BackgroundOver the last 5 years (2013–2017), the Caribbean region has faced an unprecedented crisis of co-occurring epidemics of febrile illness due to arboviruses transmitted by the Aedes sp. mosquito (dengue, chikungunya, and Zika). Since 2013, the Caribbean island of Barbados has experienced 3 dengue outbreaks, 1 chikungunya outbreak, and 1 Zika fever outbreak. Prior studies have demonstrated that climate variability influences arbovirus transmission and vector population dynamics in the region, indicating the potential to develop public health interventions using climate information. The aim of this study is to quantify the nonlinear and delayed effects of climate indicators, such as drought and extreme rainfall, on dengue risk in Barbados from 1999 to 2016.Methods and findingsDistributed lag nonlinear models (DLNMs) coupled with a hierarchal mixed-model framework were used to understand the exposure–lag–response association between dengue relative risk and key climate indicators, including the standardised precipitation index (SPI) and minimum temperature (Tmin). The model parameters were estimated in a Bayesian framework to produce probabilistic predictions of exceeding an island-specific outbreak threshold. The ability of the model to successfully detect outbreaks was assessed and compared to a baseline model, representative of standard dengue surveillance practice. Drought conditions were found to positively influence dengue relative risk at long lead times of up to 5 months, while excess rainfall increased the risk at shorter lead times between 1 and 2 months. The SPI averaged over a 6-month period (SPI-6), designed to monitor drought and extreme rainfall, better explained variations in dengue risk than monthly precipitation data measured in millimetres. Tmin was found to be a better predictor than mean and maximum temperature. Furthermore, including bidimensional exposure–lag–response functions of these indicators—rather than linear effects for individual lags—more appropriately described the climate–disease associations than traditional modelling approaches. In prediction mode, the model was successfully able to distinguish outbreaks from nonoutbreaks for most years, with an overall proportion of correct predictions (hits and correct rejections) of 86% (81%:91%) compared with 64% (58%:71%) for the baseline model. The ability of the model to predict dengue outbreaks in recent years was complicated by the lack of data on the emergence of new arboviruses, including chikungunya and Zika.ConclusionWe present a modelling approach to infer the risk of dengue outbreaks given the cumulative effect of climate variations in the months leading up to an outbreak. By combining the dengue prediction model with climate indicators, which are routinely monitored and forecasted by the Regional Climate Centre (RCC) at the Caribbean Institute for Meteorology and Hydrology (CIMH), probabilistic dengue outlooks could be included in the Caribbean Health-Climatic Bulletin, issued on a quarterly basis to provide climate-smart d...

A workshop was held at the University of the West Indies, Jamaica, in May 2012 to build capacity in climate data rescue and to enhance knowledge about climate change in the Caribbean region. Scientists brought their daily observational surface temperature and precipitation data from weather stations for an assessment of quality and homogeneity and for the calculation of climate indices helpful for studying climate change in their region. This study presents the trends in daily and extreme temperature and precipitation indices in the Caribbean region for records spanning the 1961-2010 and 1986-2010 intervals. Overall, the results show a warming of the surface air temperature at land stations. In general, the indices based on minimum temperature show stronger warming trends than indices calculated from maximum temperature. The frequency of warm days, warm nights and extreme high temperatures has increased while fewer cool days, cool nights and extreme low temperatures were found for both periods. Changes in precipitation indices are less consistent and the trends are generally weak. Small positive trends were found in annual total precipitation, daily intensity, maximum number of consecutive dry days and heavy rainfall events particularly during the period 1986-2010. Correlations between indices and the Atlantic multidecadal oscillation (AMO) index suggest that temperature variability and, to a lesser extent, precipitation extremes are related to the AMO signal of the North Atlantic surface sea temperatures: stronger associations are found in August and September for the temperature indices and in June and October for some of the precipitation indices.

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Abstract. Dansgaard-Oeschger events occurred frequently during Marine Isotope Stage 3 (MIS3), as opposed to the following MIS2 period, which included the Last Glacial Maximum (LGM). Transient climate model simulations suggest that these abrupt warming events in Greenland and the North Atlantic region are associated with a resumption of the Thermohaline Circulation (THC) from a weak state during stadials to a relatively strong state during interstadials. However, those models were run with LGM, rather than MIS3 boundary conditions. To quantify the influence of different boundary conditions on the climates of MIS3 and LGM, we perform two equilibrium climate simulations with the threedimensional earth system model LOVECLIM, one for stadial, the other for interstadial conditions. We compare them to the LGM state simulated with the same model. Both climate states are globally 2 • C warmer than LGM. A striking feature of our MIS3 simulations is the enhanced Northern Hemisphere seasonality, July surface air temperatures being 4 • C warmer than in LGM. Also, despite some modification in the location of North Atlantic deep water formation, deep water export to the South Atlantic remains unaffected. To study specifically the effect of orbital forcing, we perform two additional sensitivity experiments spun up from our stadial simulation. The insolation difference between MIS3 and LGM causes half of the 30-60 • N July temperature anomaly (+6 • C). In a third simulation additional freshwater forcing halts the Atlantic THC, yielding a much colder North Atlantic region (−7 • C). Comparing our simulation with proxy data, we find that the MIS3 climate with collapsed THC Correspondence to: C. J. Van Meerbeeck (cedric.van.meerbeeck@falw.vu.nl) mimics stadials over the North Atlantic better than both control experiments, which might crudely estimate interstadial climate. These results suggest that freshwater forcing is necessary to return climate from warm interstadials to cold stadials during MIS3. This changes our perspective, making the stadial climate a perturbed climate state rather than a typical, near-equilibrium MIS3 climate.