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Before attributing cause and consequence to climate change, the precise patterns of change must be known. Ground records across much of Europe show a 1-2 °C rise in temperatures in 1989 with no significant rise since then. The timing and spatial uniformity of this pattern, relative to changes in the distribution and incidence of many vector-borne diseases, are sufficient to falsify most simple claims that climate change is the principal cause of disease emergence. Furthermore, age-specific increases in incidence indicate causes other than, or in addition to, climate change. Unfortunately, many public health professionals repeat the received wisdom that climate change is worsening the burden of indirectly transmitted infections; this 'expert opinion' soon becomes consensus dogma divorced from quantitative evidence. The pressing need is to gather appropriate data to test the simple concept that the composition and relative importance of disparate multifactorial factors, commonly integrated within a causal nexus, will inevitably vary with the geographical, cultural, socio-economical, wildlife, etc. context. The greatest impact of warming occurs at the geographical limits of current distributions, where low temperatures limit the hazard of infected vectors. Within core endemic regions, changing exposure of humans to this hazard, through changing socio-economic factors is evidently more important amongst both the poor and the wealthy.

There is no doubt that all vector-borne diseases are very sensitive to climatic conditions. Many such diseases have shown marked increases in both distribution and incidence during the past few decades, just as human-induced climate change is thought to have exceeded random fluctuations. This coincidence has led to the general perception that climate change has driven disease emergence, but climate change is the inevitable backdrop for all recent events, without implying causality. Coincidence and causality can be disentangled using tick-borne encephalitis (TBE) as a test case, based on the excellent long-term data for this medically significant European disease system. Detailed analysis of climate records since 1970 has revealed abrupt temperature increases just prior to the dramatic upsurge in TBE incidence in many parts of central and eastern Europe. Furthermore, the seasonal patterns of this temperature change are such as might have favoured the transmission of TBE virus between co-feeding ticks. Nevertheless, the pattern of climate change is too uniform to explain the marked heterogeneity in the timing and degree of TBE upsurge, for example in different counties within each of the Baltic countries. Recent decreases as well as increases in TBE incidence must also be taken into account. Instead of a single cause, a network of interacting factors, acting synergistically but with differential force in space and time, would generate this epidemiological heterogeneity. From analysis of past and present events, it appears that human behavioural factors have played a more significant role than purely biological enzootic factors, although there is an explicit causal linkage from one to the other. This includes a range of abiotic and biotic environmental factors, together with human behaviour determined by socio-economic conditions. Many of the abrupt changes followed from the shift from planned to market economies with the fall of Soviet rule. Comparisons between eight countries have indeed revealed a remarkable correlation between poverty indicators and the relative degree of upsurge in TBE from 1993. Against this background of longer-term shifts in TBE incidence, sudden spikes in incidence appear to be due to exceptional weather conditions affecting people's behaviour, which have a differential impact depending on socio-economic factors. This new perspective may also help explain the epidemiology of Crimean-Congo haemorrhagic fever around the eastern Mediterranean region, including the current exceptional epidemic in Turkey.

The article discusses the dynamics and control of emerging vector-borne zoonosis. The emergence of the zoonotic diseases in new regions is mainly caused by the movement of pathogens brought about by trade and people's travel. Evidence revealed that climate change is now playing a less important role in the emergence of vector-borne diseases.

Investigates the interrelation of climatic change with the resurgence of malaria in the East African highlands. Factors contributing to the Plasmodium falciparum transmission; Trend of monthly and annual meteorological variables in the highlands; Use of augmented Dickey-Fuller test in analyzing the meteorological variables.

In our study we did not address the impact of predicted climate change on malaria incidence because a complete global assessment is reported elsewhere. Regarding the climate surfaces we used, the data set has superior spatial resolution compared with other data sets of similar temporal extent, and has been used to quantify climate change across Africa at 0.5 × 0.5° spatial resolution (although the resulting maps are smoothed to emphasize regional changes). It is inconsistent to assert that these same data are insufficient to demonstrate a lack of climate change. [ABSTRACT FROM AUTHOR]

Climate has a significant impact on malaria incidence and we have predicted that forecast climate changes might cause some modifications to the present global distribution of malaria close to its present boundaries. However, it is quite another matter to attribute recent resurgences of malaria in the highlands of East Africa to climate change. Analyses of malaria time-series at such sites have shown that malaria incidence has increased in the absence of co-varying changes in climate. We find the widespread increase in resistance of the malaria parasite to drugs and the decrease in vector control activities to be more likely driving forces behind the malaria resurgence. [Copyright &y& Elsevier]

Malaria epidemics in the highlands of East Africa garner significant research attention, due, in part, to their proposed sensitivity to climate change. In a recent article, Zhou et al. claim that increases in climate variance, rather than simple increases in climate mean values, have had an important role in the resurgence of malaria epidemics in the East African highlands since the early 1980s. If proven, this would be an interesting result but we believe that the methods used do not test the hypothesis suggested. [Copyright &y& Elsevier]