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Cholera Seasonality in Madras (1901–1940): Dual Role for Rainfall in Endemic and Epidemic Regions

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Abstract

The seasonality of cholera and its spatial variability remain unexplained. Uncovering the role of environmental drivers in these seasonal patterns is critical to understand temporal variability at longer time scales, including trends and interannual variability. Rainfall has been proposed as a key driver of the seasonality of cholera. To address this hypothesis, we examine the association between rainfall and cholera in both time and space using the extensive historical records for the districts of Madras in former British India (1901–1940). We show the existence of two main spatial clusters that differ not just in the effect of rainfall but also in the seasonal pattern and frequency of periods with and without cholera mortality. The results support a model of cholera seasonality with two different routes of transmission: one is enhanced by increasing rainfall (in areas with abundant water), the other is buffered by increasing water. We discuss how the dual nature of the influence of rainfall creates different temporal patterns in regions where cholera is either “endemic” or “epidemic.”

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Acknowledgments

We thank two anonymous reviewers for their comments. This work was supported by the National Science Foundation–National Institutes of Health (Ecology of Infectious Diseases Grant EF 0430 120) and the National Oceanic and Atmospheric Administration (Oceans and Health Grant NA 040 AR 460019).

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Authors and Affiliations

  1. Department of Ecology and Evolutionary Biology, University of Michigan, 830 North University, 2041 Natural Science Building, Ann Arbor, Michigan, 48109-1048, USA

    Diego Ruiz-Moreno & Mercedes Pascual

  2. Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, University of London, London, UK

    Menno Bouma

  3. Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, USA

    Andrew Dobson

  4. Center for Ocean–Land–Atmosphere Studies, Calverton, USA

    Benjamin Cash

Authors
  1. Diego Ruiz-Moreno
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  2. Mercedes Pascual
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  3. Menno Bouma
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  4. Andrew Dobson
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  5. Benjamin Cash
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Correspondence to Diego Ruiz-Moreno.

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Ruiz-Moreno, D., Pascual, M., Bouma, M. et al. Cholera Seasonality in Madras (1901–1940): Dual Role for Rainfall in Endemic and Epidemic Regions. EcoHealth 4, 52–62 (2007). https://doi.org/10.1007/s10393-006-0079-8

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  • DOI: https://doi.org/10.1007/s10393-006-0079-8

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