Weather conditions and legionellosis: a nationwide case-crossover study among Medicare recipients.

IF 2.5 4区 医学 Q3 INFECTIOUS DISEASES Epidemiology and Infection Pub Date : 2024-10-17 DOI:10.1017/S0950268824000979
Timothy J Wade, Carly Herbert
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Abstract

Legionellosis is a respiratory infection caused by Legionella sp. that is found in water and soil. Infection may cause pneumonia (Legionnaires' Disease) and a milder form (Pontiac Fever). Legionella colonizes water systems and results in exposure by inhalation of aerosolized bacteria. The incubation period ranges from 2 to 14 days. Precipitation and humidity may be associated with increased risk. We used Medicare records from 1999 to 2020 to identify hospitalizations for legionellosis. Precipitation, temperature, and relative humidity were obtained from the PRISM Climate Group for the zip code of residence. We used a time-stratified bi-directional case-crossover design with lags of 20 days. Data were analyzed using conditional logistic regression and distributed lag non-linear models. A total of 37 883 hospitalizations were identified. Precipitation and relative humidity at lags 8 through 13 days were associated with an increased risk of legionellosis. The strongest association was precipitation at day 10 lag (OR = 1.08, 95% CI = 1.05-1.11 per 1 cm). Over 20 days, 3 cm of precipitation increased the odds of legionellosis over four times. The association was strongest in the Northeast and Midwest and during summer and fall. Precipitation and humidity were associated with hospitalization among Medicare recipients for legionellosis at lags consistent with the incubation period for infection.

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天气条件与军团菌病:一项针对医疗保险受益人的全国性病例交叉研究。
军团菌病是由存在于水和土壤中的军团菌引起的呼吸道感染。感染可能导致肺炎(军团病)和较轻的肺炎(庞蒂亚克热)。军团菌在水系统中定植,通过吸入气溶胶细菌导致感染。潜伏期为 2 到 14 天。降雨和潮湿可能与风险增加有关。我们利用 1999 年至 2020 年的医疗保险记录来确定军团菌病的住院病例。降水量、温度和相对湿度均来自居住地邮政编码的 PRISM 气候组。我们采用了滞后 20 天的时间分层双向病例交叉设计。数据采用条件逻辑回归和分布滞后非线性模型进行分析。共确定了 37 883 例住院病例。滞后 8 天至 13 天的降水和相对湿度与军团菌病风险的增加有关。关联性最强的是滞后第 10 天的降水(OR = 1.08,95% CI = 1.05-1.11 per 1 cm)。在 20 天内,3 厘米的降水量使军团菌病的发病几率增加了四倍多。这种关联在东北部和中西部以及夏秋季最为明显。降水和湿度与医疗保险受益人因军团菌病住院治疗的相关性滞后于感染的潜伏期。
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来源期刊
Epidemiology and Infection
Epidemiology and Infection 医学-传染病学
CiteScore
4.10
自引率
2.40%
发文量
366
审稿时长
3-6 weeks
期刊介绍: Epidemiology & Infection publishes original reports and reviews on all aspects of infection in humans and animals. Particular emphasis is given to the epidemiology, prevention and control of infectious diseases. The scope covers the zoonoses, outbreaks, food hygiene, vaccine studies, statistics and the clinical, social and public-health aspects of infectious disease, as well as some tropical infections. It has become the key international periodical in which to find the latest reports on recently discovered infections and new technology. For those concerned with policy and planning for the control of infections, the papers on mathematical modelling of epidemics caused by historical, current and emergent infections are of particular value.
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