Childhood rotavirus infection associated with temperature and particulate matter 2.5 µm: A retrospective cohort study

Hui Chen Tseng, Fung Chang Sung, Chih Hsin Mou, Chao W. Chen, Shan P. Tsai, Dennis P.H. Hsieh, Chung Yen Lu, Pei Chun Chen, Ya Ling Tzeng*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review


No study has ever investigated how ambient temperature and PM2.5 mediate rotavirus infection (RvI) in children. We used insurance claims data from Taiwan in 2006–2012 to evaluate the RvI characteristics in children aged ≤ 9. The RvI incidence rates were higher in colder months, reach-ing the highest in March (117.0/100 days), and then declining to the lowest in July (29.2/100 days). The age–sex-specific average incident cases were all higher in boys than in girls. Stratified analysis by temperature (<20, 20–24, and ≥25C) and PM2.5 (<17.5, 17.5–31.4, 31.5–41.9, and ≥42.0 µg/m3 ) showed that the highest incidence was 16.4/100 days at average temperatures of <20C and PM2.5 of 31.5–41.9 µg/m3, with Poisson regression analysis estimating an adjusted relative risk (aRR) of 1.26 (95% confidence interval (CI) = 1.11–1.43), compared to the incidence at the reference condition (<20C and PM2.5 < 17.5 µg/m3 ). As the temperature increased, the incident RvI cases reduced to 4.84 cases/100 days (aRR = 0.40, 95% CI = 0.35–0.45) when it was >25C with PM2.5 < 17.5 µg/m3, or to 9.84/100 days (aRR = 0.81, 95% CI = 0.77–0.93) when it was >25C with PM2.5 > 42 µg/m3 . The seasonal RvI is associated with frequent indoor personal contact among children in the cold months. The association with PM2.5 could be an alternative assessment due to temperature inversion.

Original languageEnglish
Article number12570
JournalInternational Journal of Environmental Research and Public Health
Issue number23
StatePublished - 01 12 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.


  • Ambient temperature
  • Fine particulate matter
  • Interaction
  • Rotavirus infection
  • Seasonality


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