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Climate Change and Human Health Literature Portal Environmental exposures and invasive meningococcal disease: An evaluation of effects on varying time scales

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Kinlin LM, Spain CV, Ng V, Johnson CC, White ANJ, Fisman DN
2009
American Journal of Epidemiology. 169 (5): 588-595

Invasive meningococcal disease (IMD) is an important cause of meningitis and bacteremia worldwide. Seasonal variation in IMD incidence has long been recognized, but mechanisms responsible for this phenomenon remain poorly understood. The authors sought to evaluate the effect of environmental factors on IMD risk in Philadelphia, Pennsylvania, a major urban center. Associations between monthly weather patterns and IMD incidence were evaluated using multivariable Poisson regression models controlling for seasonal oscillation. Short-term weather effects were identified using a case-crossover approach. Both study designs control for seasonal factors that might otherwise confound the relation between environment and IMD. Incidence displayed significant wintertime seasonality (for oscillation, P < 0.001), and Poisson regression identified elevated monthly risk with increasing relative humidity (per 1% increase, incidence rate ratio = 1.04, 95% confidence interval: 1.004, 1.08). Case-crossover methods identified an inverse relation between ultraviolet B radiation index 1-4 days prior to onset and disease risk (odds ratio = 0.54, 95% confidence interval: 0.34, 0.85). Extended periods of high humidity and acute changes in ambient ultraviolet B radiation predict IMD occurrence in Philadelphia. The latter effect may be due to decreased pathogen survival or virulence and may explain the wintertime seasonality of IMD in temperate regions of North America.

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Resource Description

    Air Pollution, Meteorological Factor, Precipitation, Solar Radiation, Temperature
    • Air Pollution, Meteorological Factor, Precipitation, Solar Radiation, Temperature: Ground-Level Ozone, Particulate Matter, Other Air Pollution, Specify
      • Ground-Level Ozone, Particulate Matter, Other Air Pollution, Specify: Lead; SOx
      Air Pollution (other)
    • Air Pollution, Meteorological Factor, Precipitation, Solar Radiation, Temperature: Variability
    Urban
    United States
    Infectious Disease
    • Infectious Disease: Airborne Disease
      • Airborne Disease: Meningitis
      Airborne Disease
    Research Article
    Vulnerable Population
    • Vulnerable Population: Children, Elderly
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