title: The impact of temperature and relative humidity on spatiotemporal patterns of infant bronchiolitis epidemics in the contiguous United States.
abstract: Infant bronchiolitis is primarily due to infection by respiratory syncytial virus (RSV), which is highly seasonal. The goal of the study is to understand how circulation of RSV is impacted by fluctuations in temperature and humidity in order to inform prevention efforts. Using data from the Military Health System (MHS) Data Repository (MDR), we calculated rates of infant bronchiolitis for the contiguous US from July 2004 to June 2013. Monthly temperature and relative humidity were extracted from the National Climate Data Center. Using a spatiotemporal generalized linear model for binomial data, we estimated bronchiolitis rates and the effects of temperature and relative humidity while allowing them to vary over location and time. Our results indicate a seasonal pattern that begins in the Southeast during November or December, then spreading in a Northwest direction. The relationships of temperature and humidity were spatially heterogeneous, and we find that climate can partially account for early onset or longer epidemic duration. Small changes in climate may be associated with larger fluctuations in epidemic duration.
authors.affiliation: Brigham Young University, Provo, UT, USA. Electronic address: chantel.sloan@byu.edu.
authors.forename: Chantel
authors.initials: C
authors.lastname: Sloan
authors.affiliation: Brigham Young University, Provo, UT, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Heaton
authors.affiliation: Brigham Young University, Provo, UT, USA.
authors.forename: Sorah
authors.initials: S
authors.lastname: Kang
authors.affiliation: Brigham Young University, Provo, UT, USA.
authors.forename: Candace
authors.initials: C
authors.lastname: Berrett
authors.affiliation: Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Pingsheng
authors.initials: P
authors.lastname: Wu
authors.affiliation: Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Tebeb
authors.initials: T
authors.lastname: Gebretsadik
authors.affiliation: Health ResearchTx, Trevose, PA, USA; Navy and Marine Corps Public Health Center, Portsmouth, VA, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Sicignano
authors.affiliation: Navy and Marine Corps Public Health Center, Portsmouth, VA, USA.
authors.forename: Amber
authors.initials: A
authors.lastname: Evans
authors.affiliation: Naval Medical Research Unit Dayton, Wright Patterson AFB, OH, USA.
authors.forename: Rees
authors.initials: R
authors.lastname: Lee
authors.affiliation: Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Tina
authors.initials: T
authors.lastname: Hartert
mesh_terms: D001988:Bronchiolitis / Q000453:epidemiology*; D058872:Epidemics / Q000517:prevention & control; D006801:Humans; D006813:Humidity; D007223:Infant; D007231:Infant, Newborn; D018113:Respiratory Syncytial Virus, Human / Q000302:isolation & purification; D012621:Seasons; D062206:Spatial Analysis; D013696:Temperature; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: Climate; RSV; Respiratory; Seasonal