PDF(Pubmed)
Abstract：
Drought is an understudied driver of infectious disease dynamics. Amidst the ongoing southwestern North American megadrought, California (USA) is having the driest multi-decadal period since 800 CE, exacerbated by anthropogenic warming. In this study, we aimed to examine the influence of drought on coccidioidomycosis, an emerging infectious disease in southwestern USA.
We analysed California census tract-level surveillance data from 2000 to 2020 using generalised additive models and distributed monthly lags on precipitation and temperature. We then developed an ensemble prediction algorithm of incident cases of coccidioidomycosis per census tract to estimate the counterfactual incidence that would have occurred in the absence of drought.
Between April 1, 2000, and March 31, 2020, there were 81 448 reported cases of coccidioidomycosis throughout California. An estimated 1467 excess cases of coccidioidomycosis were observed in California in the 2 years following the drought that occurred between 2007 and 2009, and an excess 2649 drought-attributable cases of coccidioidomycosis were observed in the 2 years following the drought that occurred between 2012 and 2015. These increased numbers of cases more than offset the declines in cases that occurred during drought. An IQR increase in summer temperatures was associated with 2·02 (95% CI 1·84-2·22) times higher incidence in the following autumn (September to November), and an IQR increase in precipitation in the winter was associated with 1·45 (1·36-1·55) times higher incidence in the autumn. The effect of winter precipitation was 36% (25-48) stronger when preceded by two dry, rather than average, winters. Incidence in arid counties was most sensitive to precipitation fluctuations, while incidence in wetter counties was most sensitive to temperature.
In California, multi-year cycles of dry conditions followed by a wet winter increases transmission of coccidioidomycosis, especially in historically wetter areas. With anticipated increasing frequency of drought in southwestern USA, continued expansion of coccidioidomycosis, along with more intense seasons, is expected. Our results motivate the need for heightened precautions against coccidioidomycosis in seasons that follow major droughts.
National Institutes of Health.
We analysed California census tract-level surveillance data from 2000 to 2020 using generalised additive models and distributed monthly lags on precipitation and temperature. We then developed an ensemble prediction algorithm of incident cases of coccidioidomycosis per census tract to estimate the counterfactual incidence that would have occurred in the absence of drought.
Between April 1, 2000, and March 31, 2020, there were 81 448 reported cases of coccidioidomycosis throughout California. An estimated 1467 excess cases of coccidioidomycosis were observed in California in the 2 years following the drought that occurred between 2007 and 2009, and an excess 2649 drought-attributable cases of coccidioidomycosis were observed in the 2 years following the drought that occurred between 2012 and 2015. These increased numbers of cases more than offset the declines in cases that occurred during drought. An IQR increase in summer temperatures was associated with 2·02 (95% CI 1·84-2·22) times higher incidence in the following autumn (September to November), and an IQR increase in precipitation in the winter was associated with 1·45 (1·36-1·55) times higher incidence in the autumn. The effect of winter precipitation was 36% (25-48) stronger when preceded by two dry, rather than average, winters. Incidence in arid counties was most sensitive to precipitation fluctuations, while incidence in wetter counties was most sensitive to temperature.
In California, multi-year cycles of dry conditions followed by a wet winter increases transmission of coccidioidomycosis, especially in historically wetter areas. With anticipated increasing frequency of drought in southwestern USA, continued expansion of coccidioidomycosis, along with more intense seasons, is expected. Our results motivate the need for heightened precautions against coccidioidomycosis in seasons that follow major droughts.
National Institutes of Health.
摘要：
背景：干旱是传染病动力学的一个未被研究的驱动因素。在持续的北美西南部大干旱中，加利福尼亚州（美国）是自公元800年以来最干旱的年代，人为变暖加剧了。在这项研究中,我们旨在研究干旱对球虫菌病的影响，美国西南部的一种新出现的传染病。
方法：我们使用广义累加模型和分布的每月降水和温度滞后，分析了2000年至2020年的加利福尼亚人口普查道水平监测数据。然后，我们开发了每个人口普查道的球孢子菌病事件病例的集成预测算法，以估计在没有干旱的情况下发生的反事实发生率。
结果：在2000年4月1日至2020年3月31日之间，整个加利福尼亚州有81448例报告的球孢子菌病病例。在2007年至2009年发生干旱后的2年内，在加利福尼亚州估计观察到了1467例额外的球孢子菌病病例，在2012年至2015年发生干旱后的2年内观察到了2649例额外的可归因于干旱的球孢子菌病病例。这些病例数量的增加足以抵消干旱期间病例数量的下降。夏季温度的IQR升高与次年秋季（9月至11月）的发生率高2·02（95％CI1·84-2·22）有关，冬季降水的IQR增加与秋季的发病率高1·45（1·36-1·55）倍有关。冬季降水的影响在两次干旱之前增强了36％（25-48），而不是平均水平，温特斯。干旱县的发病率对降水波动最敏感，而较湿润县的发病率对温度最敏感。
结论：在加利福尼亚州，干旱条件下的多年周期和潮湿的冬季增加了球孢菌病的传播，尤其是在历史较湿润的地区。随着预计美国西南部干旱频率的增加，球孢子菌病的持续扩张，随着更强烈的季节，是预期的。我们的结果表明，在主要干旱之后的季节中，需要加强对球虫菌病的预防措施。
背景：美国国立卫生研究院。
方法：我们使用广义累加模型和分布的每月降水和温度滞后，分析了2000年至2020年的加利福尼亚人口普查道水平监测数据。然后，我们开发了每个人口普查道的球孢子菌病事件病例的集成预测算法，以估计在没有干旱的情况下发生的反事实发生率。
结果：在2000年4月1日至2020年3月31日之间，整个加利福尼亚州有81448例报告的球孢子菌病病例。在2007年至2009年发生干旱后的2年内，在加利福尼亚州估计观察到了1467例额外的球孢子菌病病例，在2012年至2015年发生干旱后的2年内观察到了2649例额外的可归因于干旱的球孢子菌病病例。这些病例数量的增加足以抵消干旱期间病例数量的下降。夏季温度的IQR升高与次年秋季（9月至11月）的发生率高2·02（95％CI1·84-2·22）有关，冬季降水的IQR增加与秋季的发病率高1·45（1·36-1·55）倍有关。冬季降水的影响在两次干旱之前增强了36％（25-48），而不是平均水平，温特斯。干旱县的发病率对降水波动最敏感，而较湿润县的发病率对温度最敏感。
结论：在加利福尼亚州，干旱条件下的多年周期和潮湿的冬季增加了球孢菌病的传播，尤其是在历史较湿润的地区。随着预计美国西南部干旱频率的增加，球孢子菌病的持续扩张，随着更强烈的季节，是预期的。我们的结果表明，在主要干旱之后的季节中，需要加强对球虫菌病的预防措施。
背景：美国国立卫生研究院。
