02160nas a2200313   4500000000100000008004100001653002700042653002400069653001200093653002200105653000900127653001300136100001200149700001400161700001300175700001900188700001400207700001500221700001200236700001500248700001300263700001400276245008100290856006200371300000800433490000600441520138500447022001401832       2017                            d10aMycobacterium ulcerans10aGeneralist pathogen10aClimate10aAquatic ecosystem10aNTDs10atropical1 aCombe M1 aVelvin CJ1 aMorris A1 aGarchitorena A1 aCarolan K1 aSanhueza D1 aRoche B1 aCouppié P1 aGuegan J1 aGozlan RE00aGlobal and local environmental changes as drivers of Buruli ulcer emergence.  uhttp://www.nature.com/emi/journal/v6/n4/pdf/emi20177a.pdf  ae340 v63 a<p>Many emerging infectious diseases are caused by generalist pathogens that infect and transmit via multiple host species with multiple dissemination routes, thus confounding the understanding of pathogen transmission pathways from wildlife reservoirs to humans. The emergence of these pathogens in human populations has frequently been associated with global changes, such as socio-economic, climate or biodiversity modifications, by allowing generalist pathogens to invade and persist in new ecological niches, infect new host species, and thus change the nature of transmission pathways. Using the case of Buruli ulcer disease, we review how land-use changes, climatic patterns and biodiversity alterations contribute to disease emergence in many parts of the world. Here we clearly show that Mycobacterium ulcerans is an environmental pathogen characterized by multi-host transmission dynamics and that its infectious pathways to humans rely on the local effects of global environmental changes. We show that the interplay between habitat changes (for example, deforestation and agricultural land-use changes) and climatic patterns (for example, rainfall events), applied in a local context, can lead to abiotic environmental changes and functional changes in local biodiversity that favor the pathogen's prevalence in the environment and may explain disease emergence.</p>
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