Download Serbia - unfccc

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Name/s of institution(s) and any collaborating partner(s)
Ministry of Agriculture and Environmental Protection
Institute of Public Health of Serbia
University of Novi Sad
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Country/Countries of focus (if global, please specify)
Republic of Serbia
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Relevant impact/s of climate change on health (see topics 1-3 above)
Increased mortality during the summer heat wave (mostly cardiovascular and malignant
neoplasms mortality)
Increase of incidence of vector-borne diseases (malaria, dengue, West Nile virus, etc.), as
well as the spread of waterborne diseases
Description of the activity, including
o Research, analyses, tools, methods or approaches (that have been used or
developed), etc.
Monitoring results and research by Institute of Public health of Serbia
Expert judgement based on the EU monitoring results and research
o Key results (including both quantitative and qualitative evidence)
During last decade Serbia faces with damage to human health related to observed climate change
in both direct and indirect ways. During the summer heat wave on July 2007 increased mortality
was recorded in Belgrade. It was found that as mean daily temperature increases over 90th, 95th
and 99th percentiles, average number of deaths increases for 15.3%, 22.4% and 32.0%
(Stojanovic et al., 2014). There were a total of 167 excess deaths between 16 and 24 July, 2007.
People aged 75 years and older accounted for 151 (90%) of all excess deaths and increase of
mortality among elderly was 76% in comparison to the baseline mortality. Cardiovascular and
malignant neoplasms mortality accounted for the highest absolute numbers of excess deaths, 77
and 49, respectively, but the biggest relative increase in mortality was from diabetes mellitus
(286%), chronic kidney disease (200%), respiratory system diseases (73%), and nervous system
diseases (67%). Excess female mortality was over two times higher than excess male mortality
(54%:23%) (Bogdanovic et al, 2013).
During floods that hit Serbia in May 2014, as a direct impact 51 casualties was recorded related
to the floods and landslides, of which 23 drowned. An indirect threat of flooding was potential
occurrence of contamination of surface water, groundwater and surrounding soils with hazardous
materials and sewage. Heavy metals were released from mine workings to the Korenita stream in
Loznica Municipality when a dam broke. Also, spring supply for Mali Zvornik Municipality was
affected by heavy metals due to the groundwater level raising into old mine workings, and had to
be taken out of service. Another indirect impact of this flood episode on health sector was that 15
municipalities reported that some of its health facilities had been damaged and several of them
were temporally closed.
On the other hand, indirectly, climate change brings new challenges in controlling of infectious
diseases. Climate change will definitely lead to a change of distribution and increase of incidence
of vector-borne diseases (malaria, dengue, West Nile virus, etc.), as well as the spread of
waterborne diseases, such as cholera and diarrhea. In 2012 Institute of Public Health of Serbia
established a seasonal permanent monitoring of West Nile virus for human population. During
summer season of 2012, total number of registered (probable and confirmed) cases was 71,
including nine deaths that may be linked to West Nile virus. In 2013, 302 cases of West Nile
virus infection were recorded by the end of October, as well as 35 mortality cases, which are
approximately four times higher than for 2012. This large increase suggests that West Nile virus
may represent a growing threat to human health in Serbia in the future. Beside West Nile fever,
Lyme disease as well as malaria occurrence is increasing (Figure 1). In 2012, these two vectorborne diseases, closely related to climate conditions experienced mild decline, while the
increasing trend six years before is obvious. For the first time in past several years, in 2012, was
reported inflammation of the brain caused by a virus transmitted by ticks (four cases).
According to the relevant legislation, West Nile fever is not subject to mandatory reporting.
However, taking into account the epidemiological situation of the disease in countries
environment, the presence of house mosquito, Culex pipiens, which is the main vector of the
disease in Serbia, the presence of reservoirs of infection (different types of birds) and the
corresponding climatic conditions in summer, Institute of Public Health of Serbia (IPHS) in May
2012, forwarded to the municipal institutes methodological guidelines for establishing control
over the West Nile fever.
Institute of Public Health of Serbia together with Republic Hydrometeorological Service of
Serbia (RHMSS) introduced an early warning system in situations when extreme climate
conditions threaten the health of the population. From the 1st May to the 30th of September,
RHMSS will issue an alert to the possible occurrence of periods with extreme temperatures
published on its website, but they will also forward the alert to the IPHS web site
(http://www.batut.org.rs/index.php?category_id=159) in order to take preventive measures to
minimize the risk to the public health.
Moreover, analysis show following impacts of climate change on human health (modified Maibach et al., 2011 and Kovats and Kristie, 2006):
Weather
events
Heat
Waves
Populations most
affected
Elderly,
children,
Premature death
diabetes, poor, urban
Heat-related illnesses such as heat stroke, residents, people with
heat exhaustion, and kidney stones
respiratory
diseases,
Heat stress
those active outdoors
Excess deaths
(workers,
athletes,
etc.).
Health effects
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Children, those active
- Increased asthma occurrence
outdoors
(workers,
Poor air - Increased chronic obstructive pulmonary
athletes, etc.), elderly,
quality
disease (COPD) and other respiratory
people with respiratory
diseases
diseases, poor.
2 Injuries
Residents in flood
3 Death from drowning
prone areas, elderly,
Extreme
4 Increased water-borne diseases
from children,
poor,
rainfall
pathogens and water contamination from residents in the areas
and floods
sewage overflows
under the risk of water
5 Increased food-borne disease
torrents
 Death from burns and smoke inhalation
People with respiratory
 Injuries
diseases, people in
Wildfires
 Eye and respiratory illness due to fire-related areas
prone
to
air pollution
wildfires
- Disruptions in food supply
- Changing patterns of crops, pests, and weed
species
- Water shortages
Droughts
Poor, elderly, children
- Malnutrition
- Food- and water-borne disease
- Emergence of new vector-borne and zoonotic
disease
- Increased food-borne disease, such as
Salmonella poisoning
Increased - Increased vector-borne disease such as West
Children
average
Nile virus, encephalitis, Lyme disease, etc.
Those active outdoors
temperatur - Increased strain on regional drinking water
(workers, athletes, etc.)
e
supplies
- Increased vulnerability to wildfires and
associated air pollution
People with respiratory
Increased
disease, people with
temperatur - Increased allergies caused by pollen
acute
allergies,
e
and - Increased number of cases of rashes and
children, those active
rising CO2
allergic reactions from plants such as weeds
outdoors
(workers,
levels
athletes, etc.)
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o Include outputs of the activity (e.g. papers, publications, policies, etc.)
Publications, National communication, workshops for stakeholders
o Potential challenges met when undertaking the activity, and how those have
been overcome
Law level of understanding of importance of the issues
Insufficient reediness for inclusion of the findings into policies and actions in the sector
o Planned next steps (as appropriate)
Despite the reported progress in the area of monitoring of vector borne disease and development
of early warning system on heath waves, important improvements are still needed. Therefore,
deeper and more detailed analysis of impacts of observed and projected climate conditions and
establishment of data basis, potentially in cooperation with World Health Organization are
needed and planned.
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Good practices and lessons learned (as appropriate)
Improvement of cooperation among stakeholders (more efficient involvement of
Ministry of Health) is required
Establishment of unique data base available to public is among the highest priority
Raising awareness activities on continuous basis are required
 Relevant hyperlinks, including to information sources
http://www.klimatskepromene.rs
http://www.hidmet.gov.rs
http://www.batut.org.rs
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Contact details for further information
Danijela Bozanic, UNFCCC NFP
[email protected]
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Relevant pictures/graphics
Figure 1: Number of Lyme disease (left) and of Malaria tropica (right) cases in Serbia in the period
2006-2012 (source: Institute of Public Health of Serbia)