A multijurisdictional healthcare-associated outbreak of Ralstonia pickettii from contaminated saline, Australia 2023

and COVID-19 antibody were performed, along with complete blood count.Results: A total of 2858 tests were performed out of which 56% were males and 44% females.During phase I (pre-floods), 5.2% had malaria, 1.9% had HCV, and 12% were positive for COVID-19 antibody.During phase II (post-floods), 46.6% were positive for malaria, 31.7% for COVID-19 antibody, 9.2% for HCV, 8% COVID-19 antigen, and few cases of HIV, hepatitis B, and typhoid were also detected.Discussion: This study highlights the pressing health challenges faced by remote areas in Sindh, Pakistan, exacerbated by climate change-induced events like floods.The comparative analysis of disease distribution before and after the 2022 floods underscores the vulnerability of these regions to infectious diseases like malaria and COVID-19.Conclusion: Climate change poses a significant threat to lowincome countries, especially remote areas, worsening the already considerable disease burden they face.Routine monitoring and surveillance of disease prevalence is crucial to create targeted interventions that bridge the gap in these vulnerable regions and lessen the burden on the healthcare systems.