This doctoral dissertation research project investigates the socio-ecological factors underpinning the changing geography and epidemiology of dengue fever, focusing on the recent dengue fever outbreaks in Key West, Florida. Dengue fever, a viral disease spread by infected Aedes mosquitoes, was once thought to be close to eradication. However, the disease has seen a global resurgence in recent years with increasing cases and a broadened geographical distribution. Typically conceived of as a disease of poor, urban areas in developing countries, outbreaks have also occurred in rural communities, arid and sub-tropical climates, and in wealthier developed countries, including several states in the southern US. These outbreaks have generated calls within the health community to better understand the changing geographic and epidemiological dimensions of dengue fever. A broadened understanding of dengue ecology is particularly important amidst projections that climate change may facilitate infectious disease spread through temperature and precipitation impacts on the mosquito and virus. Particularly important to discussions of climate and disease are the socio and political contexts of outbreaks that influence the abilities of local actors to respond to these projections. This includes social causes of vulnerability, and citizen and institutional responses to epidemics. Of particular importance is understanding the patchwork of actors involved in managing, controlling, and eradicating mosquito breeding spaces, often with divergent interests and goals. As the most recent outbreak to occur in the US, Key West provides an ideal location to study the socio-ecological factors of dengue in a place of recent re-emergence. To do so, this project uses a mixed methods approach that combines dynamic mosquito modeling using climate data and climate change scenarios with neighborhood focus groups, and interviews with residents, public health and vector control officials. The ultimate goals of this research are to identify: 1. Current and projected future impacts of climate on dengue virus and mosquito populations in Key West and other parts of the southern US, 2. How mosquitoes are differentially managed across the city, 3. How socio-ecological variables constrain or enable individuals to adhere to dengue and mosquito control messages, and 4. How control strategies and responsibilities are understood and internalized by local officials and citizens. A fuller understanding of the socio-ecological conditions surrounding the Key West outbreaks will shed light on the causes of similar outbreaks in places such as Texas and Hawaii. Additionally, the results of the study will highlight important complexities to consider in discussions of vulnerability and adaptation to disease under climate change in the southern US, and more globally as well.
Public health programs are continuously confronted with multiple community health issues to address. Changing socio-ecological conditions can shift the borders of infectious diseases, re-situating nuisance vectors as health concerns. Confronting climate change projections will require long-term planning and adaptive strategies that consider not only biophysical characteristics of the mosquito, but take into account processes that can create and eliminate social vulnerability. Understanding the complexities surrounding mosquito control will be of use for counties at risk for dengue emergence, as well as other diseases established in the US such as West Nile virus, La Crosse encephalitis, or nuisance mosquitoes. The findings of this work will be available through academic journals, public talks, and science outreach blogs. The climate scenarios generated will be made available to assist with long-term planning efforts. This doctoral dissertation research improvement award will provide support to enable an exceptionally able student to establish an independent research career in a high-visibility field of national and international relevance to major social and environmental challenges.
