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Seasonal co-occurrences (alignment of seasonal peaks) and synchronization (similarity of seasonal patterns) of infections are noted, yet rarely explored due to their complexity and methodological limitations. We proposed a systematic approach to evaluate the co-occurrence of seasonal peaks using a combination of L-moments, seasonality characteristics such as the timing (phase) and intensity (amplitude) of peaks, and three metrics of serial, phase-phase, and phase-amplitude synchronization. We used public records on counts of nine foodborne infections abstracted from CDC\u2019s FoodNet Fast online platform for the US and ten representative states from 1996 to 2017 (264\u00a0months). Based on annualized and trend-adjusted Negative Binomial Harmonic Regression (NBHR) models augmented with the \u03b4-method, we determined that seasonal peaks of<jats:italic>Campylobacter<\/jats:italic>,<jats:italic>Salmonella<\/jats:italic>, and Shiga toxin-producing<jats:italic>Escherichia Coli<\/jats:italic>(STEC) were tightly clustered in late-July at the national and state levels. Phase-phase synchronization was observed between<jats:italic>Cryptosporidium<\/jats:italic>and<jats:italic>Shigella<\/jats:italic>,<jats:italic>Listeria<\/jats:italic>, and<jats:italic>Salmonella<\/jats:italic>(\u03c1\u2009=\u20090.51, 0.51, 0.46; p\u2009&lt;\u20090.04). Later peak timing of STEC was associated with greater amplitude nationally (\u03c1\u2009=\u20090.50, p\u2009=\u20090.02) indicating phase-amplitude synchronization. Understanding of disease seasonal synchronization is essential for developing reliable outbreak forecasts and informing stakeholders on mitigation and preventive measures.<\/jats:p>","DOI":"10.1038\/s41598-020-74435-9","type":"journal-article","created":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T10:07:55Z","timestamp":1602756475000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Seasonal synchronization of foodborne outbreaks in the United States, 1996\u20132017"],"prefix":"10.1038","volume":"10","author":[{"given":"Ryan B.","family":"Simpson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingjie","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena N.","family":"Naumova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,15]]},"reference":[{"key":"74435_CR1","unstructured":"Centers for Disease Control and Prevention (CDC). 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