The effects of ambient temperature on outpatient visits for varicella and herpes zoster in Shanghai, China: a time-series study.
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BACKGROUND: The seasonality of varicella and herpes zoster has been widely observed, but there is limited evidence on their associations with ambient temperature. OBJECTIVE: The associations between ambient temperature and outpatient visits for varicella and herpes zoster were examined. METHODS: We collected daily outpatient visit data for varicella (N = 3520) and herpes zoster (N = 6614) from a major hospital in Shanghai, China, from 2008 to 2010. We adopted the generalized additive model in time-series analysis to investigate the short-term associations between temperature and outpatient visits for varicella and herpes zoster after controlling for seasonal trends, day of the week, and humidity. RESULTS: A 1C increase in daily mean temperature was associated with a 1.33% (95% confidence interval 0.93%-1.74%) decrease in outpatient visits for varicella whereas it was associated with a 2.18% (95% confidence interval 1.90%-2.46%) increase in outpatient visits for herpes zoster. LIMITATIONS: Only 1 hospital was included and we did not control for individual-level risk factors. CONCLUSION: Our results demonstrated that temperature variation might be an important risk factor for varicella and herpes zoster in China.