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

p = 0.01766; τ = 0.6). By 2030 we anticipate a further increase in numbers of invaded sites and adult females sampled, by 1.71 and 1.27 fold, respectively (Fig 2B and 2C). Spearman rank-order correlation between the frequency of WNV detections in Cx. pipiens at 11 sites and the corresponding mean values of climate time series was the highest for TOA (r = 0.755; p = 0.00008), then for Ta (r = 0.616; p = 0.00294), RMS (r = 0.499; p = 0.02119), and TMS (r = 0.477; p = 0.02856). Fig 3A depicts the Poisson regression model for the dependence of a number of detections per site (frequency - λ) on TOA, which is statistically significant (p = 0.01393). The output of the model (lnλ = −7.923+1.533×TOA) indicates that for an increase of 0.5˚C in TOA (presuming that all other factors needed for the circulation of WNV are kept constant), a twofold increase in the incidence of WNV positive Cx. pipiens could be projected. Fig 3B depicts that most of the sites with the high frequency of WNV occurrence (�2) were distributed along the northwest-southeast axis of the VPS. Melanoma incidence and UVR doses Fig 4B shows the positive relative change of UVRD, remarkably covering an eastern, southern, western, and partly central area of VPS. Specifically, the projected increase is twofold going from the west and northwest (0.60%) towards the east and southeast where it reaches values of about 1.20%. The EBU-POM model (for nine sites) shows a significant expected increase of 56% in the number of HD days in the VPS (Fig 4A), compared to the period 1961–1990. Addi-

tionally, we observed a decrease of 1.1% in the number of days with maximum air temperature Tmax � 25˚C (Warm Days—WD). This prolongs the exposure of outdoor working adults to UVR and thus leads to an increase in melanoma risk. This risk becomes even more significant because of the increase in cumulative values of UVR doses (Fig 4C). Fig 4D depicts the cumu- lative incidence of melanoma for the period 1985–2004 with an increasing monotonic trend (r = 0.9712 and p = 0.000003). Discussion Here we presented an intriguing comparison of the impact of climate change on complex sys- tems including mosquito vectors, pathogens, and melanoma, which are all indicators of the risk imposed on human health. Our objectives were to use historical, previously unpublished sets of entomological and published clinical data and examine the importance of temperature in contributing to the spreading of the malaria vector An. hyrcanus; to differentiate between sites with a specific frequency of WNV occurrence in Cx. pipiens, and to assess the impact of increasing UVR and HD on melanoma incidence using the EBU-POM regional model data. A similar approach was recently used in observing the dramatic decline in total flying insect bio- mass in protected areas in Germany [41]. Despite globalisation trends, researchers have become "closed" in their ever-smaller com- munication circles which are not limited by state or national borders but by the professional language and way of thinking. Thus, by the end of the 20th century, the scientific community

has been faced with problems in communication within its confines. One of the principal rea- sons why vector-borne diseases (VBD) are so difficult to predict, is the complex interaction of multiple factors (vector, host, pathogen, environment including short-term weather patterns and long-term climate change) in space and time [42,43]. Only groups from multiple sectors that communicate and work together on specific aspects of VBD systems will be able to answer the most exciting and pressing problems in the field [42]. Authors of this paper started collabo- ration in 2003 comparing the climates of the foci of WNV circulation in USA (California Cen- tral Valley) and Europe (Bucharest area) with VPS. As compared climates showed quite similar patterns, colleagues from public health and veterinary joined the initial group of 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 9 / 17