Shifting patterns: Infectious disease dynamics in a changing world

Studies of the relationship between infectious disease dynamics and climate variability address temporal patterns at seasonal and interannual scales.  Increasingly, the population dynamics of infectious diseases that are climate driven, such as cholera and malaria, must be understood in the context of long-term change, that is, under non-stationary conditions.  I illustrate here the interplay of long-term trends and the faster population dynamics of outbreaks with case studies for endemic cholera in Bangladesh and epidemic malaria in transition regions.  For cholera, the problem of a long-term trend in transmission is considered in the context of forecasting.  For malaria, resonance between climate forcing and disease dynamics is shown to be facilitated by an increasing rate of transmission.