Examining the relationship between infectious diseases and flooding in Europe: A systematic literature review and summary of possible public health interventions

Brown, Lisa; Murray, Virginia

Some studies showed the frequency of infectious diseases can increase in the weeks to months after flooding, and Figure 1 illustrates when infectious disease outbreaks following flood events are likely to occur. However, there remains scientific uncertainty about the strength of association between infectious disease incidence and flooding. Floods can cause population displacement and changes in population density, raise concern about waste management and the availability of clean water, as well as affect the availability and access to healthcare services. All of these are risk factors for an infectious disease outbreak. Kouadio et al. 13 and Watson et al. 67 suggested that unless there is a substantial population displacement, there is minimal risk of infectious disease transmission and outbreaks following flooding. Overall, the risk of infectious disease following flooding is context-specific, differs between countries, and is dependent upon a number of synergistic factors. Outbreaks of leptospirosis and diarrheal diseases following flooding have been documented in Europe 18, 24, 28, 29, 34, 36, 38, [41] [42] [43] but the evidence of increased incidence of vector-borne diseases following flooding is lacking because the time lag before onset can be several months. 68 Past studies have indicated possible associations between vector-borne diseases and flooding in Europe. 36, [59] [60] [61] European residents may be exposed to these risks while traveling. Foreign relief workers can potentially introduce infectious diseases into an area affected by flooding and these workers may be susceptible to endemic diseases that are more prevalent because of the flood.