title: Spatiotemporal patterns of infant bronchiolitis in a Tennessee  Medicaid population.
abstract: Respiratory syncytial virus (RSV) is a major cause of worldwide morbidity and mortality in infants, primarily through the induction of bronchiolitis. RSV epidemics are highly seasonal, occurring in the winter months in the northern hemisphere. Within the United States, RSV epidemic dynamics vary both spatially and temporally. This analysis employs a retrospective space–time scan statistic to locate spatiotemporal clustering of infant bronchiolitis in a very large Tennessee (TN) Medicaid cohort. We studied infants less than 6 months of age (N = 52,468 infants) who had an outpatient visit, emergency department visit, or hospitalization for bronchiolitis between 1995 and 2008. The scan statistic revealed distinctive and consistent patterns of deviation in epidemic timing. Eastern TN (Knoxville area) showed clustering in January and February, and Central TN (Nashville area) in November and December. This is likely due to local variation in geography-associated factors which should be taken into consideration in future modeling of RSV epidemics.
authors: Vanderbilt Center for Asthma & Environmental Health Sciences Research, Vanderbilt University Medical Center, Nashville, TN, United States.
authors: Chantel D
authors: CD
authors: Sloan
authors: Tebeb
authors: T
authors: Gebretsadik
authors: Pingsheng
authors: P
authors: Wu
authors: Kecia N
authors: KN
authors: Carroll
authors: Edward F
authors: EF
authors: Mitchel
authors: Tina V
authors: TV
authors: Hartert
mesh_terms: D001988:Bronchiolitis / Q000453:epidemiology* / Q000209:etiology / Q000821:virology; D016000:Cluster Analysis; D015331:Cohort Studies; D058872:Epidemics / Q000706:statistics & numerical data*; D005260:Female; D062305:Geographic Mapping; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D018357:Respiratory Syncytial Virus Infections / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D012621:Seasons; D062206:Spatial Analysis; D013714:Tennessee / Q000453:epidemiology; D014481:United States
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