{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:33:09Z","timestamp":1790602389229,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>New preventive therapeutics could substantially reduce bronchiolitis cases requiring acute care. Understanding the post\u2010pandemic geographic distribution of bronchiolitis morbidity can guide targeted immunization campaigns in high\u2010risk areas. This study aimed to identify geographic clusters of bronchiolitis acute care discharges across Connecticut.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cross\u2010sectional cohort study used a statewide database to identify home ZIP Code Tabulation Areas (ZCTAs) of children under 2 years discharged following bronchiolitis emergency visits or hospitalizations. Discharges were evaluated across five periods (March 2018 \u2013 December 2022) to account for seasonality and COVID\u201019. ZCTA case rates were based on U.S. Census American Community Survey data. Geographical clustering was assessed using Moran's I, Getis\u2010Ord Gi*, and Poisson Space\u2010Time Scan (SaTScan) analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 10,065 bronchiolitis emergency department and hospital discharges during the study period. Spatial autocorrelation \u2013 the degree of clustering of high burden areas \u2013 was moderate both before and after the pandemic (Moran's I: 0.21\u20130.25), but weak during the first pandemic year. Getis\u2010Ord Gi* analysis demonstrated bronchiolitis hotspots in two of Connecticut's poorer cities in all five assessed time periods. Spatiotemporal analyses also demonstrated significant clustering in the major population centers during the traditional winter season, before and after the first year of the COVID\u201019 pandemic, when cases were minimal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Bronchiolitis seasonality re\u2010emerged following the COVID\u201019 pandemic. Geographic clusters of bronchiolitis were consistently identified in poorer areas across time points. Prioritizing resources to these areas, including targeted immunization\u2010promotion campaigns, could improve outcomes in more efficient, equitable ways.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71450","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T07:39:13Z","timestamp":1766993953000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mapping Bronchiolitis in Connecticut Before and After the COVID\u201019 Pandemic"],"prefix":"10.1002","volume":"61","author":[{"given":"Alexander H.","family":"Hogan","sequence":"first","affiliation":[{"name":"Division of Hospital Medicine, Connecticut Children's Hartford Connecticut USA"},{"name":"Department of Pediatrics University of Connecticut School of Medicine Farmington Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Geography Marshall University Huntington West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doug","family":"Brugge","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences University of Connecticut School of Medicine Farmington Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew F.","family":"Beck","sequence":"additional","affiliation":[{"name":"Department of General and Community Pediatrics Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati School of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debarchana","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Geography University of Connecticut Storrs Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000001145"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.15.1440"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-2742"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-2614"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.1148"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2022.06.003"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-032755"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.08.007"},{"key":"e_1_2_11_10_1","unstructured":"C.Noelke N.McArdle B.DeVoe et al. Child Opportunity Index 3.0: Technical Documentation. Brandeis University;2024:30\u201331 https:\/\/www.diversitydatakids.org\/sites\/default\/files\/file\/COI30_TechDoc_20240313.pdf."},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41562-021-01079-8"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.2196\/40792"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.26370"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000004101"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2013182117"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.13298"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000002279"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7241e1"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7234a4"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiac216"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.27041"},{"key":"e_1_2_11_22_1","unstructured":"ChimeData \u2010 Connecticut Hospital Association accessed October 21 2024 https:\/\/cthosp.org\/member-services\/chimedata\/?mobileFormat=false."},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-14-199"},{"key":"e_1_2_11_24_1","unstructured":"U. C.Bureau. Glossary. Census.gov accessed December 18 2024 https:\/\/www.census.gov\/programs-surveys\/geography\/about\/glossary.html."},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2020.6007"},{"key":"e_1_2_11_26_1","unstructured":"US Census Bureau. American Community Survey (ACS). Census.gov accessed July 14 2023 https:\/\/www.census.gov\/programs-surveys\/acs."},{"key":"e_1_2_11_27_1","unstructured":"K.WalkerandM.HermanTidycensus: Load US Census Boundary and Attribute Data as \u201ctidyverse\u201d and'sf'\u2010Ready Data Frames. Published online2024 https:\/\/walker-data.com\/tidycensus\/."},{"key":"e_1_2_11_28_1","unstructured":"Environmental Systems Research Institute (ESRI). ArcGIS Pro. Published online November 1 2023."},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/13658816.2014.928822"},{"key":"e_1_2_11_30_1","unstructured":"E. K.CromleyandS. L.McLaffertyGIS and Public Health. The Guilford Press;2012."},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-4632.1992.tb00261.x"},{"key":"e_1_2_11_32_1","unstructured":"Hot Spot Analysis (Getis\u2010Ord Gi*) (Spatial Statistics)\u2014ArcGIS Pro | Documentation accessed August 15 2025 https:\/\/pro.arcgis.com\/en\/pro-app\/latest\/tool-reference\/spatial-statistics\/hot-spot-analysis.htm."},{"key":"e_1_2_11_33_1","unstructured":"What Is a z\u2010score? What Is a p\u2010value?\u2014ArcGIS Pro | Documentation accessed May 31 2024 https:\/\/pro.arcgis.com\/en\/pro-app\/latest\/tool-reference\/spatial-statistics\/what-is-a-z-score-what-is-a-p-value.htm."},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268812003135"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0227803"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.3138\/U558-H737-6577-8U31"},{"key":"e_1_2_11_37_1","unstructured":"R Core Team. R: A Language and Environment for Statistical Computing. Published Online2020 https:\/\/www.r-project.org\/."},{"key":"e_1_2_11_38_1","unstructured":"M.Kulldorff SaTScan. Published online2024 https:\/\/www.satscan.org\/."},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7214a1"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.41779"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofae069"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-12-95"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.abd6421"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofae238"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12998"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2023-065140"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.32766"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2023-061803"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2023-007284"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200101000-00003"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1177\/0309133307083294"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s44212-022-00021-1"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71450","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.71450","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71450","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T08:27:52Z","timestamp":1769675272000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.71450"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,28]]},"references-count":51,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/ppul.71450"],"URL":"https:\/\/doi.org\/10.1002\/ppul.71450","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,28]]},"assertion":[{"value":"2025-04-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71450"}}