{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T06:18:10Z","timestamp":1787811490006,"version":"build-2784847793"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Meteorological factors are key triggers for infectious diseases in high-density cities, yet their influence on the acute disease patterns of influenza, mumps, scarlet fever, and hand-foot-and-mouth disease (HFMD) remains unclear. This study aims to reveal the variations in relative risk and secondary infection associated with meteorological factors, thereby providing clues for further confirmatory research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed city-wide incidence data from 2012 to 2020 alongside daily meteorological observations. Distributed lag non-linear models (DLNM) were used to quantify exposure-lag-response relationships. Andersen-Gill models assessed effects on disease recurrence, and Cox models evaluated risks of sequential infections between disease pairs, stratified by season.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The peak-risk temperatures were 14.5\u202f\u00b0C for influenza, 18.5 \u00b0C for mumps, 17 \u00b0C for scarlet fever, and 28.5 \u00b0C for hand-foot-and-mouth disease (HFMD). Average temperature (AT) increase raised influenza recurrence risk (e.g., 1.3% higher risk per 1 \u00b0C in children aged 0\u201314\u202fyears). Greater temperature variability reduced sequential infection risk for influenza after HFMD in the cold season (Hazard Ratio [HR]\u202f=\u202f0.16) and warm season (HR\u202f=\u202f0.14). Increased diurnal temperature range also lowered this risk in the cold season (HR\u202f=\u202f0.09). Higher AT in warm season reduced sequential infection risks from influenza to HFMD (HR\u202f=\u202f0.61). Increased relative humidity was protective in the cold season but became a risk factor in the warm season in specific disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Meteorological factors are pivotal in modulating the dynamics of common infections, and influencing both recurrence and sequential transmission. The protective effect of increased temperature variability against secondary infections highlights a complex climate-susceptibility interaction at the population level.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1920316","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:33:55Z","timestamp":1787808835000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Unraveling meteorologically influenced recurrence and sequential infection risks among influenza, mumps, scarlet fever, and hand-foot-and-mouth disease: evidence from Shenzhen, China"],"prefix":"10.3389","volume":"14","author":[{"given":"Hongxin","family":"Lyu","sequence":"first","affiliation":[{"name":"Shenzhen Longhua District Center for Disease Control and Prevention (Shenzhen Longhua District Health Supervision Office)","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huawei","family":"Xiong","sequence":"additional","affiliation":[{"name":"Shenzhen Center for Disease Control and Prevention","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jue","family":"Liao","sequence":"additional","affiliation":[{"name":"Academy of Medical Sciences, Shanxi Medical University","place":["Jinzhong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lifang","family":"Cai","sequence":"additional","affiliation":[{"name":"Futian District Center for Disease Control and Prevention","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanpeng","family":"Cheng","sequence":"additional","affiliation":[{"name":"Shenzhen Center for Disease Control and Prevention","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"127","DOI":"10.3967\/bes2025.016","article-title":"The impacts of climate change on the environment and human health in China: a call for more ambitious action","volume":"38","author":"Tong","year":"2025","journal-title":"Biomed Environ Sci"},{"key":"ref2","volume-title":"COP29 Special Report on Climate Change and Health: Health is the Argument for Climate Action","year":"2024"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.jcv.2017.07.004","article-title":"Retrospective use of next-generation sequencing reveals the presence of enteroviruses in acute influenza-like illness respiratory samples collected in south\/south-east Asia during 2010\u20132013","volume":"94","author":"Rutvisuttinunt","year":"2017","journal-title":"J Clin 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