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Climate change may have substantial effects on the transmission of YF and we present the first analysis of the potential impact on disease burden. We extend an existing model of YF transmission to account for rainfall and a temperature suitability index and project transmission intensity across the African endemic region in the context of four climate change scenarios. We use these transmission projections to assess the change in burden in 2050 and 2070. We find disease burden changes heterogeneously across the region. In the least severe scenario, we find a 93.0%[95%CI(92.7, 93.2%)] chance that annual deaths will increase in 2050. This change in epidemiology will complicate future control efforts. Thus, we may need to consider the effect of changing climatic variables on future intervention strategies.<\/jats:p>","DOI":"10.7554\/elife.55619","type":"journal-article","created":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T20:00:29Z","timestamp":1595880029000},"update-policy":"https:\/\/doi.org\/10.7554\/elife.55619","source":"Crossref","is-referenced-by-count":59,"title":["The effect of climate change on yellow fever disease burden in Africa"],"prefix":"10.7554","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3734-9081","authenticated-orcid":true,"given":"Katy AM","family":"Gaythorpe","sequence":"first","affiliation":[{"name":"Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arran","family":"Hamlet","sequence":"additional","affiliation":[{"name":"Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Cibrelus","sequence":"additional","affiliation":[{"name":"World Health Organisation, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tini","family":"Garske","sequence":"additional","affiliation":[{"name":"Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil M","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4374","published-online":{"date-parts":[[2020,7,28]]},"reference":[{"key":"bib1","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1007\/s11222-008-9110-y","article-title":"A tutorial on adaptive MCMC","volume":"18","author":"Andrieu","year":"2008","journal-title":"Statistics and Computing"},{"key":"bib2","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1146\/annurev.ento.52.110405.091454","article-title":"Yellow fever: a disease that has yet to be conquered","volume":"52","author":"Barrett","year":"2007","journal-title":"Annual Review of Entomology"},{"key":"bib3","doi-asserted-by":"publisher","DOI":"10.1186\/1756-3305-6-351","article-title":"Modelling adult aedes aegypti and aedes albopictus survival at different temperatures in laboratory and field settings","volume":"6","author":"Brady","year":"2013","journal-title":"Parasites & Vectors"},{"key":"bib4","doi-asserted-by":"publisher","DOI":"10.1186\/1756-3305-7-338","article-title":"Global temperature constraints on aedes aegypti and ae\u00a0albopictus persistence and competence for dengue virus transmission","volume":"7","author":"Brady","year":"2014","journal-title":"Parasites & Vectors"},{"key":"bib5","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1086\/286078","article-title":"Distribution, diversity, and latitude in african primates","volume":"150","author":"Cowlishaw","year":"1997","journal-title":"The American Naturalist"},{"key":"bib6","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1093\/oxfordjournals.aje.a117853","article-title":"The effect of various temperatures in modifying the extrinsic incubation period of the yellow fever virus in a\u00ebdes aegypti*","volume":"16","author":"Davis","year":"1932","journal-title":"American Journal of Epidemiology"},{"key":"bib7","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1093\/trstmh\/tru086","article-title":"Rapid assessment of yellow fever viral activity in the central african republic","volume":"108","author":"Diallo","year":"2014","journal-title":"Transactions of the Royal Society of Tropical Medicine and Hygiene"},{"key":"bib8","first-page":"849","article-title":"LandScan: a global population database for estimating populations at risk","volume":"66","author":"Dobson","year":"2000","journal-title":"Photogrammetric Engineering and Remote Sensing"},{"key":"bib9","volume-title":"Projections World Population Prospects","author":"DoE United Nations","year":"2017","unstructured":"DoE United Nations. 2017. 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