A time series analysis of the relationship of ambient temperature and common bacterial enteric infections in two Canadian provinces.

The incidence of enteric infections in the Canadian population varies seasonally, and may be expected to be change in response to global climate changes. To better understand any potential impact of warmer temperature on enteric infections in Canada, we investigated the relationship between ambient temperature and weekly reports of confirmed cases of three pathogens in Canada: Salmonella, pathogenic Escherichia coli and Campylobacter, between 1992 and 2000 in two Canadian provinces. We used generalized linear models (GLMs) and generalized additive models (GAMs) to estimate the effect of seasonal adjustments on the estimated models. We found a strong non-linear association between ambient temperature and the occurrence of all three enteric pathogens in Alberta, Canada, and of Campylobacter in Newfoundland-Labrador. Threshold models were used to quantify the relationship of disease and temperature with thresholds chosen from 0 to -10 degrees C depending on the pathogen modeled. For Alberta, the log relative risk of Salmonella weekly case counts increased by 1.2%, Campylobacter weekly case counts increased by 2.2%, and E. coli weekly case counts increased by 6.0% for every degree increase in weekly mean temperature. For Newfoundland-Labrador the log relative risk increased by 4.5% for Campylobacter for every degree increase in weekly mean temperature.

A role of high impact weather events in waterborne disease outbreaks in Canada, 1975 - 2001.

Recent outbreaks of Escherichia coli O157:H7, Campylobacter, and Cryptosporidium have heightened awareness of risks associated with contaminated water supply. The objectives of this research were to describe the incidence and distribution of waterborne disease outbreaks in Canada in relation to preceding weather conditions and to test the association between high impact weather events and waterborne disease outbreaks. We examined extreme rainfall and spring snowmelt in association with 92 Canadian waterborne disease outbreaks between 1975 and 2001, using case-crossover methodology. Explanatory variables including accumulated rainfall, air temperature, and peak stream flow were used to determine the relationship between high impact weather events and the occurrence of waterborne disease outbreaks. Total maximum degree-days above 0 degrees C and accumulated rainfall percentile were associated with outbreak risk. For each degree-day above 0 degrees C the relative odds of an outbreak increased by a factor of 1.007 (95% confidence interval [CI] = 1.002 - 1.012). Accumulated rainfall percentile was dichotomized at the 93rd percentile. For rainfall events greater than the 93rd percentile the relative odds of an outbreak increased by a factor of 2.283 (95% [CI] = 1.216 - 4.285). These results suggest that warmer temperatures and extreme rainfall are contributing factors to waterborne disease outbreaks in Canada. This could have implications for water management and public health initiatives.