title: Assessing climate variability effects on dengue incidence in San Juan, Puerto Rico.
abstract: We test the hypothesis that climate and environmental conditions are becoming favorable for dengue transmission in San Juan, Puerto Rico. Sea Level Pressure (SLP), Mean Sea Level (MSL), Wind, Sea Surface Temperature (SST), Air Surface Temperature (AST), Rainfall, and confirmed dengue cases were analyzed. We evaluated the dengue incidence and environmental data with Principal Component Analysis, Pearson correlation coefficient, Mann-Kendall trend test and logistic regressions. Results indicated that dry days are increasing and wet days are decreasing. MSL is increasing, posing higher risk of dengue as the perimeter of the San Juan Bay estuary expands and shorelines move inland. Warming is evident with both SST and AST. Maximum and minimum air surface temperature extremes have increased. Between 1992 and 2011, dengue transmission increased by a factor of 3.4 (95% CI: 1.9-6.1) for each 1 °C increase in SST. For the period 2007-2011 alone, dengue incidence reached a factor of 5.2 (95% CI: 1.9-13.9) for each 1 °C increase in SST. Teenagers are consistently the age group that suffers the most infections in San Juan. Results help understand possible impacts of different climate change scenarios in planning for social adaptation and public health interventions.
authors.affiliation: Environmental Health Department, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, P.O. Box 365067, San Juan 00936, Puerto Rico. pablo.mendez1@upr.edu.
authors.forename: Pablo
authors.initials: P
authors.lastname: Méndez-Lázaro
authors.affiliation: Institute for Marine Remote Sensing, College of Marine Science, University of South Florida, 140 7th Ave. South, St. Petersburg, FL 33701, USA. carib@usf.edu.
authors.forename: Frank E
authors.initials: FE
authors.lastname: Muller-Karger
authors.affiliation: Institute for Marine Remote Sensing, College of Marine Science, University of South Florida, 140 7th Ave. South, St. Petersburg, FL 33701, USA. dotis@mail.usf.edu.
authors.forename: Daniel
authors.initials: D
authors.lastname: Otis
authors.affiliation: Institute for Marine Remote Sensing, College of Marine Science, University of South Florida, 140 7th Ave. South, St. Petersburg, FL 33701, USA. mjm8@mail.usf.edu.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: McCarthy
authors.affiliation: Center for Public Health Preparedness, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, P.O. Box 365067, San Juan 00936, Puerto Rico. marisol.pena@upr.edu.
authors.forename: Marisol
authors.initials: M
authors.lastname: Peña-Orellana
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002947:Cities; D057231:Climate Change; D003715:Dengue / Q000453:epidemiology* / Q000635:transmission*; D003716:Dengue Virus / Q000502:physiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D015233:Models, Statistical; D011634:Public Health; D011647:Puerto Rico / Q000453:epidemiology; D055815:Young Adult