Campylobacteriosis Risk Of Hospital Admission Related To Extreme Weather Event Frequency In Maryland

Abstract

Introduction: Limited understanding exists regarding the association between extreme weather events and risk of Campylobacteriosis, particularly for communities in coastal regions. Methods: Laboratory culture-confirmed cases of Campylobacteriosis were obtained from the Maryland Foodborne Diseases Active Surveillance Network for Maryland from 2002 to 2012 along with clinical and demographic information. This data was combined with location and calendar day specific extreme temperature and precipitation events calculated using a 30-year baseline (1960-1989). Multivariate negative binomial regression utilizing generalized estimation equations was used to investigate the associations between Campylobacteriosis and extreme weather events. Results: There were 4,804 cases of Campylobacteriosis from 2002-2012 in Maryland. Through stratified analysis, we observed a 2% increase in risk of Campylobacteriosis for Non-Hispanic Whites associated with a one-unit increase in extreme precipitation events, but a marginally significant decrease in risk for extreme temperature events (IRR 0.98, 95% CI: 0.97, 1.00). For a one-unit increase in extreme precipitation events, this risk was considerably higher in the Eastern Shore region (IRR 1.05, 95% CI: 1.01, 1.09), and during the El Niño period (IRR 1.10, 95% CI: 1.06, 1.14). Discussion: Our data suggest that Campylobacteriosis is associated with extreme precipitation events in Maryland. The risk was more pronounced in the coastal areas and during El Niño periods. Extreme precipitation related flooding in coastal areas could bring water contaminated with bacterial pathogens (originating from point sources such as municipal wastewater treatment plants and animal feeding operations) into close proximity with individuals, where frequency of contact (via swimming or recreation) may be higher. Increased risk associated with the El Niño period could be related to the more intense precipitation events during this time period.