But within two weeks, Easton died of a water-borne infection, marking the first known case in Nebraska of the amoeba-related illness linked to warm rivers and lakes.
Like so many 8-year-old kids, Easton Gray loved being outside, so it was no surprise that a summer day last year found him doing what he loved: swimming in the Elkhorn River.
For 60-something Lana Brodersen, it was her love of mushroom hunting – and a close encounter with ticks – that brought her brush with death.
And for 50-something Sue Adkins, it was a single mosquito bite that left her so weak she couldn’t lift a spoonful of Cheerios.
While the illnesses these three Nebraskans suffered are rare and could happen regardless of climate change, scientists say the conditions conducive for them to occur are becoming more common as Nebraska warms. The result, they say, is that Nebraska, along with the rest of the world, is on the cusp of a riskier, less healthy future.
Climate change is the single biggest health threat facing humanity, according to the World Health Organization.
From flooding to drought to infectious diseases, the adverse health effects of climate change already are evident in Nebraska, said Jesse Bell, a nationally recognized authority on climate change and health. He is a director of UNMC's Water, Climate and Health Program.
“As you project it forward, those changes will only get greater,” he said. “If we don’t understand the potential impacts, it’s going to make us less prepared for the future.”
“We still have a lot of work to do in understanding the impacts of climate (change) on human health, especially in places like Nebraska,” Bell said. “A lot of times, we’re overlooked or potentially neglected when we’re talking about the impacts of climate change, especially on human health in this part of the country.”
Risks already present in Nebraska underscore the state's vulnerability. Nebraska already is:
- A hotspot for mosquito- and tick-borne diseases.
- A crossroads for eastern and western plant species, which results in a greater potential for allergic reactions.
- One of the most flood-prone states in the nation.
- Home to extreme and violent weather.
The bottom line is that human-caused climate change is already happening and is expected to intensify, according to Bell and Daniel R. Brooks, an adjunct professor with the University of Nebraska-Lincoln’s school of biological sciences. He is an international expert and author on climate change and emerging infectious diseases.
“The danger is great, the time is short, we are largely unprepared,” Brooks said. “But we can do something about it if we want.”
Here is what is known about climate change in Nebraska and some of the ways it affects human health.
Rapid change under way
The rate of change is accelerating.
Already, Nebraska’s average temperature has risen to the point that it is on par with the 1930s, a decade marked by the Dust Bowl, according to the National Centers for Environmental Information.
That’s because of a 1.6 degree increase in average temperature over the last 120-plus years, according to the National Oceanic and Atmospheric Administration, the parent agency of the National Centers and the National Weather Service.
(Most of Nebraska's warming has occurred in the winter and spring and during the night as opposed to during the day. That, plus increasing humidity and cloud cover, helps explain why Nebraska hasn't seen the record summertime highs of the 1930s)
But within the next 30 years, Nebraska is expected to warm more than it has in the past century-plus, perhaps substantially more, said Martha Durr, Nebraska’s State Climatologist. Durr said it's possible Nebraska's average temperature could rise by 5 degrees or more by 2050. If that happens, the state's average temperature will be warmer than 2012, the state’s hottest, driest year on record. That year, Nebraska had its worst wildfires, dozens of communities restricted water use, and range conditions were so poor ranchers sold off portions of their herds.
A warmer planet is also a wetter one, and that’s reflected, scientists say, in the increase in heavy downpours in Nebraska and elsewhere.
The Iowa Flood Center, located at the University of Iowa, has examined historical records and concluded the last 50 to 70 years have seen an increase in flooding in this part of the country.
All of these changes in climate — warmer weather, wetter weather and drought — affect public health.
The planet is changing at such a rapid pace that biological systems are getting jumbled as they move with it, said Brooks, who has written a book on the topic. Hosts, such as people, plants and animals, are mixing with pathogens in new ways, creating the potential for an unknown number of mutations.
“A minefield of evolutionary accidents waiting to happen,” he said. “It’s an enormous problem."
Nebraska already is a hotbed for vector-borne diseases, based on its high rate of mosquito-borne West Nile disease and a number of emerging tick-borne diseases, said Joseph Fauver, an assistant professor of epidemiology in UNMC’s College of Public Health.
Here’s what’s known about them:
Mosquitoes: Warmer temperatures associated with climate change can accelerate mosquito development as well as the incubation of the virus that causes West Nile within the insects, according to EPA.
More than 4,000 Nebraskans are known to have contracted West Nile disease since the virus arrived in 1999, giving the state the fourth-highest cumulative tally of reported cases. Nebraska is surpassed only by states with larger populations: California, Colorado and Texas.
Researchers theorize that Nebraska’s extreme swings in weather may explain why it ranks high for West Nile. Rainy weather followed by hot, dry stretches can generate the stagnant pools of water in which West Nile-carrying mosquitoes thrive.
Among the Omaha-area residents who have been infected is Sue Adkins. Back in 2011, an itchy welt on her neck was initially an annoyance. But within three days, she couldn’t lift a spoon and soon she was hospitalized. It took her a year to recover but she still experiences lingering effects, she said. She no longer can tolerate being outdoors for long periods during hot weather.
Ticks: Health officials are beginning to find more tick-borne diseases as tick populations expand, Fauver said.
Black-legged ticks in Nebraska tested positive for the bacteria that causes Lyme disease for the first time in 2021. Two Nebraska cases of Lyme were reported that year. Both patients likely were exposed near each other in Thurston County, in the northeast corner of the state. While no Omaha area cases have been reported, the presence of the black-legged tick, also known as a deer tick, has been confirmed in the metro area.
“Historically, Nebraska hasn’t had a terribly high incidence of tick-borne diseases, but that’s been steadily marching up over the last 20-ish years,” Fauver said.
A tick native to the south, the lone star tick, also has moved into part of eastern Nebraska and much of Iowa. Not only can the lone star tick carry several diseases, its bite also can trigger an allergy to red meat.
Lana Brodersen of Fremont found out the hard way about the red meat allergy after being bitten by multiple ticks while mushroom hunting last May.
In early June, she broke out in hives and then went into anaphylactic shock, a severe allergic reaction that can be deadly if not treated quickly. The reason? Several hours earlier, she had eaten a hamburger.
Roberto Cortinas of the University of Nebraska School of Veterinary Medicine and Biomedical Sciences noted last summer that ticks are always moving into new areas. But when winters were harsher, they didn’t survive the colder months and didn’t establish a presence.
Other possible threats: An amoeba called Naegleria fowleri, on the other hand, is thought to occur naturally in Nebraska waters and is normally harmless. But when water temperatures reach the mid-80s it transforms to an infectious state.
That was the case in August when Easton went swimming in the Elkhorn. Due to drought, the river was running about 50% of normal, and when particularly hot weather hit, water temperatures climbed above 85 degrees.
Young Easton’s death was the second of its kind in the region last summer. A Missouri resident died of the infection in July after swimming in a lake in south-central Iowa.
Scientists fear other insect borne diseases could be headed to Nebraska.
Two types of Aedes mosquitoes that in warmer parts of the world carry dengue and Zika virus are found in the state. In Nebraska, they do not carry those pathogens. But that, theoretically, could change if those viruses migrate and infect local mosquitoes.
And, as the armadillo moves northward into Nebraska, it could bring with it Chagas disease, an infection carried by a parasite that favors the odd creature.
Those are a few of the known threats. As Brooks says, there's a myriad of unknowable threats ahead as species comingle.
Drought is expected to become more frequent and intense as the state becomes hotter, and with it will come a raft of drought-associated public health threats: range fires, water shortages, dust storms, economic hardship and increased mental health stresses.
In the space of 10 years, Nebraska experienced both its hottest, driest year on record (2012), and its fourth driest year (2022), according to the National Centers for Environmental Information.
Research by UNMC scientists and others has found an association between drought in Nebraska and an increase in deaths. Subsequent national research found a relationship between drought and suicides.
Not surprisingly, the relationship became stronger as drought intensified.
“Drought is not similar to natural disasters where there is an immediate impact,” said Azar Abadi, a climate epidemiologist who, as a research assistant professor at UNMC, participated in the study. “The impacts are more hidden.”
Abadi is now with the University of Alabama at Birmingham.
The drought years of 2012 and 2022 were Nebraska’s worst fire years on record, with hundreds of thousands of acres burning. In 2022, four firefighters died fighting the wildfires in Nebraska and dozens were injured in Nebraska, with many suffering smoke inhalation.
Wildfire smoke, both locally and over long distances, can cause adverse impacts on respiratory and cardiovascular health, according to the Environmental Protection Agency. In the fall of 2020, as wildfire raged in the western U.S., Nebraskans experienced a number of days with degraded air quality.
Drought also jeopardizes the ability of utilities and industry to function, which can have spin-off effects. During the 2012 drought, more than 80 Nebraska communities instituted water restrictions, according to the Nebraska Department of Health and Human Services.
An “atlas of human suffering” is how the head of the United Nations describes the consequences of the rapidly changing climate. That’s because climate change amplifies conditions that destabilize lives, such as floods, wildfires and drought and their related impacts like economic hardship, hunger and homelessness.
With those challenges, psychiatrists say, come mental health struggles. Increasingly, concerns about mental health are being seen in rural Nebraska, where livelihoods depend upon the weather. In addition to extreme weather, Nebraska’s ag producers are juggling the effects of inflation, supply chain delays and storm damage to farm equipment. That’s on top of typical family stresses.
“Climate change adds a lot of additional variability and unpredictability into a system that was already unpredictable,” said John Hansen, president of the Nebraska Farmers Union. “Just in recent years, we've added the words ‘bomb cyclone’ and ‘derecho’ to our vocabulary. ‘Atmospheric rivers’ and ‘polar vortex’. We’re struggling to find words to describe the size and the enormity of the change.”
The number of Nebraskans seeking mental health help through the Rural Response Hotline more than tripled between 2019 and 2022, Hansen said. The Farmers Union is one of the founding sponsors of the hotline, the longest, continuously serving rural crisis line in the country.
The 8,369 calls received last year were a record since the hotline launched in 1984, he said. Some of the increase was due to greater visibility and a jump in funding, he said, but the calls wouldn’t be coming in if the need wasn’t there.
That doesn’t mean that people calling the hotline are tying their difficulties to climate change. A substantial share of rural Nebraskans, especially those whose jobs are ag-related, say too much attention is paid to climate change, according to a 2022 survey by UNL.
In the Omaha metro, therapist Megan Smith says more of her clients in the last five years have begun talking about climate change.
Distress, anxiety, despair and sleepless nights are common manifestations, she said.
Couples, she said, are having to work through disagreements over whether to have children, how to invest their money and even whether to remain in Omaha.
While not everyone brings up climate change, she hears about it from all ages, from “kiddos” to parents.
“When they look into the future, it’s hard for them to imagine a future,” she said.
Since solving the climate crisis is beyond any individual's ability, Smith said she focuses on helping people connect with each other to make tangible changes within their world.
Emma Baker speaks wistfully of the summer of 2021, when she hung an American flag for the first time outside the home she and her husband had just purchased in central Omaha.
“I have this really cool video of our little house with a flag outside of it,” she said.
That was a lifetime ago and a different Emma Baker.
A few months later, flash flooding in pockets of eastern Omaha left their home near 48th Avenue and Center Streets uninhabitable.
Like many others who lose homes to flooding, the couple didn’t have flood insurance because they never imagined their home was at risk. And as with others, the flooding turned out to be just the beginning of their problems.
Months of bureaucratic dead-ends followed. Eventually, their bank collected on its first-time home-buyers mortgage insurance but the couple was left in debt without a home.
“It changed the fiber of our family, it changed who we are as humans,” she said. “I will literally never see anything in my world the same. It shakes everything we once understood. Even patriotism feels different after we lost our house.”‘
The August storm that flooded the Baker home generated “off the charts” rainfall rates of more than 5 inches an hour, according to the National Weather Service. The 2-3 inches of rain that fell wasn’t record-setting, but the intensity of the rain overwhelmed Omaha’s sewer system.
Scientists have long predicted that climate change would generate bigger storms because a warmer atmosphere can hold more moisture, allowing storms to "wring out" more moisture.
The year 2019 will be remembered for a catastrophic March flood, but other flooding also occurred in Nebraska that year, one of a string of wet years.
Of Nebraska’s 93 counties, 84 qualified for federal disaster assistance in 2019. While many Nebraskans had flood insurance, an unknown number of others didn’t. The Nebraska Emergency Management Agency estimated that 7,000 homes were damaged by severe weather that year and 1,000 received a flood insurance payout.
The health effects from the March storm were significant. Some communities lost access to clean drinking water, and some sewage treatment plants ceased functioning. Health care facilities, including hospitals and long-term care facilities were damaged, with some the latter eventually closing. In Fremont, the community and its hospital improvised to continue providing care after floodwaters cut the city off from the rest of the state.
Rachel Lookadoo, a preparedness expert and assistant professor in UNMC's College of Public Health, said weather events like the 2019 floods signal a need for health care facilities and public health officials to factor them into their planning.
"Those extreme events that are impacting people's health immediately and are impacting their access to health care, those are becoming more frequent and more intense, so we need to be doing more preparation for those kinds of events," she said.
In the summer of 2018, more than 100 volunteers answered a call by the Hall County Sheriff’s Office to search a cornfield for a missing farmworker.
The 52-year-old man had succumbed the day before on what was a relatively typical hot, humid summer day in Nebraska. Heat indexes in the field were likely above 100 degrees, according to reports at the time.
Outdoor workers, from farmers to construction workers to trash haulers, are among those most likely to suffer from heat stress as Nebraska warms, researchers say.
Others at risk include the very young and the elderly and those with compromised health.
If changes in greenhouse gas emissions continue on their current pace, Nebraska is expected to have a climate similar to southern Kansas within the next 30 years, Durr said. From there it gets worse: Over the lifetime of someone born today, Nebraska is likely to shift to a climate similar to Texas.
Depending upon where they live in the state, Nebraskans experience an average of 10 to 20 days a year with temperatures greater than 95 degrees, according to Durr. Over the next 30 years, the number of high-temperature days is expected to double, she said.
And while humans can escape to their air-conditioned buildings, wildlife and livestock can struggle as temperatures and humidity rises. Rising nighttime temperatures especially are considered a stressor because nights are when nature typically “cools off” and resets for the next day.
The health effects from rising temperatures, according to UNMC, include increased potential for heat stroke, a worsening of respiratory disease and reduced water quality due to such things as toxic algae, a type of bacteria that is harmful to animals and humans.
Hot weather also can jeopardize food security in a number of ways. Besides more intense drought, it can kill pollen, which prevents plants such as corn, tomatoes, green beans and zucchini from setting fruit.
Hot days contribute to respiratory disease by affecting air quality. In cities such as Omaha, the heat “bakes” air pollutants into a harmful gas known as ozone. That has led to the EPA and local public health officials to issue health alerts on days when ozone levels are high in the metro area.
Toxic algae first became an issue in Nebraska in 2004, when the deaths of five dogs were linked to possible exposure in lakes south of Omaha. Since then, state environmental regulators have begun issuing alerts when testing finds the bacteria at a public lakes.
Allergies and asthma
Studies already link climate change with both longer and more intense pollen seasons. For people with pollen allergies, that means more days of drippy noses and itchy eyes. Those with asthma face the potential for more asthma symptoms.
A 2021 study, in fact, found that pollen seasons nationwide start 20 days earlier and run 10 days longer and feature 21% more pollen than in 1990. The greatest increases in pollen were recorded in the Midwest and Texas.
In the metro area, data from a pollen tracking network indicates that the fall ragweed season increased by 15 days, based on monitors in Bellevue.
Dr. Linda Ford, a Bellevue allergist who has been tracking pollen counts for decades, said cedar trees now typically start to release pollen in February, a couple of weeks earlier than in the past.
“So we are seeing that impact from climate change,” Ford said.
Dr. Andrew Rorie, an allergist and assistant professor of allergy and immunology at UNMC, said longer growing seasons and more carbon dioxide are combining to help plants grow faster and produce more pollen, not just over the course of a year but also at peak production. Some studies also indicate that pollen is more allergenic because of climate change.
Dr. Jill Poole, division chief and professor of allergy and immunology at UNMC, said certain air pollutants, some of which are expected to increase with climate change, appear to interact with pollen when it comes to asthma impacts.
Recent studies by Poole and other UNMC researchers indicate that pediatric emergency room visits for asthma were high on summer days when pollen and air pollutants such as sulfur dioxide and particulates were high.
While most efforts to address climate change focus on slowing greenhouse gas emissions, others by necessity are aimed at identifying threats and preparing for them.
Nebraska and its communities already are taking some steps, but experts say more needs to be done. Some of those steps include monitoring for diseases, bolstering preparedness among public health systems and health facilities, and planning for extremes in weather such as drought and flooding.
Surveillance is critical, Brooks said, including looking for the unexpected.
Nebraska for years has been monitoring mosquitoes and toxic algae and more recently stepped up surveillance efforts for ticks.
A working group made up of researchers from universities and the state's health and agriculture departments is focusing on educating health care providers and people at occupational risk of tick-borne diseases, said Travis Bourret, an associate professor in Creighton University School of Medicine’s medical microbiology and immunology department.
“It’s incredibly important for the public to understand that there’s a risk of Lyme disease but even more so for our clinicians to understand that we have Lyme disease here, because that really dictates whether a person is going to be tested” for the illness, he said.
Researchers at the University of Nebraska-Lincoln launched a citizen science and education effort called Tick Tag Go in 2019 that allows Nebraskans to submit photos of ticks they encounter in their daily activities.
Another goal of the group is to improve signage at parks where people might come in contact with ticks, he said. Group members also have been applying for funding that would allow them to establish a center to screen ticks for diseases.
Nebraska's testing of public lakes for toxic algae has made it a leader. Some states rely on volunteers to test lakes, but Nebraska officials proactively testpopular public lakes during the warm months.
Strengthening public health systems includes understanding who is at greatest risk from extreme heat and figuring out how to communicate that risk.
In Nebraska, UNMC scientists have mapped vulnerability to heat events. In the Omaha metro, a team last summer mapped heat spots and found that some parts of eastern Omaha averaged about 9 degrees warmer than other areas; the analysis is ongoing. In other cities in the U.S., such maps have been used to develop heat action plans, add cooling stations to bus shelters, educate residents and policymakers and inform additional research.
Lincoln and Lancaster County have a head start in Nebraska when it comes to climate preparedness. The city already has a climate action plan and the Lincoln/Lancaster County Health Department is working to create an action plan on heat, including seeking new ways to track its effects on health, said Scott Holmes, manager of its environmental public health division. Flooding and air pollutants, including smoke from wildfires, also are on the list.
The City of Omaha, meanwhile, is seeking to hire a firm to develop a climate plan for the city. The state has not launched one.
The Papio-Missouri River Natural Resources District has long warned that Omaha is at great risk from flooding. Should Omaha experience a storm similar to the 2010 one that flooded Ames, Iowa, the Papio-NRD has estimated that 13,000 people would be displaced and more than $2.1 billion in damage would occur. Congress has authorized additional flood protections for the Omaha metro — but has not provided any money to get the work done.
In terms of preparing for extreme weather, Lincoln is debating how to address flood risks on the Salt Creek system due to changed weather patterns.
"Things are already changed," said Holmes, the Lincoln/Lancaster health official. "This is not a future issue. This is a today issue."