Fig. 4: Future ENSO change and its effects on the global dengue burden.

Changes in the ENSO amplitude (a) and global mean teleconnection strength (the absolute value of teleconnection) with local temperature (b) and local precipitation (c) between 1940–2019 and 2020–2099 for multiple ensemble members of CMIP6 simulations from four scenarios. The ENSO amplitude was measured as the standard deviation of the DJF NINO3.4 series. We selected 69 out of 88 ensemble members for SSP1-2.6, 105 out of 150 for SSP2-4.5, 101 out of 134 for SSP3-7.0, and 58 out of 94 for SSP5-8.5 because the bias between simulated amplitude and observed amplitude in 1980–2019 is less than 50% of the observed amplitude⁷⁷. Error bars indicate the median and the 25th–75th percentiles. Source data are provided as a Source Data file. Changes in global dengue cases due to changes in ENSO amplitude (d) and teleconnection strength with temperature (e). Changes in global dengue cases were calculated as the change rate in dengue cases between projected future (2020–2099) and counterfactual future without ENSO evolution under human-induced warming (Methods). Each dot corresponds to one CMIP6 simulation. Lines denote mean values, shaded areas denote the 95% CIs, and the regression lines and 95% CIs are drawn for all simulations and scenarios. The significant level is assessed by a two-tailed test. Source data are provided as a Source Data file. f Changes in global dengue cases due to changes in El Niño and La Niña events between projected future and counterfactual future. The calculation was based on the median values of projected changes in the ENSO amplitude and teleconnection strength across CMIP6 simulations. Dots denote averages, and bars indicate the 95% CIs from 1000 bootstrapping of regression coefficients. SSP1-2.6, low-emission scenario, the Paris Agreement to limit warming to 1.5 °C–2.0 °C above the pre-industrial level; SSP2-4.5, middle of the road, following historical trends; SSP3-7.0, a fragmented world with regional differences in climate policy; and SSP5-8.5, high-emission scenario, no additional climate policy³⁹. Source data are provided as a Source Data file.