Flood-associated disease outbreaks and transmission in Southeast Asia - Introduction 17
Authors: Boonfei Tan 1
Source: Frontiers
Photo/Image Source: Unsplash
2.4 Changing climate and flood-induced shifts in transmission
More than half (58%) of known human infectious diseases worsen with floods and other climate hazards, spreading through multiple transmission pathways that drive flood-related outbreaks (Mora et al., 2022). Most floods in SEA are driven by the East Asian Summer Monsoon (EASM), which brings peak rainfall during the boreal summer (May–September) (Chen et al., 2025; Loo et al., 2015). Seasonal monsoons are strongly associated with increased incidence of dengue, leptospirosis, and typhoid across several regions of SEA (Chadsuthi et al., 2021; Matsushita et al., 2018; Cunha et al., 2022; Benedum et al., 2018); for example, in Myanmar, peak rainfall has been linked to cholera outbreaks (Roobthaisong et al., 2017). Our Philippines case study (2022–2023) further illustrates this pattern (Figure 2). In 2023, rainfall was anomalously high during January–February and peaked within the core Southwest Monsoon (Weeks 22–43). This rainfall pattern coincided with elevated early-year dengue, leptospirosis, and typhoid case counts that declined soon after the monsoon subsided (Figure 3). In contrast, 2022 exhibited a late rainfall peak around epidemiological week 45, beyond the official monsoon window, and correspondingly sustained disease activity into the post-monsoon period. The persistence of cases beyond the monsoon season in 2022 is consistent with the delayed environmental effects of late-season rains (Chadsuthi et al., 2021; Matsushita et al., 2018; Cunha et al., 2022). To provide a balanced regional view, we tabulated flood-associated disease events across multiple AMS, including outbreaks following non-monsoon flood events, to illustrate the recurring post-flood transmission risk during and beyond the monsoon context (Table 1).
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