{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T16:13:47Z","timestamp":1781108027242,"version":"3.54.1"},"reference-count":48,"publisher":"National Academy of Sciences","issue":"51","license":[{"start":{"date-parts":[[2017,4,24]],"date-time":"2017-04-24T00:00:00Z","timestamp":1492992000000},"content-version":"vor","delay-in-days":182,"URL":"http:\/\/www.pnas.org\/site\/misc\/userlicense.xhtml"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes for Health Research","doi-asserted-by":"crossref","award":["343143"],"award-info":[{"award-number":["343143"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.pnas.org"],"crossmark-restriction":true},"short-container-title":["Proc. Natl. Acad. Sci. U.S.A."],"published-print":{"date-parts":[[2016,12,20]]},"abstract":"<jats:p>\n                    Although the global climate is changing at an unprecedented rate, links between weather and infectious disease have received little attention in high income countries. The \u201cEl Ni\u00f1o Southern Oscillation\u201d (ENSO) occurs irregularly and is associated with changing temperature and precipitation patterns. We studied the impact of ENSO on infectious diseases in four census regions in the United States. We evaluated infectious diseases requiring hospitalization using the US National Hospital Discharge Survey (1970\u20132010) and five disease groupings that may undergo epidemiological shifts with changing climate: (\n                    <jats:italic>i<\/jats:italic>\n                    ) vector-borne diseases, (\n                    <jats:italic>ii<\/jats:italic>\n                    ) pneumonia and influenza, (\n                    <jats:italic>iii<\/jats:italic>\n                    ) enteric disease, (\n                    <jats:italic>iv<\/jats:italic>\n                    ) zoonotic bacterial disease, and (v) fungal disease. ENSO exposure was based on the Multivariate ENSO Index. Distributed lag models, with adjustment for seasonal oscillation and long-term trends, were used to evaluate the impact of ENSO on disease incidence over lags of up to 12 mo. ENSO was associated more with vector-borne disease [relative risk (RR) 2.96, 95% confidence interval (CI) 1.03\u20138.48] and less with enteric disease (0.73, 95% CI 0.62\u20130.87) in the Western region; the increase in vector-borne disease was attributable to increased risk of rickettsioses and tick-borne infectious diseases. By contrast, ENSO was associated with more enteric disease in non-Western regions (RR 1.12, 95% CI 1.02\u20131.15). The periodic nature of ENSO may make it a useful natural experiment for evaluation of the impact of climatic shifts on infectious disease risk. The impact of ENSO suggests that warmer temperatures and extreme variation in precipitation events influence risks of vector-borne and enteric disease in the United States.\n                  <\/jats:p>","DOI":"10.1073\/pnas.1604980113","type":"journal-article","created":{"date-parts":[[2016,10,24]],"date-time":"2016-10-24T23:09:50Z","timestamp":1477350590000},"page":"14589-14594","update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":46,"title":["Impact of El Ni\u00f1o Southern Oscillation on infectious disease hospitalization risk in the United States"],"prefix":"10.1073","volume":"113","author":[{"given":"David N.","family":"Fisman","sequence":"first","affiliation":[{"name":"Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada;"},{"name":"Division of Infectious Diseases, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashleigh R.","family":"Tuite","sequence":"additional","affiliation":[{"name":"Prevention Policy Modeling Laboratory, Harvard T. H. Chan School of Public Health, Boston, MA 02115;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin A.","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada;"},{"name":"Public Health Ontario, Toronto, ON M5G 1V2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"341","published-online":{"date-parts":[[2016,10,24]]},"reference":[{"key":"e_1_3_3_1_2","volume-title":"Climate Change 2007: The Physical Science Basis","author":"Solomon S","year":"2007","unstructured":", eds S Solomon, (Cambridge Univ Press, Cambridge, UK Climate Change 2007: The Physical Science Basis, 2007)."},{"key":"e_1_3_3_2_2","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.ijid.2007.11.003","article-title":"Insights into infectious disease in the era of Hippocrates","volume":"12","author":"Pappas G","year":"2008","unstructured":"G Pappas, IJ Kiriaze, ME Falagas, Insights into infectious disease in the era of Hippocrates. Int J Infect Dis 12, 347\u2013350 (2008).","journal-title":"Int J Infect Dis"},{"key":"e_1_3_3_3_2","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1146\/annurev.publhealth.28.021406.144128","article-title":"Seasonality of infectious diseases","volume":"28","author":"Fisman DN","year":"2007","unstructured":"DN Fisman, Seasonality of infectious diseases. Annu Rev Public Health 28, 127\u2013143 (2007).","journal-title":"Annu Rev Public Health"},{"key":"e_1_3_3_4_2","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.epidem.2013.09.004","article-title":"Examining rainfall and cholera dynamics in Haiti using statistical and dynamic modeling approaches","volume":"5","author":"Eisenberg MC","year":"2013","unstructured":"MC Eisenberg, G Kujbida, AR Tuite, DN Fisman, JH Tien, Examining rainfall and cholera dynamics in Haiti using statistical and dynamic modeling approaches. Epidemics 5, 197\u2013207 (2013).","journal-title":"Epidemics"},{"key":"e_1_3_3_5_2","first-page":"99","article-title":"El Ni\u00f1o and the dynamics of vectorborne disease transmission","volume":"107","author":"Hales S","year":"1999","unstructured":"S Hales, P Weinstein, Y Souares, A Woodward, El Ni\u00f1o and the dynamics of vectorborne disease transmission. Environ Health Perspect 107, 99\u2013102 (1999).","journal-title":"Environ Health Perspect"},{"key":"e_1_3_3_6_2","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1126\/science.1244325","article-title":"Altitudinal changes in malaria incidence in highlands of Ethiopia and Colombia","volume":"343","author":"Siraj AS","year":"2014","unstructured":"AS Siraj, , Altitudinal changes in malaria incidence in highlands of Ethiopia and Colombia. Science 343, 1154\u20131158 (2014).","journal-title":"Science"},{"key":"e_1_3_3_7_2","first-page":"715","article-title":"Climate change and infectious diseases in North America: The road ahead","volume":"178","author":"Greer A","year":"2008","unstructured":"A Greer, V Ng, D Fisman, Climate change and infectious diseases in North America: The road ahead. CMAJ 178, 715\u2013722 (2008).","journal-title":"CMAJ"},{"key":"e_1_3_3_8_2","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.3201\/eid1310.061586","article-title":"Dengue fever seroprevalence and risk factors, Texas-Mexico border, 2004","volume":"13","author":"Brunkard JM","year":"2007","unstructured":"JM Brunkard, , Dengue fever seroprevalence and risk factors, Texas-Mexico border, 2004. Emerg Infect Dis 13, 1477\u20131483 (2007).","journal-title":"Emerg Infect Dis"},{"key":"e_1_3_3_9_2","doi-asserted-by":"crossref","first-page":"1235367","DOI":"10.1126\/science.1235367","article-title":"Quantifying the influence of climate on human conflict","volume":"341","author":"Hsiang SM","year":"2013","unstructured":"SM Hsiang, M Burke, E Miguel, Quantifying the influence of climate on human conflict. Science 341, 1235367 (2013).","journal-title":"Science"},{"key":"e_1_3_3_10_2","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/S1473-3099(09)70104-5","article-title":"Climate change and infectious diseases in Europe","volume":"9","author":"Semenza JC","year":"2009","unstructured":"JC Semenza, B Menne, Climate change and infectious diseases in Europe. Lancet Infect Dis 9, 365\u2013375 (2009).","journal-title":"Lancet Infect Dis"},{"key":"e_1_3_3_11_2","unstructured":"; Climate.gov El Ni\u00f1o & La Ni\u00f1a (El Ni\u00f1o-Southern Oscillation) (National Oceanic and Atmospheric Administration Washington DC). Available at https:\/\/www.climate.gov\/enso. Accessed May 9 2016. (2016)."},{"key":"e_1_3_3_12_2","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1038\/nature10311","article-title":"Civil conflicts are associated with the global climate","volume":"476","author":"Hsiang SM","year":"2011","unstructured":"SM Hsiang, KC Meng, MA Cane, Civil conflicts are associated with the global climate. Nature 476, 438\u2013441 (2011).","journal-title":"Nature"},{"key":"e_1_3_3_13_2","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1175\/1520-0493(1987)115<1606:GARSPP>2.0.CO;2","article-title":"Global and regional scale precipitation patterns associated with El Ni\u00f1o\/Southern Oscillation","volume":"115","author":"Ropelewski CF","year":"1987","unstructured":"CF Ropelewski, MS Halpert, Global and regional scale precipitation patterns associated with El Ni\u00f1o\/Southern Oscillation. Mon Weather Rev 115, 1606\u20131626 (1987).","journal-title":"Mon Weather Rev"},{"key":"e_1_3_3_14_2","doi-asserted-by":"crossref","first-page":"6268","DOI":"10.1175\/2009JCLI2838.1","article-title":"Understanding the characteristics of daily precipitation over the United States using the North American Regional Reanalysis","volume":"22","author":"Becker EJ","year":"2009","unstructured":"EJ Becker, EH Berbery, RW Higgins, Understanding the characteristics of daily precipitation over the United States using the North American Regional Reanalysis. J Clim 22, 6268\u20136286 (2009).","journal-title":"J Clim"},{"key":"e_1_3_3_15_2","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1175\/1520-0442(1992)005<0577:STPAWT>2.0.CO;2","article-title":"Anomalous temperature patterns associated with the Southern Oscillation","volume":"5","author":"Halpert MS","year":"1992","unstructured":"MS Halpert, CF Ropelewski, Anomalous temperature patterns associated with the Southern Oscillation. J Clim 5, 577\u2013593 (1992).","journal-title":"J Clim"},{"key":"e_1_3_3_16_2","unstructured":"; Climate Prediction Center State El Ni\u00f1o Impacts (National Weather Service Silver Spring MD). Available at www.cpc.ncep.noaa.gov\/products\/analysis_monitoring\/ensostuff\/states\/states.html. Accessed May 12 2016. (1997)."},{"key":"e_1_3_3_17_2","first-page":"55","article-title":"Climate change impacts and vegetation response on the island of Madagascar","volume":"363","author":"Ingram JC","year":"2005","unstructured":"JC Ingram, TP Dawson, Climate change impacts and vegetation response on the island of Madagascar. Philos Trans A Math Phys Eng Sci 363, 55\u201359 (2005).","journal-title":"Philos Trans A Math Phys Eng Sci"},{"key":"e_1_3_3_18_2","doi-asserted-by":"crossref","first-page":"20578","DOI":"10.1073\/pnas.0710860105","article-title":"El Nino\/Southern Oscillation response to global warming","volume":"106","author":"Latif M","year":"2009","unstructured":"M Latif, NS Keenlyside, El Nino\/Southern Oscillation response to global warming. Proc Natl Acad Sci USA 106, 20578\u201320583 (2009).","journal-title":"Proc Natl Acad Sci USA"},{"key":"e_1_3_3_19_2","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1038\/19505","article-title":"Increased El Ni\u00f1o frequency in a climate model forced by future greenhouse warming","volume":"398","author":"Timmermann A","year":"1999","unstructured":"A Timmermann, , Increased El Ni\u00f1o frequency in a climate model forced by future greenhouse warming. Nature 398, 694\u2013697 (1999).","journal-title":"Nature"},{"key":"e_1_3_3_20_2","doi-asserted-by":"crossref","first-page":"10962","DOI":"10.1073\/pnas.1503190112","article-title":"Changing central Pacific El Ni\u00f1os reduce stability of North American salmon survival rates","volume":"112","author":"Kilduff DP","year":"2015","unstructured":"DP Kilduff, E Di Lorenzo, LW Botsford, SL Teo, Changing central Pacific El Ni\u00f1os reduce stability of North American salmon survival rates. Proc Natl Acad Sci USA 112, 10962\u201310966 (2015).","journal-title":"Proc Natl Acad Sci USA"},{"key":"e_1_3_3_21_2","doi-asserted-by":"crossref","first-page":"3049","DOI":"10.1073\/pnas.0600057103","article-title":"The effect of climate variation on agro-pastoral production in Africa","volume":"103","author":"Stige LC","year":"2006","unstructured":"LC Stige, , The effect of climate variation on agro-pastoral production in Africa. Proc Natl Acad Sci USA 103, 3049\u20133053 (2006).","journal-title":"Proc Natl Acad Sci USA"},{"key":"e_1_3_3_22_2","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1080\/09603120701849836","article-title":"Climate influence on dengue epidemics in Puerto Rico","volume":"18","author":"Jury MR","year":"2008","unstructured":"MR Jury, Climate influence on dengue epidemics in Puerto Rico. Int J Environ Health Res 18, 323\u2013334 (2008).","journal-title":"Int J Environ Health Res"},{"key":"e_1_3_3_23_2","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1111\/j.1750-2659.2008.00047.x","article-title":"Association of early annual peak influenza activity with El Ni\u00f1o southern oscillation in Japan","volume":"2","author":"Zaraket H","year":"2008","unstructured":"H Zaraket, R Saito, N Tanabe, K Taniguchi, H Suzuki, Association of early annual peak influenza activity with El Ni\u00f1o southern oscillation in Japan. Influenza Other Respi Viruses 2, 127\u2013130 (2008).","journal-title":"Influenza Other Respi Viruses"},{"key":"e_1_3_3_24_2","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.puhe.2006.01.011","article-title":"El Ni\u00f1o effects on influenza mortality risks in the state of California","volume":"120","author":"Choi KM","year":"2006","unstructured":"KM Choi, G Christakos, ML Wilson, El Ni\u00f1o effects on influenza mortality risks in the state of California. Public Health 120, 505\u2013516 (2006).","journal-title":"Public Health"},{"key":"e_1_3_3_25_2","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/1475-2875-8-6","article-title":"The role of ENSO in understanding changes in Colombia\u2019s annual malaria burden by region, 1960-2006","volume":"8","author":"Mantilla G","year":"2009","unstructured":"G Mantilla, H Oliveros, AG Barnston, The role of ENSO in understanding changes in Colombia\u2019s annual malaria burden by region, 1960-2006. Malar J 8, 6 (2009).","journal-title":"Malar J"},{"key":"e_1_3_3_26_2","first-page":"399","article-title":"Environmental temperature, cholera, and acute diarrhoea in adults in Lima, Peru","volume":"22","author":"Lama JR","year":"2004","unstructured":"JR Lama, CR Seas, R Le\u00f3n-Bar\u00faa, E Gotuzzo, RB Sack, Environmental temperature, cholera, and acute diarrhoea in adults in Lima, Peru. J Health Popul Nutr 22, 399\u2013403 (2004).","journal-title":"J Health Popul Nutr"},{"key":"e_1_3_3_27_2","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.1126\/science.289.5485.1766","article-title":"Cholera dynamics and El Ni\u00f1o-Southern Oscillation","volume":"289","author":"Pascual M","year":"2000","unstructured":"M Pascual, X Rod\u00f3, SP Ellner, R Colwell, MJ Bouma, Cholera dynamics and El Ni\u00f1o-Southern Oscillation. Science 289, 1766\u20131769 (2000).","journal-title":"Science"},{"key":"e_1_3_3_28_2","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1016\/S0140-6736(03)14695-8","article-title":"El Ni\u00f1o and health","volume":"362","author":"Kovats RS","year":"2003","unstructured":"RS Kovats, MJ Bouma, S Hajat, E Worrall, A Haines, El Ni\u00f1o and health. Lancet 362, 1481\u20131489 (2003).","journal-title":"Lancet"},{"key":"e_1_3_3_29_2","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.2105\/AJPH.91.8.1200","article-title":"Association of normal weather periods and El Ni\u00f1o events with hospitalization for viral pneumonia in females: California, 1983-1998","volume":"91","author":"Ebi KL","year":"2001","unstructured":"KL Ebi, KA Exuzides, E Lau, M Kelsh, A Barnston, Association of normal weather periods and El Ni\u00f1o events with hospitalization for viral pneumonia in females: California, 1983-1998. Am J Public Health 91, 1200\u20131208 (2001).","journal-title":"Am J Public Health"},{"key":"e_1_3_3_30_2","unstructured":"; National Center for Health Statistics National Hospital Discharge Survey (US Centers for Disease Control and Prevention Atlanta GA). Available at www.cdc.gov\/nchs\/nhds\/. Accessed May 9 2016. (2016)."},{"key":"e_1_3_3_31_2","first-page":"1","article-title":"2006 national hospital discharge survey","volume":"2008","author":"DeFrances CJ","year":"2008","unstructured":"CJ DeFrances, CA Lucas, VC Buie, A Golosinskiy, 2006 national hospital discharge survey. Natl Health Stat Rep 2008, 1\u201320 (2008).","journal-title":"Natl Health Stat Rep"},{"key":"e_1_3_3_32_2","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1093\/aje\/kws463","article-title":"The co-seasonality of pneumonia and influenza with Clostridium difficile infection in the United States, 1993-2008","volume":"178","author":"Brown KA","year":"2013","unstructured":"KA Brown, N Daneman, P Arora, R Moineddin, DN Fisman, The co-seasonality of pneumonia and influenza with Clostridium difficile infection in the United States, 1993-2008. Am J Epidemiol 178, 118\u2013125 (2013).","journal-title":"Am J Epidemiol"},{"key":"e_1_3_3_33_2","doi-asserted-by":"crossref","first-page":"2224","DOI":"10.1002\/sim.3940","article-title":"Distributed lag non-linear models","volume":"29","author":"Gasparrini A","year":"2010","unstructured":"A Gasparrini, B Armstrong, MG Kenward, Distributed lag non-linear models. Stat Med 29, 2224\u20132234 (2010).","journal-title":"Stat Med"},{"key":"e_1_3_3_34_2","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1056\/NEJM200005113421904","article-title":"Mortality from pneumonia in children in the United States, 1939 through 1996","volume":"342","author":"Dowell SF","year":"2000","unstructured":"SF Dowell, BA Kupronis, ER Zell, DK Shay, Mortality from pneumonia in children in the United States, 1939 through 1996. N Engl J Med 342, 1399\u20131407 (2000).","journal-title":"N Engl J Med"},{"key":"e_1_3_3_35_2","first-page":"313","volume-title":"Systematic Reviews in Health Care: Meta-Analysis in Context","author":"Deeks J","year":"1995","unstructured":"J Deeks, D Altman, Effect measures for meta-analysis of trials with binary outcomes. Systematic Reviews in Health Care: Meta-Analysis in Context, eds M Egger, G Davey Smith, DG Altman (BMJ Publishing Group, London), pp. 313\u2013335 (1995)."},{"key":"e_1_3_3_36_2","first-page":"1","article-title":"Surveillance for Lyme disease: United States, 1992-1998","volume":"49","author":"Orloski KA","year":"2000","unstructured":"KA Orloski, EB Hayes, GL Campbell, DT Dennis, Surveillance for Lyme disease: United States, 1992-1998. MMWR Surveillance Summaries 49, 1\u201311 (2000).","journal-title":"MMWR Surveillance Summaries"},{"key":"e_1_3_3_37_2","doi-asserted-by":"crossref","first-page":"e145","DOI":"10.1371\/journal.pbio.0040145","article-title":"Climate, deer, rodents, and acorns as determinants of variation in lyme-disease risk","volume":"4","author":"Ostfeld RS","year":"2006","unstructured":"RS Ostfeld, CD Canham, K Oggenfuss, RJ Winchcombe, F Keesing, Climate, deer, rodents, and acorns as determinants of variation in lyme-disease risk. PLoS Biol 4, e145 (2006).","journal-title":"PLoS Biol"},{"key":"e_1_3_3_38_2","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1089\/153036601750137688","article-title":"Effects of acorn production and mouse abundance on abundance and Borrelia burgdorferi infection prevalence of nymphal Ixodes scapularis ticks","volume":"1","author":"Ostfeld RS","year":"2001","unstructured":"RS Ostfeld, , Effects of acorn production and mouse abundance on abundance and Borrelia burgdorferi infection prevalence of nymphal Ixodes scapularis ticks. Vector Borne Zoonotic Dis 1, 55\u201363 (2001).","journal-title":"Vector Borne Zoonotic Dis"},{"key":"e_1_3_3_39_2","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1089\/1530366041210765","article-title":"Precipitation and the occurrence of lyme disease in the northeastern United States","volume":"4","author":"McCabe GJ","year":"2004","unstructured":"GJ McCabe, JE Bunnell, Precipitation and the occurrence of lyme disease in the northeastern United States. Vector Borne Zoonotic Dis 4, 143\u2013148 (2004).","journal-title":"Vector Borne Zoonotic Dis"},{"key":"e_1_3_3_40_2","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/j.1948-7134.2014.12070.x","article-title":"Abundance and seasonal activity of questing Ixodes ricinus ticks in their natural habitats in southern Germany in 2011","volume":"39","author":"Schulz M","year":"2014","unstructured":"M Schulz, M Mahling, K Pfister, Abundance and seasonal activity of questing Ixodes ricinus ticks in their natural habitats in southern Germany in 2011. J Vector Ecol 39, 56\u201365 (2014).","journal-title":"J Vector Ecol"},{"key":"e_1_3_3_41_2","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1603\/033.046.0508","article-title":"Precipitation and temperature as predictors of the local abundance of Ixodes scapularis (Acari: Ixodidae) nymphs","volume":"46","author":"Schulze TL","year":"2009","unstructured":"TL Schulze, RA Jordan, CJ Schulze, RW Hung, Precipitation and temperature as predictors of the local abundance of Ixodes scapularis (Acari: Ixodidae) nymphs. J Med Entomol 46, 1025\u20131029 (2009).","journal-title":"J Med Entomol"},{"key":"e_1_3_3_42_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2166\/wh.2009.143","article-title":"Rainfall and outbreaks of drinking water related disease and in England and Wales","volume":"7","author":"Nichols G","year":"2009","unstructured":"G Nichols, C Lane, N Asgari, NQ Verlander, A Charlett, Rainfall and outbreaks of drinking water related disease and in England and Wales. J Water Health 7, 1\u20138 (2009).","journal-title":"J Water Health"},{"key":"e_1_3_3_43_2","unstructured":"NW-QAN (2014) Regional Assessment of Groundwater Quality in the Basin and Range Rio Grande Coastal Basins and Central Valley Aquifer Systems of the Southwestern United States (US Geological Survey Reston VA). Available at water.usgs.gov\/nawqa\/studies\/praq\/swpa\/. Accessed May 15 2016."},{"key":"e_1_3_3_44_2","doi-asserted-by":"crossref","unstructured":"R Foti JA Ramirez TC Brown Vulnerability of U.S. Water Supply to Shortage: A Technical Document Supporting the Forest Service 2010 RPA Assessment (US Department of Agriculture Fort Collins CO). Gen. Tech. Rep. RMRS-GTR-295. Available at www.fs.fed.us\/rm\/pubs\/rmrs_gtr295.pdf. Accessed May 9 2014. (2012).","DOI":"10.2737\/RMRS-GTR-295"},{"key":"e_1_3_3_45_2","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1007\/BF03403685","article-title":"Estimating the under-reporting rate for infectious gastrointestinal illness in Ontario","volume":"96","author":"Majowicz SE","year":"2005","unstructured":"SE Majowicz, , Estimating the under-reporting rate for infectious gastrointestinal illness in Ontario. Can J Public Health 96, 178\u2013181 (2005).","journal-title":"Can J Public Health"},{"key":"e_1_3_3_46_2","doi-asserted-by":"crossref","first-page":"2158","DOI":"10.1126\/science.1063699","article-title":"Climate warming and disease risks for terrestrial and marine biota","volume":"296","author":"Harvell CD","year":"2002","unstructured":"CD Harvell, , Climate warming and disease risks for terrestrial and marine biota. Science 296, 2158\u20132162 (2002).","journal-title":"Science"},{"key":"e_1_3_3_47_2","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1056\/NEJM197712012972201","article-title":"Legionnaires\u2019 disease: Description of an epidemic of pneumonia","volume":"297","author":"Fraser DW","year":"1977","unstructured":"DW Fraser, , Legionnaires\u2019 disease: Description of an epidemic of pneumonia. N Engl J Med 297, 1189\u20131197 (1977).","journal-title":"N Engl J Med"},{"key":"e_1_3_3_48_2","first-page":"617","article-title":"West Nile virus activity: Eastern United States, 2001","volume":"50","author":"Centers for Disease Control and Prevention (CDC)","year":"2001","unstructured":"; Centers for Disease Control and Prevention (CDC), West Nile virus activity: Eastern United States, 2001. MMWR Morb Mortal Wkly Rep 50, 617\u2013619 (2001).","journal-title":"MMWR Morb Mortal Wkly Rep"}],"container-title":["Proceedings of the National Academy of Sciences"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.pnas.org\/syndication\/doi\/10.1073\/pnas.1604980113","content-type":"unspecified","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/pnas.org\/doi\/pdf\/10.1073\/pnas.1604980113","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T10:53:18Z","timestamp":1654599198000},"score":1,"resource":{"primary":{"URL":"https:\/\/pnas.org\/doi\/full\/10.1073\/pnas.1604980113"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,24]]},"references-count":48,"journal-issue":{"issue":"51","published-print":{"date-parts":[[2016,12,20]]}},"alternative-id":["10.1073\/pnas.1604980113"],"URL":"https:\/\/doi.org\/10.1073\/pnas.1604980113","relation":{},"ISSN":["0027-8424","1091-6490"],"issn-type":[{"value":"0027-8424","type":"print"},{"value":"1091-6490","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10,24]]},"assertion":[{"value":"2016-10-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}