title: Time trends in pediatric hospitalizations for varicella infection are associated with climatic changes: a 22-year retrospective study in a tertiary Greek referral center.
abstract: OBJECTIVE
  The transmission rate of air-borne infectious diseases may vary secondary to climate conditions. The study assessed time trends in the seasonality of hospitalized varicella cases in a temperate region in relation to climatic parameters prior to the implementation of universal varicella immunization.
  
  
  METHODS
  A retrospective descriptive study was conducted among all pediatric and adolescent varicella patients (n = 2366) hospitalized at the "Aghia Sophia" Children's Hospital during 1982-2003 in Athens, Greece. Date of infection was computed based on hospital admission date. Seasonal and monthly trends in the epidemiology of varicella infection were assessed with time series analysis (ARIMA modeling procedure). The correlation between the frequency of varicella patients and the meteorological parameters was examined by the application of Generalized Linear Models with Gamma distribution.
  
  
  RESULTS
  During 1982-2003, the occurrence of hospitalized varicella cases increased during summer (p = 0.025) and decreased during autumn (p = 0.021), and particularly in September (p = 0.003). The frequency of hospitalized varicella cases was inversely associated with air temperature (p<0.001). In contrast, the occurrence of hospitalized varicella cases was positively associated with wind speed (p = 0.009).
  
  
  CONCLUSIONS
  Pediatric hospitalizations for varicella infection rates have increased during summer and decreased during autumn in the examined temperate region. Time trends in hospitalized varicella cases are associated with climatic variables.
authors.affiliation: Second University Department of Pediatrics, P. & A. Kyriakou Children's Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.
authors.forename: Elena
authors.initials: E
authors.lastname: Critselis
authors.forename: Panagiotis T
authors.initials: PT
authors.lastname: Nastos
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Theodoridou
authors.forename: Maria
authors.initials: M
authors.lastname: Theodoridou
authors.forename: Maria N
authors.initials: MN
authors.lastname: Tsolia
authors.forename: Christos
authors.initials: C
authors.lastname: Hadjichristodoulou
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Papaevangelou
mesh_terms: D000293:Adolescent; D002644:Chickenpox / Q000453:epidemiology* / Q000266:history; D002648:Child; D002675:Child, Preschool; D002980:Climate; D057231:Climate Change; D006115:Greece; D049673:History, 20th Century; D049674:History, 21st Century; D006760:Hospitalization / Q000639:trends*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012621:Seasons; D062606:Tertiary Care Centers