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It’s no secret that as the Earth heats up, tropical diseases spread—certain microorganisms just prefer a warm, steamy environment for breeding (don’t we all?). There are a number of ways that wilderness medicine providers can help patients and humankind as a species adapt to the changing infectious diseases patterns caused by climate change.

First, even providers in temperate climates should consider subscribing to infectious and tropical diseases information sources. On Medscape, providers can choose Infectious Disease Med Pulse, and the column by Dr. Auwaerter. Providers can join the American Society of Tropical Medicine and Hygiene and even receive news and information on infectious diseases transmission for free. The QxMD medical app comes with an account that offers infectious diseases article updates in the provider’s inbox. Most importantly, providers should sign up for alerts from National Neglected Tropical Disease Day, as the diseases high-income nations have formerly ignored in research protocols will continue to worsen as warm areas spread. Providers can use the “Learn More” tab on that page to sign up. Historically, providers in many high-income nations have been taught to relegate management of infectious diseases to the specialist, or write tropical diseases off as “zebras”, but with a changing global climate, practitioners should increasingly expand their differential to adapt. The “wilderness” is different now, and it is in everyone’s backyard.

Secondly, when selecting their yearly CMEs, healthcare providers can consider studying in three major overlapping and interacting categories of infectious diseases affected by climate change: waterborne, zoonotic, and viral. As flooding changes, for example, systematic analysis has found alterations in patterns of childhood diarrhea caused by Cryptosporidium, which kills in low-resource and disaster areas; consider similar spread of the respiratory and GI pathogen Legionella, along with waterborne amoebas. Zoonotic diseases affected by climate change are not limited to the viral diseases carried by mosquitoes, such as chikungunya and dengue—tick-borne illnesses such as Crimean-Congo hemorrhagic fever also seem to be showing an altered distribution pattern. The Wilderness Medical Society offers CMEs on these topics for wilderness medicine practitioners of all levels.

Third, and most difficult, providers should also be aware of our role in research and development of tropical diseases treatments and understand the way that a changing environmental climate highlights past economic and moral choices that have furthered inequality in global disease research. Unfortunately, as the global hegemony predominantly funds research for diseases that affect the wealthy, diseases limited to the tropics have frequently been ignored. There’s no dengue antiviral on the horizon. We still use the same ancient antiparasitics for horrific diseases carried by the tsetse fly. Meanwhile, HIV antivirals continue to go through their fourth and fifth iterations because politicized support in the U.S .bloomed in the 1980s as soon as AIDS hit a wealthier sector of the community: LGBT+ artists and activists vs. lower income “less important” Black populations. Obviously, all severe diseases, especially HIV, require research and development that no one in their right mind would oppose. It is telling, however, which financial sectors sway our disease selections, especially when companies benefit socially from emphasizing funding for illnesses with already-excellent treatments—instead of expanding access for those who cannot obtain those treatments, or funding new research for diseases that continue to have absolutely unacceptable outcomes. Disease research shouldn’t be a resource battle between any vulnerable interest groups, but in the countries that hold the money we often have moral preferences for certain illnesses and sympathy for certain sufferers. Climate change makes us pay for these biases now, especially in the field of tropical medicine, as “their” diseases become “ours”, too.

As climate change alters the inequality landscape, we need to recognize our own health predispositions on the individual level so we can separate them from the patient in front of us. As climate change alters disease distribution and post-pandemic economic realities continue to further unrest between income sectors, how will we adjust our patient counseling to better reach vulnerable patients suffering all infectious illnesses? How can we firmly promote good public health practices without solidifying class enmity and the stigma of “contamination”?

We as human health advocates have the capacity to understand and adapt to altered disease patterns; as climate change forces us as a species to share more of the same “disease experiences”. we should also unite to eliminate and prevent the inequalities in research and clinical care that have historically harmed our ability to adapt and survive together. There will always be debate about top-down versus grassroots public health and environmental policy, but as providers, healthcare can and should start with us: the way we educate ourselves, and our infected patients, makes all the difference for disease transmission in a shifting world.

Jungle canopy, Hawaii. Image credit: Brian Finelli.

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