PRE VACCINATION MEASLES OUTBREAKS IN ENGLAND AND WALES: NONLINEAR ASSOCIATION ANALYSIS SUGGESTS A LEADING ROLE FOR PRESTON.

Measles data from pre-vaccination era in England and Wales were submitted to nonlinear association analysis. The method's rationale lies on the supposal that strong association between two time series when one of them is shifted in time respect to the other might be taken as an evidence for spatial-temporal causality. A threshold value for the nonlinear determination coefficient ( ) was set as criterion of strong association ( > 0.55). The common pattern for most of the cities was that outbreaks in a given place might be anticipated by some cities whereas followed by others. Only Preston preceded other cities and never followed any other. This result might be plausible since this port is an important node of human exchange with other cities. The associations respect to Preston were markedly nonlinear and the spread from there was slower, perhaps due to climatic causes. We conclude that nonlinear association approach is a promising way of exploring spatial-temporal epidemics data.