. 2015 Jan 26;7:ecurrents.outbreaks.95fbc4a8fb4695e049baabfc2fc8289f. [Version 1] doi: 10.1371/currents.outbreaks.95fbc4a8fb4695e049baabfc2fc8289f

Table 2. El-Nino-Associated Disease Transmission Enhancement in Human Populations: Examples.

Disease	Region	Possible El Nino Effects on Disease Dynamics
Cholera	Africa ¹¹ ^, ¹² : Great Lakes region; Asia ¹ ^, ¹⁸ ^, ¹⁹ ^, ²⁰ ^, ²¹ ^, ²² : Bangladesh, India (coastal), Sri Lanka; South America ⁴⁵ : Peru	Warmer water temperatures promote bacteria proliferation; flooding causes contamination of water sources, and may increase susceptibility to infection via stress.
Dengue	Asia/Pacific ¹ ^, ¹³ ^, ¹⁴ ^, ¹⁵ ^, ¹⁶ ^, ¹⁷ : Indonesia, Thailand, Pacific Islands, Australia (Queensland); North America ²³ ^, ²⁴ ^, ²⁵ : Mexico, United States (southern); South America ¹ ^, ²⁶ : Colombia, Ecuador (coastal), French Guiana, Suriname	Dry conditions: Peri-domestic water storage promotes Aedes aegypti mosquito vector breeding; elevated temperatures reduce the extrinsic incubation period in Ae. aegypti and Ae. albopictus vectors; warm, dry conditions may promote vegetation patterns favorable for vector development. Wet conditions: Elevated rainfall promotes Ae. aegypti and Ae. albopictus breeding.
Hantavirus infection	Asia ²⁷ ^, ²⁸ ^, ²⁹ ^, ³⁰ ^, ³¹ : China (eastern; hemorrhagic fever with renal syndrome); North America ³² : United States (southwestern; hantavirus pulmonary syndrome)	Elevated rainfall increases food availability for rodent reservoirs (vegetation), which expands rodent populations and may promote contact with humans.
Leishmaniasis	Central/South America ¹ ^, ³³ ^, ³⁴ ^, ³⁵ ^, ³⁶ : Brazil (eastern), Costa Rica, Colombia, French Guiana	Warmer temperatures or dry conditions may favor sand fly vectors or contribute to waning human immunity (e.g., via malnutrition or temporarily suppressing disease transmission).
Malaria	Asia ¹ ^, ³⁷ ^, ³⁸ : China (Anhui Province), India/Pakistan (Punjab), Sri Lanka; South America ¹ ^, ³⁹ ^, ⁴⁰ ^, ⁴¹ : Colombia, French Guiana, Guyana, Peru (coastal), Venezuela	Elevated rainfall promotes Anopheles mosquito vector breeding and survival, and vectorial capacity.
Plague	Africa ⁴³ : Madagascar; North America ⁴⁴ : United States (western)	Heavy rains increase food availability for populations of susceptible rodents; cooler temperatures may increase infectious flea abundance.
Rift Valley fever	Africa ² ^, ⁵ : East Africa	Flooding of dry mosquito vector habitats promotes hatching of (transovarially-) infected eggs, and vector breeding and survival.
Respiratory illness	Asia ⁴⁶ ^, ⁴⁷ : Southeast Asia/Indonesia	Drought may contribute to forest fires, which cause air pollution that may increase risk of respiratory infection.
Ross River virus disease	Asia ¹ ^, ⁴² : Australia (Queensland/Murray-Darling River region)	Warm conditions may increase mosquito vector longevity, and thereby vectorial capacity.