PLoS Neglected Tropical Diseases
http://www.plosntds.org/
[Accessed 2 July 2016]

.
Editorial
Southern Europe’s Coming Plagues: Vector-Borne Neglected Tropical Diseases
Peter J. Hotez
| published 30 Jun 2016 | PLOS Neglected Tropical Diseases
http://dx.doi.org/10.1371/journal.pntd.0004243
[Excerpts]
The factors responsible for promoting the vector-borne NTDs in Southern Europe are under investigation, but there are some key lead possibilities to consider:.
Poverty.
Throughout the world’s low- and middle-income countries, poverty is a major social determinant promoting the ongoing transmission of NTDs. Previous findings have determined that comparable levels of extreme poverty can also be found among the G20 countries and are also contributing to widespread NTDs [32,33]. It is interesting to note how the emergence or re-emergence of Southern Europe’s major NTDs roughly coincides with the European debt crisis that began in 2009 when countries such as Greece, Portugal, and Spain experienced difficulties in repaying their government debts without outside assistance. Ultimately, Greece defaulted on its debt to the International Monetary Fund in 2015, thereby precipitating a financial crisis linked to high unemployment. There is an important need to better understand the link between poverty and NTDs. So far, it has been found that NTDs flourish in impoverished settings, but also that NTDs exhibit a unique ability to reinforce poverty through their debilitating effects on workers, women, and growing and developing children.

Mass human migrations.
Still another key social factor may be the humanitarian crisis linked to hundreds of thousands of people fleeing conflicts in Libya, Syria, and Iraq due to the occupation of ISIS [34]. In so doing, they could be introducing or re-introducing NTDs endemic to the Middle East and North Africa, including the vector-borne NTDs highlighted above. For example, cutaneous leishmaniasis in Syria, where it is often known as “Aleppo Evil,” has reached hyperendemic proportions due to breakdowns in health systems and lack of access to essential medicine, with at least tens of thousands of new cases annually [35]. Quite possibly both cutaneous leishmaniasis and sand fly vectors are being routinely re-introduced into Southern Europe.

Climate change.
Finally, it has been noted that outside of the Arctic region, Europe’s single largest temperature increases associated with serious heat waves are now occurring in Southern Europe [36]. The factors promoting climate change include increased greenhouse gas emissions as a result of agriculture; burning of coal, oil, and gas (fossil fuels); landfills; and industrial pollutants [36]. Increased temperatures are helping to facilitate the survival and longevity of insects and snails with the capacity to transmit NTDs. Climate change may also promote the spread of some of Southern Europe’s vector-borne NTDs to Northern Europe, including WNV and leishmaniasis [19,37]…