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Introduction Climate change refers to long-term shifts in weather conditions and patterns of extreme weather events, with recent earthquakes, natural disasters, there is epidemic and increase in many paediatric infectious diseases (PID) worldwide, including some newly-circulating ones, such as Zika virus and arbo-viruses in North America and the Caribbean, Ebola and Cholera outbreak in Africa, SIRS in middle east e.t.c. This reflects the combined impacts of rapid demographic, environmental, social, technological and other changes in our ways of living. Aims We reviewed the available scientific evidences of the impact of recent climate change on PID and also examines the observed and predicted impacts of changes in major climate variables on pathogen, host, and transmission of PID in order to estimate the future burden of infectious diseases on children. Methods We reviewed published and unpublished literature on climate change and PID. The data were mainly descriptive and we used predictive analytical modelling to assess the future burden. Findings We observed evidence of associations between climatic conditions and PID in children with different modality of transmission. The responsible agents identified were viruses, bacteria, protozoa and parasites, with various adaptations in the host. Increasing temperature was the most important contributing factor when compared with other natural disasters. There is a global resurgence of hitherto controlled diseases and the emergence of new ones with redistribution of existing infectious diseases due to an unstable climate. Many of the most common infectious diseases, and particularly those transmitted by vectors, are highly sensitive to climate variation. New and resurgent vector-borne communicable diseases, including arbo-viruses, such as dengue, Zika and Ebola, and malaria are evident widely. Other infectious diseases, such cholera have shown increased outbreaks due to elevated temperature and flooding with the resultant displacement of affected people. Conclusions Changes in infectious disease transmission patterns are a likely major consequence of climate change. There is need for a better understanding of the causal relationships, in order to predict the future impacts of this on children’s health. In addition, paediatrician are likely to see an increasing number of cases due to adverse effects of climate change. An international collaborative effort with an integrated model of care is therefore required.

Introduction Since 2015, an outbreak of Zika Virus infection (ZiKV) has been reported in over 30 countries. Emerging evidence suggest ZikV causes a spectrum of neurologic diseases both directly and by secondary autoimmunity. In pregnancy, ZiKV is a well-known cause of congenital brain abnormalities, including microcephaly.1 It has also been linked with Guillain-Barre syndrome.2 However, its association with meningoencephalitis is not well described, especially in children. Methods We undertook a systematic review of the English literature published from 1947 to August 2017 to evaluate the risk factors, distribution, pathogenesis, clinical presentation, management and outcomes of encephalitis following Zika virus infection. Data sources included MEDLINE, EMBASE, Cochrane library, and references within identified articles. We also searched the papers using the ISI web of knowledge, to identify relevant articles and conference proceedings. Results We identified 167 potential studies, of which 16 were duplicates and 140 were excluded on the basis of title and abstracts (figure 1). There were 9784 with suspected ZiKV in all age groups. 1411 cases were confirmed ZiKV either by RT-PCR in plasma, CSF and urine, ELIZA or MRI. There were 26 (1.8%) cases of meningoencephalitis. Among eight studies reporting clinical characteristics and outcomes of 16 cases, the mean age was 43 years (Range 19–81) and 75% (n=12) of cases were male. 63% (n=10) of the cases required admission to ITU, with a crude case fatality rate of 12% (n=2). Conclusions and clinical implications Complications from ZiKV, although uncommon, may be severe. With international spread, clinicians need to be aware that ZiKV may be associated with meningoencephalitis. Although our review found a paucity of evidence of Zika virus associated meningoencephalitis in children, standardising the collection and reporting for individual cases across regions and countries would further allow meaningful analysis of the data collected, enabling monitoring of trends over time.