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Objective: To examine whether high ambient temperature and diurnal temperature range during the summer are associated with risk of stroke/transient ischemic attack (TIA)., Methods: A time-stratified case-crossover study design was conducted. The study sample comprised all individuals aged ≥50 years who had a stroke/TIA reported to the Israeli National Stroke Registry between 2014 and 2016 during the summer season. Daily temperature data were retrieved from the Israel Meteorological Service. Conditional logistic regression models were used with relative humidity and air pollution as covariates., Results: The sample included 15,123 individuals who had a stroke/TIA during the summer season (mean age 73 ± 12 years; 54% males). High ambient temperature was associated with stroke/TIA risk starting from the day before the stroke event, and increasing in strength over a six-day lag (OR = 1.10 95%CI 1.09-1.12). Moreover, a larger diurnal temperature range prior to stroke/TIA occurrence was associated with decreased stroke/TIA risk (OR = 0.96 95%CI 0.95-0.97 for a six-day lag)., Conclusions: High ambient temperature may be linked to increased risk of cerebrovascular events in subsequent days. However, relief from the heat during the night may attenuate this risk., Competing Interests: Declaration of competing interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Leishmaniasis is a vector-borne disease, caused by the infection of Leishmania parasites which are transmitted by the bite of infected female phlebotomine sand flies. Leishmania tropica is transmitted by Phlebotomus sergenti and Phlebotomus arabicus while the main reservoir host is the rock hyrax. A marked increase in the incidence of cutaneous leishmaniasis (CL) caused by L. tropica has been detected in recent years in Israel; it is associated with infections which have emerged in new urban and rural foci. The objective of this study is to contribute to a better understanding of the preferred habitat, spatial activities and host-sand fly relationships of both species of vectors within various types of land use., Methods: Using CDC-type traps, we investigated the activity levels of sand flies. A field survey was conducted in 2016 at Elifelet, an agricultural village characterized by various types of land use. Movement patterns of P. sergenti between rock-piles were investigated by using colour-marked sugar baits and analyses of recapture patterns. In 2017, a survey was conducted in the hilly Jordan River area, by comparing sand flies and rock hyrax activities in relation to the size of rock-piles and vegetation cover., Results: Both sexes of both species were found to have a clear preference for rocky habitats over other land use types in rural landscapes. Movement patterns of P. sergenti were characterized by their high presence close to the rocks and an exponential decrease in their recapture, commensurate with the distance from the rocks. Host-sand fly relationships were found to have a higher correlation between rock hyrax activity levels for females than for males of both species of sand flies. Males exhibited the strongest association with the size of rock-piles., Conclusions: The results suggest a strong affinity of both phlebotomine vector species to the rocky habitats of the Mediterranean areas. We suggest that rock-piles are associated with populations of rock hyraxes attracting female sand flies seeking blood sources. Rapid human population growth, coupled with intensive land-use changes and the creation of artificial rock-piles, which created potential habitats for both vectors and hosts in the proximity of many settlements, have increased the prevalence of L. tropica among the human population in the region.

Cutaneous leishmaniasis caused by Leishmania tropica, transmitted by Phlebotomus sergenti and Phlebotomus arabicus, has been detected in Israel. This research strives to identify the complexity of temperature effects on vectors of L. tropica and to analyze seasonality and distribution across altitudinal levels. Sand fly trappings were conducted monthly during 2015-2016 in an endemic region for L. tropica in the eastern Galilee. Trappings were conducted in hyrax den sites across a broad topographic and climatic gradient. Using N-mixture models, we investigated the activity levels of sand flies as related to temporary and periodic climatic variables. We tested generality of climate-driven models using Root-Mean-Square Error (RMSE) values by comparing the 2015-2016 data with trapping data from 2013. P. sergenti activity was found to be positively and exponentially correlated with early night temperatures and more strongly correlated with average early-night temperatures for two weeks. P. arabicus exhibited a linear correlation with temperature. Climate-driven models for both species yielded lower RMSE values for the 2013 data, which validate the generality of the models. Considerable differences were found in slope coefficients of temperature effect on sand fly activity among sites related to elevation levels, implying differential local responses of sand flies to temperature., (© 2018 The Society for Vector Ecology.)

Background: Campylobacter spp. are the leading cause of foodborne infection worldwide, with a seasonal disease peak that might be affected by temperature increase. We studied the relationship between ambient temperature and weekly notified Campylobacter spp.infections., Methods: Data on 29,762 laboratory-confirmed cases of Campylobacter infection for the period, January, 1999 to December, 2010 were retrieved from the Ministry of Health registry. To estimate the association between the number of weekly cases of Campylobacter infection and the national average temperature at lags 0-3 weeks, firstly, we used GAM models, and secondly two-segment piecewise linear Poisson regressions. The effect of temperature was adjusted for seasonality, long-term trends and holidays., Results: We found a J-shaped relationship between ambient temperature and notified Campylobacter spp., Cases: For C. jejuni in all ages, the curve below the threshold was constant and the percent increase in cases for 1 °C above a threshold of 27 °C was 15.4% (95%CI: 6.7-24.1%). For ages 3-10 yr and > =26 yr the curve was constant below the threshold and positive above it; the percent increase in cases for 1 °C was 17.7%(95%CI: 6.0-29.4%) and 23.7%(95%CI: 11.6-35.8%), respectively. For ages 0-2 yr the curve was linear with no threshold and the percent increase for 1 °C was 5.1%(95%CI: 2.1-8.1%). For ages 11-25 yr the curve was always constant. Results for C. coli were similar., Conclusion: Our findings indicate that higher temperatures throughout the year affect Campylobacter spp. morbidity, especially in younger children. This should be taken into consideration in public education and health system preparedness for temperature increases as a result of climate change., (Copyright © 2018. Published by Elsevier Inc.)

The linkage between NHL morbidity and residence near heavy roads is analyzed among the Jewish population of the Haifa Metropolis, Israel. The addresses of 1436 patients (94.5% of all cases, 1995-2004) were geocoded. The geographic distribution of NHL patients was adjusted by the overall density of population in the study area. The analysis indicates steady decline in the "density adjusted" numbers of patients as a function of increasing road distances (P<0.01). Differences between genders/age groups were not found. The much higher occurrence of NHL in areas near main roads may be indicative of disease risks.

Climate change and West Nile fever (WNV) are both subjects of global importance. Many mosquitoes and the diseases they carry, including West Nile virus (WNV), are sensitive to temperature increase. The current study analyzes the lag correlations between weather conditions (especially air temperature) and 1) Culex pipiens mosquito population abundance, and 2) WNF frequency in humans, between 2001 and 2005 in Israel. These 5 years follow a long period with a documented tendency for temperature increase in the hot season in the country. Monthly anomalies of minimum and maximum temperatures, relative seasonal rainfall contribution, mosquito samplings (hazard level), and WNF cases (hospital admission dates and patients' addresses) were analyzed. Logistic regression was calculated between the climatic data and the mosquito samples, as Spearman correlations and Pearson cross-correlations were calculated between daily temperature values (or daily precipitation amounts) and the hospital admission dates. It was found that the disease appearance reflects the population distribution, while the risk tends to escalate around the metropolis characterized by an urban heat island. Positive anomalies of the temperature during the study period appear to have facilitated the mosquito abundance and, consequently, the disease emergence in humans. An important finding is the potential influence of extreme heat in the early spring on the vector population increase and on the disease's appearance weeks later. Awareness of such situations at the beginning of the spring may help authorities to reduce the disease risk before it becomes a real danger.

In 1996, a major unexplained outbreak of systemic Vibrio vulnificus infection erupted among Israeli fish market workers. The origins of this emergent infectious disease have not been fully understood. A possible link between climate change and disease emergence is being investigated. Meteorological service data from 1981, the earliest detection and reporting of V. vulnificus for the time in Israel, to 1998 for two stations located within the main inland fish farm industry were analyzed. The 1996-1998 summers were identified as the hottest ever recorded in Israel in the previous 40 years. Time series of monthly minimum, maximum, and mean temperatures showed significant increase in the summer temperatures along the 18 years. The highest minimum temperature value was recorded in summer 1996. Lag correlation analysis revealed significant correlations between temperature values and hospital admission dates. The eruption appeared 25-30 days after the extreme heat conditions in summer 1996, at a lag of 3 weeks in summer 1997 while the results for 1998 were at a lag of less than a week. Higher significant results were detected for the daily minimum temperatures in summer 1996 compatible with the disease eruption. These findings suggest that high water temperature might have impacted the ecology of our study area and caused the emergence of the disease, as an effect of global climate change.

The West Nile Virus (WNV) outbreak in Israel in 2000 appeared after medical and climatic warning signs. Re-analysis of the epidemic from a new viewpoint, the regional impact of global warming, especially the worsening in the summers' heat conditions, is presented. The disease appeared averagely at a lag of 3-9 weeks (strongest correlation = lag of 7 weeks). The minimum temperature was found as the most important climatic factor that encourages the disease earlier appearance. Extreme heat is more significant than high air humidity for increasing WNV cases. An early extreme rise in the summer temperature could be a good indicator of increased vector populations. While 93.5% of cases were in the metropolitan areas, the disease was not reported in the sub-arid regions. The outbreak development was comparable to the cases from Romania (1996) and NYC (1999). Each of those epidemics appeared after a long heatwave.