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Extreme weather events (EWEs) often create conditions conducive to outbreaks of infectious diseases. The upsurge of insect, rodent and water-borne diseases following Hurricane Mitch in Central America in October, 1998 highlights this connection. Heavy rains can produce new breeding sites for insects, drive rodents from burrows and contaminate clean water systems. Conversely, flooding followed by drought can spread fungal spores and spark fires. The 1997/98 El Niño-related extreme weather events spawned "clusters" of disease outbreaks in many regions of the globe. In the Horn of Africa extensive flooding led to large outbreaks of malaria, in the Rift Valley fever and cholera. In Latin America, extreme weather was associated with outbreaks of malaria, dengue fever and cholera. In Indonesia and surrounding island nations, delayed monsoons - and the compounding effects of local farming practices - led to prolonged fires, widespread respiratory illness, and significant losses of wildlife.