It's not the heat, it's the humidity: Wet weather increases Legionellosis risk in the greater Philadelphia metropolitan area
It's not the heat, it's the humidity: Wet weather increases Legionellosis risk in the greater Philadelphia metropolitan area
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DOI：
10.1086/498248
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发表时间：
2005-12-15
影响因子：
6.4
通讯作者：
Newbern, C
中科院分区：
文献类型：
--
作者：
Fisman, DN;Lim, S;Newbern, C
背景。军团菌在环境中大量存在，并且越来越多地被认为是严重肺炎的原因。大费城都会区 (GPMA) 社区获得性军团菌病病例的增加引起了人们的担忧，即环境因素的变化可能会影响疾病的发生。方法。我们使用传统的泊松回归分析和病例交叉研究方法评估了 GPMA 中天气模式与军团病发生之间的关联。后一种方法控制可能混淆天气与疾病发生之间关系的季节性因素，并允许识别与疾病相关的急性天气模式。结果。 1995 年至 2003 年间，共报告了 240 例军团病病例。病例发生具有明显的夏季季节性。通过泊松回归分析，病例的发生与月平均温度（每摄氏度的发病率比[IRR]，1.07[95%置信区间{CI}，1.05-1.09]）和相对湿度（相对湿度每增加1%，IRR，1.09[95%CI，1.06-1.12]）相关。然而，病例交叉分析发现，病例发生前 6-10 天与降水（比值比 [OR]，2.48 [95% CI，1.30-3.12]）和湿度增加（相对湿度每增加 1%，OR，1.08 [95% CI，1.05-1.11]）密切相关。病例发生与降水和湿度增加存在显着的剂量反应关系。结论。尽管在 GPMA 中，军团病主要发生在夏季，但最好在潮湿的天气下预测疾病的急性发生。这一发现与目前对该病原体生态特征的理解一致，并支持散发性军团菌病是通过水源污染而发生的论点。
Background. Legionella species are abundant in the environment and are increasingly recognized as a cause of severe pneumonia. Increases in cases of community-acquired legionellosis in the greater Philadelphia metropolitan area (GPMA) led to concern that changing environmental factors could influence occurrence of disease.Methods. We evaluated the association between weather patterns and occurrence of legionellosis in the GPMA, using both traditional Poisson regression analysis and a case-crossover study approach. The latter approach controls for seasonal factors that could confound the relationship between weather and occurrence of disease and permits the identification of acute weather patterns associated with disease.Results. A total of 240 cases of legionellosis were reported between 1995 and 2003. Cases occurred with striking summertime seasonality. Occurrence of cases was associated with monthly average temperature ( incidence rate ratio [IRR] per degree Celsius, 1.07 [95% confidence interval {CI}, 1.05-1.09]) and relative humidity ( IRR per 1% increase in relative humidity, 1.09 [95% CI, 1.06-1.12]) by Poisson regression analysis. However, case-crossover analysis identified an acute association with precipitation (odds ratio [OR], 2.48 [95% CI, 1.30-3.12]) and increased humidity (OR per 1% increase in relative humidity, 1.08 [95% CI, 1.05-1.11]) 6-10 days before occurrence of cases. A significant dose-response relationship for occurrence of cases was seen with both precipitation and increased humidity.Conclusions. Although, in the GPMA, legionellosis occurred predominantly during summertime, the acute occurrence of disease is best predicted by wet, humid weather. This finding is consistent with the current understanding of the ecological profile of this pathogen and supports the contention that sporadic legionellosis occurs through contamination of water sources.