Climate change impacts on Zika and dengue risk in four Brazilian cities: projections using a temperature-dependent basic reproduction number

For vectorborne diseases the basic reproduction number[R] 0, a measure of a diseases epidemic potential, is highly temperature dependent. Recent work characterizing these temperature dependencies has highlighted how climate change may impact geographic disease spread. We extend this prior work by examining how newly emerging diseases, like Zika will be impacted by specific future climate change scenarios in four diverse regions of Brazil, a country that has been profoundly impacted by Zika. We estimated a temperature-dependent[R] 0(T), derived from a compartmental transmission model, characterizing Zika (and, for comparison, dengue) transmission potential. We obtained historical temperature data for the 5-year period 2015-2019 and projections for 2045-2049 by fitting cubic spline interpolations to data from simulated atmospheric data provided by the CMIP-6 project (specifically, generated by the GFDL-ESM4 model), which provides projections under four Shared Socioeconomic Pathways (SSP). These four SSP scenarios correspond to varying levels of climate change severity. We applied this approach to four Brazilian cities (Manaus, Recife, Rio de Janeiro, and Sao Paulo) that represent diverse climatic regions. Our model predicts that the[R] 0(T) for Zika peaks at 2.7 around 30{degrees}C, while for dengue it peaks at 6.8 around 31{degrees}C. We find that the epidemic potential of Zika and dengue will increase beyond current levels in Brazil in all of the climate scenarios. For Manaus, we predict that the annual[R] 0 range will increase from 2.1-2.5, to 2.3-2.7, for Recife we project an increase from 0.4-1.9 to 0.6-2.3, for Rio de Janeiro from 0-1.9 to 0-2.3, and for Sao Paulo from 0-0.3 to 0-0.7. As Zika immunity wanes and temperatures increase, there will be increasing epidemic potential and longer transmission seasons, especially in regions where transmission is currently marginal. Surveillance systems should be implemented and sustained for early detection. Author summaryRising temperatures through climate change are expected to increase arboviral disease pressure, so understanding the impact of climate change on newly emerging diseases such as Zika is essential to prepare for future outbreaks. However, because disease transmission may be less effective at very high temperatures, it is uncertain whether risk will uniformly increase in different regions. Mathematical modeling is a useful tool for predicting the impact of temperature on arbovirus risk. We used a temperature-dependent infectious disease transmission model to derive a temperature-dependent basic reproduction number. We then used historical temperature data and temperature projections for the years 2045-2049 to forecast Zika risk in four cities in Brazil under various climate change scenarios. We predict an overall increase in arbovirus risk, as well as extended risk seasons in cities that are not currently suitable for year-round spread, such as Rio de Janeiro. We also found little-to-no protective effect of increasing temperatures even in warmer climates like Manaus. Our results indicate that preparation for future Zika outbreaks (and of those of other arboviruses including dengue) should include the implementation of national disease surveillance and early detection systems.