Association between heavy rainfall and flooding events and infectious diseases in Europe: a rapid review, 2018 to 2025.

BACKGROUNDBecause of climate change, the frequency of extreme weather events, including heavy rainfall and flooding, is increasing in Europe. It is important to understand how such events affect infectious disease incidence to inform preparedness and response activities.AIMWe aimed to gather evidence of associations between heavy rainfall and flooding and infectious disease incidence in humans in Europe, as well as report preparedness and response measures.METHODSIn this rapid review, PubMed, Embase and the Cochrane Library were searched using a combination of keywords relevant to infectious diseases as well as to heavy rainfall and flooding to identify published literature and preprints. Articles published between 1 January 2018 and 15 June 2025 were eligible for inclusion.RESULTSFrom 897 records identified, 14 articles were included in the review. In particular, outbreaks of campylobacteriosis and cases of leptospirosis were reported following heavy rainfall and flooding events in Europe. Public health communication on awareness and hygienic practices was among the most commonly reported preparedness and response measure, while structural measures such as sanitary infrastructure and One Health surveillance systems were suggested.CONCLUSIONWhile heavy rainfall and flooding have been associated with outbreaks of infectious diseases in different parts of Europe, relatively few studies investigating these associations were identified in Europe despite wide search criteria, highlighting the need for further research to strengthen European preparedness and response measures.