A 21-year retrospective analysis of environmental impacts on paediatric acute gastroenteritis in an affluent setting

Abstract Background Extreme weather events happen more frequent along with global warming and they constitute a challenge for public health preparedness. For example, many investigations showed heavy rainfall was associated with an increased risk of acute gastroenteritis. In this study, we examined the associations between different meteorological factors and paediatric acute gastroenteritis in an affluent setting in China controlling with pollutant effects. Methods Aggregated total weekly number of intestinal infection-related hospital admissions, meteorological data and fine suspended particles (PM2.5) during 1998-2018 in Hong Kong were collected and analysed by a combination of quasi-Poisson generalized additive model and distributed lag nonlinear model. Study population was restricted to children under 5 years of age at the time of admission. Results While heavy rainfall did not exhibit a statistically significant association with the risk of paediatric admission due to intestinal infections, low temperature and humidity extremes (both relative humidity and vapour pressure) did. Compared with temperature at which the lowest risk was detected (i.e. 22.5oC), the risk was 6.4% higher (95% confidence interval: 0.0% to 13.0% at 15.1oC (i.e. the 5th percentile). We also found the risk of paediatric admission was significantly associated with an increase in number of extreme cold days in a week over the study period. Conclusion Cold condition may have greater impact on disease transmission through increased stability and infectivity of enteric viruses in affluent settings like Hong Kong and thus resulted in an increase of risk for paediatric acute gastroenteritis. On the contrary, an insignificant impact from heavy rainfall and high temperature may indicate a minor effect in disease transmission through bacterial growth in contaminated food and water. With the identified impacts of weather factors, extreme weather events are likely to distort the prevalence and seasonal pattern of diarrhoeal diseases in the future.