The impact of climate change on the transmission of enteric diseases: A systematic review

• Temperature Increase: Higher temperatures enhance the survival, replication, and virulence of bacteria and viruses leading to a rise in disease incidence. • Precipitation Changes: Heavy rainfall and flooding lead to water contamination, while droughts concentrate on pathogens. • Extreme Weather Events: Events like hurricanes disrupt sanitation, causing disease outbreaks. • Seasonal and Geographic Variations: Disease incidence varies by climate and region, impacting vulnerable areas more. • Public Health Strategies: Strengthen infrastructure, early warning, and climate policies to mitigate effects. Enteric diseases are a major public health concern worldwide, particularly in low- and middle-income countries (LMICs) where inadequate water and sanitation systems amplify transmission risks. This systematic review assessed how Climate changes through rising temperatures, altered precipitation patterns, and extreme weather events—affects the transmission of enteric bacteria and viruses. Following PRISMA 2020 guidelines, peer-reviewed studies published between January 2000, and April 2024 were identified from PubMed, Web of Science, Scopus, and Google Scholar, with 42 studies meeting the inclusion criteria. Of these, 34 focused on bacterial pathogens—primarily Escherichia coli, Vibrio cholerae, Salmonella , and Campylobacter —and showed that warming, flooding, heavy rainfall, storms, and droughts enhanced their survival, growth, and virulence. Four studies reported increased detection of viral pathogens, notably Norovirus and Rotavirus , following floods, hurricanes, and drought-related water scarcity. Hydrometeorological extremes emerged as the strongest drivers, often causing measurable surges in pathogen concentrations across water systems. These findings underscore the urgent need to modernize water, sanitation, and hygiene (WASH) infrastructure, integrate climate and environmental data into public health surveillance, and develop climate-resilient health policies. Such actions are crucial to mitigate the growing burden of climate-driven enteric diseases and safeguard vulnerable populations worldwide.