Abstract

The incidence of extreme precipitation has increased with the exacerbation of worldwide climate disruption. We hypothesize an association between precipitation and the distribution patterns that would affect the endemic burden of 8 infectious diseases in Taiwan, including water- and vector-borne infectious diseases. A database integrating daily precipitation and temperature, along with the infectious disease case registry for all 352 townships in the main island of Taiwan was analysed for the period from 1994 to 2008. Four precipitation levels, <130 mm, 130–200 mm, 200–350 mm and >350 mm, were categorized to represent quantitative differences, and their associations with each specific disease was investigated using the Generalized Additive Mixed Model and afterwards mapped on to the Geographical Information System. Daily precipitation levels were significantly correlated with all 8 mandatory-notified infectious diseases in Taiwan. For water-borne infections, extreme torrential precipitation (>350 mm/day) was found to result in the highest relative risk for bacillary dysentery and enterovirus infections when compared to ordinary rain (<130 mm/day). Yet, for vector-borne diseases, the relative risk of dengue fever and Japanese encephalitis increased with greater precipitation only up to 350 mm. Differential lag effects following precipitation were statistically associated with increased risk for contracting individual infectious diseases. This study’s findings can help health resource sector management better allocate medical resources and be better prepared to deal with infectious disease outbreaks following future extreme precipitation events.

Highlights

  • Global climate disruption appears to have increased the intensity of tropical cyclones, including typhoons in Southeast Asia, hurricanes in Central America and the Southeast United States, resulting in much greater probability of extreme precipitation [1–5]

  • Observational and projection studies suggest that turbulent atmospheric activity has and will intensify the regional precipitation in the past, present and future [4–6]

  • The Pearson product-moment correlation identified that extreme precipitation events were associated with the occurrence of 8 infectious diseases with lags of 0–70 days

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Summary

Introduction

Global climate disruption appears to have increased the intensity of tropical cyclones, including typhoons in Southeast Asia, hurricanes in Central America and the Southeast United States, resulting in much greater probability of extreme precipitation [1–5]. Extreme precipitation events, increasing the amount of regional precipitation and flooding, have heightened the risk and concern over the transmission of various infectious diseases which may affect their distribution and chances of becoming epidemics [6– 12]. Contaminated water sources for drinking and recreation, due mostly to flooding after extreme precipitation, have been associated with water-borne diseases outbreaks and epidemics [7–8], [10–16]. Extreme precipitation can leave pools of stagnant water that create optimal breeding grounds and growth environments for vectors and hosts, including mosquitoes, mites, rodents and insects [9–10], [12]

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