.