Abstract

We assessed the association between climate factors and a number of aseptic meningitis cases in six metropolitan provinces of the Republic of Korea using a weekly number of cases from January 2002 to December 2012. Generalized linear quasi-Poisson models were applied to estimate the effects of climate factors on the weekly number of aseptic meningitis cases. We used generalized additive and generalized additive mixed models to assess dose–response relationships. A 1 °C increase in mean temperature was associated with an 11.4% (95% confidence interval (CI): 9.6%–13.3%) increase in aseptic meningitis with a 0-week lag; a 10 mm rise in rainfall was associated with an 8.0% (95% CI: 7.2%–8.8%) increase in aseptic meningitis with a 7-week lag; and a 1 mJ/m2 increase of solar radiation was associated with a 5.8% (95% CI: 3.0%–8.7%) increase in aseptic meningitis with a 10-week lag. Nino3 showed positive effects in all lags, and its one unit increase was associated with an 18.9% (95% CI: 15.3%–22.6%) increase of aseptic meningitis at lag 9. The variability in the relationship between climate factors and aseptic meningitis could be used to initiate preventive measures for climate determinants of aseptic meningitis.

Highlights

  • Enteroviruses (EVs) are non-enveloped RNA viruses of the family Picornaviridae

  • We found a high correlation between humidity and rainfall as well as sunshine and solar radiation

  • In 2002–2012, a total of 351,012 confirmed cases of aseptic meningitis (AM) occurred in Korea, with an average annual incidence of 6.6 per 10,000

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Summary

Introduction

Human EVs are sub-grouped into poliovirus, coxsackievirus group A (CAV), coxsackievirus group B (CBV), echovirus, and the newer EV serotypes 68 to 71 [1,2]. They spread mainly by the fecal–oral and oral–oral routes or through direct contact, water, food, or soil contaminated with feces [1,3]. Enteroviral diseases are found year-round in tropical and semi-tropical climates and primarily in the summer and fall months in temperate regions [1,2,4]. Prevalence and transmissibility vary by viral strain, climate, season, geography, crowding, and socio-economic status [4,5,6,7]. The seasonality of AM suggests that meteorological factors might influence

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