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Seasonality in six enterically transmitted diseases and ambient temperature

Published online by Cambridge University Press:  19 June 2006

E. N. NAUMOVA
Affiliation:
Tufts University School of Medicine, Boston, MA, USA
J. S. JAGAI
Affiliation:
Tufts University School of Medicine, Boston, MA, USA
B. MATYAS
Affiliation:
Massachusetts Department of Public Health, Boston, MA, USA
A. DeMARIA
Affiliation:
Massachusetts Department of Public Health, Boston, MA, USA
I. B. MacNEILL
Affiliation:
University of Western Ontario, London, Canada
J. K. GRIFFITHS
Affiliation:
Tufts University School of Medicine, Boston, MA, USA
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Abstract

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We propose an analytical and conceptual framework for a systematic and comprehensive assessment of disease seasonality to detect changes and to quantify and compare temporal patterns. To demonstrate the proposed technique, we examined seasonal patterns of six enterically transmitted reportable diseases (EDs) in Massachusetts collected over a 10-year period (1992–2001). We quantified the timing and intensity of seasonal peaks of ED incidence and examined the synchronization in timing of these peaks with respect to ambient temperature. All EDs, except hepatitis A, exhibited well-defined seasonal patterns which clustered into two groups. The peak in daily incidence of Campylobacter and Salmonella closely followed the peak in ambient temperature with the lag of 2–14 days. Cryptosporidium, Shigella, and Giardia exhibited significant delays relative to the peak in temperature (~40 days, P<0·02). The proposed approach provides a detailed quantification of seasonality that enabled us to detect significant differences in the seasonal peaks of enteric infections which would have been lost in an analysis using monthly or weekly cumulative information. This highly relevant to disease surveillance approach can be used to generate and test hypotheses related to disease seasonality and potential routes of transmission with respect to environmental factors.

Type
Research Article
Copyright
2006 Cambridge University Press