Short-term weather variability in chicago and hospitalizations for kawasaki disease

William Checkley, Judith Guzman-Cottrill, Leonardo Epstein, Nancy Innocentini, Jonathan Patz, Stanford Shulman

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Abstract

BACKGROUND: Kawasaki disease exhibits a distinct seasonality, and short-term changes in weather may affect its occurrence. METHODS: To investigate the effects of weather variability on the occurrence of this syndrome, we conducted a time-between-events analysis of consecutive admissions for Kawasaki disease to a large pediatric hospital in Chicago. We used gamma regression to model the times between admissions. This is a novel application of gamma regression to model the time between admissions as a function of subject-specific covariates. RESULTS: We recorded 723 admissions in the 18-year (1986-2003) study period, of which 700 had complete data for analysis. Admissions for Kawasaki disease in Chicago were seasonal: The mean time between admissions was 34% shorter (relative time = 0.66, 95% confidence interval 0.54-0.81) from January-March than from July-September. In 1998, we recorded a larger number of admissions for Kawasaki disease (n = 65) than in other years (mean n = 37). January-March months of 1998 were warmer by a mean of 3°C (1.5°C-4.4°C) and the mean time between admissions was 48% shorter (relative time = 0.52, 0.36-0.75) than in equivalent periods of other study years. CONCLUSIONS: Our findings show that atypical changes in weather affect the occurrence of Kawasaki disease and are compatible with a link to an infectious trigger. The analysis of interevent times using gamma regression is an alternative to Poisson regression in modeling a time series of sparse daily counts.

Original languageEnglish (US)
Pages (from-to)194-201
Number of pages8
JournalEpidemiology
Volume20
Issue number2
DOIs
StatePublished - Mar 2009

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Mucocutaneous Lymph Node Syndrome
Weather
Hospitalization
Pediatric Hospitals
Confidence Intervals

ASJC Scopus subject areas

  • Epidemiology
  • Medicine(all)

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Short-term weather variability in chicago and hospitalizations for kawasaki disease. / Checkley, William; Guzman-Cottrill, Judith; Epstein, Leonardo; Innocentini, Nancy; Patz, Jonathan; Shulman, Stanford.

In: Epidemiology, Vol. 20, No. 2, 03.2009, p. 194-201.

Research output: Contribution to journalArticle

Checkley, William ; Guzman-Cottrill, Judith ; Epstein, Leonardo ; Innocentini, Nancy ; Patz, Jonathan ; Shulman, Stanford. / Short-term weather variability in chicago and hospitalizations for kawasaki disease. In: Epidemiology. 2009 ; Vol. 20, No. 2. pp. 194-201.
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