Assessment of climate change impact on the malaria vector Anopheles hyrcanus, West Nile disease, and incidence of melanoma in the Vojvodina Province (Serbia) using data from a regional climate model

over other ecological factors. These signal the importance of monitoring the changes to the preparedness of mitigating the risk of vector-borne diseases and melanoma. Introduction Climate change is referred to as “the biggest global health threat of the 21st century” [1].The analysis of outputs from all general circulation models (GCM) suggests that the countries of the Pannonian Plain, including Serbia, are facing significant impacts of climate change, affect- ing all aspects of human life [2]. The authors of the manuscript (meteorology, entomology, vet- erinary medicine, and public health experts), have been working together since 2003, promoting the idea of multisectoral collaboration before the One Health Concept was officially inaugurated in the USA in 2007 [3], and endorsed by the European Union (EU) [4] as well as prominent organizations such as the World Health Organization (WHO), Food and Agricul- ture Organization (FAO), and the World Organization for Animal Health (OIE) in 2018 [5]. In this paper, the authors collected and analysed observed data over 31 years and related a subset to outputs from a Regional Climate Model (RCM). Vector-borne diseases and mela- noma are significant climate-driven threats for which risk sources can be clearly defined [6]. Moreover, both present progressively growing environmental threats to the animal as well as human health in the countries of the Pannonian Plane [7,8,9]. The biology and distribution of mosquito vectors and their capacity to transmit mosquito-

borne diseases are dependent on many factors such as global trade and travel, urbanisation, habitat destruction, pesticide application, host density, and climate. Anopheles hyrcanus and Culex pipiens are mosquito species that are vectors of malaria and West Nile virus (WNV) dis- ease, respectively, the two vector-borne diseases distributed worldwide [10,11]. Malaria was eradicated from Serbia and other Balkan states during the last century. However, the spreading of its vectors (Anopheles mosquitoes) and the re-emergence of the disease in Greece [12] pose a threat to the South East and Central Europe once again. In 2018, Serbia was the second Euro- pean country (after Italy) most affected by WNV disease (415 reported cases with 35 fatal out- comes). In Europe, the total number of reported human autochthonous WNV infections in 2018 (n = 2,083) exceeded, by far, the total number from the previous seven years (n = 1,832). During the same transmission season, outbreaks of West Nile fever among equids increased by 30% compared to the number of outbreaks in 2017. In total, 285 outbreaks among equids were reported by the EU Member States in 2018 [13]. Current evidence suggests that inter- annual and inter-decadal climate variability have a direct influence on the epidemiology of vector-borne diseases, with temperature and relative humidity as the principal abiotic factors influencing the life-cycles of the mosquito vector, the pathogen, the host and the interactions between them [14,15]. Melanoma is a malignant disease that has experienced a significant increase in incidence

during the last few decades all over the world [16]. Climate change impact on melanoma should be considered as a synergy of changes in UV radiation (UVR) due to stratospheric ozone depletion and the long-term increase of air temperature leading to more prolonged exposure of individuals to UVR doses and consequently to a higher risk of melanoma [17]. Melanoma mortality in the Vojvodina Province (northern Serbia) (VPS) within the period 1985–2004 shows an evident increase, placing it amongst the most vulnerable regions in the world. Thus, Jovanović et al. [7] estimated and made the list of mortality rates from malignant melanoma for males (age-standardised rate/100,000) in Europe (39 countries) for the year Impact of climate change on malaria vector, West Nile disease, and incidence of melanoma PLOS ONE | https://doi.org/10.1371/journal.pone.0227679 January 15, 2020 2 / 17 Data Availability Statement: All relevant data are within the manuscript and its Supporting Information files. Funding: This paper was realised as a part of the projects "Studying climate change and its influence on the environment: impacts, adaptation and mitigation" (III43007 - DTM, DP, IHC, VDj, ENĐ, IA, GM, AIC´) and TR31084 (DP, TP, AIC´) financed by the Ministry of Education and Science, Republic of Serbia (http://www.mpn.gov.rs/). Historical data for mosquito vectors are the outputs of projects supported by the Veterinary Directorate, Ministry of Agriculture and Environment Protection, Republic of Serbia (http://www.minpolj.gov.rs/), and Provincial Secretariat for Science and

Technological Development, the Autonomous Province of Vojvodina, project no. 114-451-2142/ 2011 (DP, TP, IHC, AIC´ - http://apv- visokoobrazovanje.vojvodina.gov.rs/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. MP is affiliated to Avia-GIS NV, which did not play a role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Role of Funders Avia-GIS NV provided support in the form of salaries for author (MP) but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of the author (MP) are articulated in the ‘author contributions’ section. Competing interests: All authors except MP have declared that no competing interests exist. Commercial affiliation of MP is to Avia-GIS NV (commercial funder) in which she is under an employment contract since September 2016. Avia- GIS NV provided support in the form of salaries for author (MP) but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. This does not alter our adherence to PLOS ONE policies on sharing data and materials.