Skip to main content
PMC home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2005 Mar;59(3):186–192. doi: 10.1136/jech.2004.020180

An initial investigation of the association between the SARS outbreak and weather: with the view of the environmental temperature and its variation

J Tan 1, L Mu 1, J Huang 1, S Yu 1, B Chen 1, J Yin 1
PMCID: PMC1733040  PMID: 15709076

Abstract

Objective: To understand the association between the SARS outbreak and the environmental temperature, and to provide a scientific basis for prevention and control measures against it.

Methods: The daily numbers of the probable SARS patients and the daily meteorological factors during the SARS outbreak period in Hong Kong, Guangzhou, Beijing, and Taiyuan were used in the data analysis. Ecological analysis was conducted to explore the association between the daily numbers of probable SARS patients and the environmental temperature and its variations.

Results: There was a significant correlation between the SARS cases and the environmental temperature seven days before the onset and the seven day time lag corresponds well with the known incubation period for SARS. The optimum environmental temperature associated with the SARS cases was between 16°C to 28°C, which may encourage virus growth. A sharp rise or decrease in the environmental temperature related to the cold spell led to an increase of the SARS cases because of the possible influence of the weather on the human immune system. This study provided some evidence that there is a higher possibility for SARS to reoccur in spring than that in autumn and winter.

Conclusion: Current knowledge based on case studies of the SARS outbreak in the four cities suggested that the SARS outbreaks were significantly associated with the temperature and its variations. However, because the fallacy and the uncontrolled confounding effects might have biased the results, the possibility of other meteorological factors having an affect on the SARS outbreaks deserves further investigation.

Full Text

The Full Text of this article is available as a PDF (100.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abdullah A. S. M. Virus pathogens suggest an autumn return. J Epidemiol Community Health. 2003 Oct;57(10):770–771. doi: 10.1136/jech.57.10.770-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Björk Jonas, Strömberg Ulf. Effects of systematic exposure assessment errors in partially ecologic case-control studies. Int J Epidemiol. 2002 Feb;31(1):154–160. doi: 10.1093/ije/31.1.154. [DOI] [PubMed] [Google Scholar]
  3. Braga Alfésio L. F., Zanobetti Antonella, Schwartz Joel. The effect of weather on respiratory and cardiovascular deaths in 12 U.S. cities. Environ Health Perspect. 2002 Sep;110(9):859–863. doi: 10.1289/ehp.02110859. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Chew F. T., Doraisingham S., Ling A. E., Kumarasinghe G., Lee B. W. Seasonal trends of viral respiratory tract infections in the tropics. Epidemiol Infect. 1998 Aug;121(1):121–128. doi: 10.1017/s0950268898008905. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Chilvers M. A., McKean M., Rutman A., Myint B. S., Silverman M., O'Callaghan C. The effects of coronavirus on human nasal ciliated respiratory epithelium. Eur Respir J. 2001 Dec;18(6):965–970. doi: 10.1183/09031936.01.00093001. [DOI] [PubMed] [Google Scholar]
  6. Choi B. C. K., Pak A. W. P. A simple approximate mathematical model to predict the number of severe acute respiratory syndrome cases and deaths. J Epidemiol Community Health. 2003 Oct;57(10):831–835. doi: 10.1136/jech.57.10.831. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Cold exposure and winter mortality from ischaemic heart disease, cerebrovascular disease, respiratory disease, and all causes in warm and cold regions of Europe. The Eurowinter Group. Lancet. 1997 May 10;349(9062):1341–1346. [PubMed] [Google Scholar]
  8. Donaldson G. C., Keatinge W. R. Early increases in ischaemic heart disease mortality dissociated from and later changes associated with respiratory mortality after cold weather in south east England. J Epidemiol Community Health. 1997 Dec;51(6):643–648. doi: 10.1136/jech.51.6.643. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Dowell S. F. Seasonal variation in host susceptibility and cycles of certain infectious diseases. Emerg Infect Dis. 2001 May-Jun;7(3):369–374. doi: 10.3201/eid0703.010301. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Drosten Christian, Günther Stephan, Preiser Wolfgang, van der Werf Sylvie, Brodt Hans-Reinhard, Becker Stephan, Rabenau Holger, Panning Marcus, Kolesnikova Larissa, Fouchier Ron A. M. Identification of a novel coronavirus in patients with severe acute respiratory syndrome. N Engl J Med. 2003 Apr 10;348(20):1967–1976. doi: 10.1056/NEJMoa030747. [DOI] [PubMed] [Google Scholar]
  11. Inoue Y., Nakao M., Ueda H., Araki T. Seasonal variation in physiological responses to mild cold air in young and older men. Int J Biometeorol. 1995 Mar;38(3):131–136. doi: 10.1007/BF01208489. [DOI] [PubMed] [Google Scholar]
  12. Ksiazek Thomas G., Erdman Dean, Goldsmith Cynthia S., Zaki Sherif R., Peret Teresa, Emery Shannon, Tong Suxiang, Urbani Carlo, Comer James A., Lim Wilina. A novel coronavirus associated with severe acute respiratory syndrome. N Engl J Med. 2003 Apr 10;348(20):1953–1966. doi: 10.1056/NEJMoa030781. [DOI] [PubMed] [Google Scholar]
  13. Kunst A. E., Looman C. W., Mackenbach J. P. Outdoor air temperature and mortality in The Netherlands: a time-series analysis. Am J Epidemiol. 1993 Feb 1;137(3):331–341. doi: 10.1093/oxfordjournals.aje.a116680. [DOI] [PubMed] [Google Scholar]
  14. Lee A. Host and environment are key factors. J Epidemiol Community Health. 2003 Oct;57(10):770–770. doi: 10.1136/jech.57.10.770. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Lipsitch Marc, Cohen Ted, Cooper Ben, Robins James M., Ma Stefan, James Lyn, Gopalakrishna Gowri, Chew Suok Kai, Tan Chorh Chuan, Samore Matthew H. Transmission dynamics and control of severe acute respiratory syndrome. Science. 2003 May 23;300(5627):1966–1970. doi: 10.1126/science.1086616. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Makie Toshio, Harada Muneaki, Kinukawa Naoko, Toyoshiba Hiroyoshi, Yamanaka Takeharu, Nakamura Tsuyoshi, Sakamoto Masako, Nose Yoshiaki. Association of meteorological and day-of-the-week factors with emergency hospital admissions in Fukuoka, Japan. Int J Biometeorol. 2002 Feb;46(1):38–41. doi: 10.1007/s00484-001-0110-2. [DOI] [PubMed] [Google Scholar]
  17. Marshall R. J., Scragg R., Bourke P. An analysis of the seasonal variation of coronary heart disease and respiratory disease mortality in New Zealand. Int J Epidemiol. 1988 Jun;17(2):325–331. doi: 10.1093/ije/17.2.325. [DOI] [PubMed] [Google Scholar]
  18. Nishiura H., Patanarapelert K., Sriprom M., Sarakorn W., Sriyab S., Ming Tang I. Modelling potential responses to severe acute respiratory syndrome in Japan: the role of initial attack size, precaution, and quarantine. J Epidemiol Community Health. 2004 Mar;58(3):186–191. doi: 10.1136/jech.2003.014894. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Riley Steven, Fraser Christophe, Donnelly Christl A., Ghani Azra C., Abu-Raddad Laith J., Hedley Anthony J., Leung Gabriel M., Ho Lai-Ming, Lam Tai-Hing, Thach Thuan Q. Transmission dynamics of the etiological agent of SARS in Hong Kong: impact of public health interventions. Science. 2003 May 23;300(5627):1961–1966. doi: 10.1126/science.1086478. [DOI] [PubMed] [Google Scholar]
  20. Shephard R. J., Shek P. N. Cold exposure and immune function. Can J Physiol Pharmacol. 1998 Sep;76(9):828–836. doi: 10.1139/cjpp-76-9-828. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES