Short-term weather variability in chicago and hospitalizations for kawasaki disease

William Checkley*, Judith Guzman-Cottrill, Leonardo Epstein, Nancy Innocentini, Jonathan Patz, Stanford Shulman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


BACKGROUND: Kawasaki disease exhibits a distinct seasonality, and short-term changes in weather may affect its occurrence. METHODS: To investigate the effects of weather variability on the occurrence of this syndrome, we conducted a time-between-events analysis of consecutive admissions for Kawasaki disease to a large pediatric hospital in Chicago. We used gamma regression to model the times between admissions. This is a novel application of gamma regression to model the time between admissions as a function of subject-specific covariates. RESULTS: We recorded 723 admissions in the 18-year (1986-2003) study period, of which 700 had complete data for analysis. Admissions for Kawasaki disease in Chicago were seasonal: The mean time between admissions was 34% shorter (relative time = 0.66, 95% confidence interval 0.54-0.81) from January-March than from July-September. In 1998, we recorded a larger number of admissions for Kawasaki disease (n = 65) than in other years (mean n = 37). January-March months of 1998 were warmer by a mean of 3°C (1.5°C-4.4°C) and the mean time between admissions was 48% shorter (relative time = 0.52, 0.36-0.75) than in equivalent periods of other study years. CONCLUSIONS: Our findings show that atypical changes in weather affect the occurrence of Kawasaki disease and are compatible with a link to an infectious trigger. The analysis of interevent times using gamma regression is an alternative to Poisson regression in modeling a time series of sparse daily counts.

Original languageEnglish
Pages (from-to)194-201
Number of pages8
Issue number2
StatePublished - Mar 2009
Externally publishedYes


  • Chicago
  • Hospitalization
  • Hospitals, Pediatric
  • Humans
  • Medical Audit
  • Mucocutaneous Lymph Node Syndrome
  • Poisson Distribution
  • Retrospective Studies
  • Weather


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