Climate change, extreme events and increased risk of salmonellosis in Maryland, USA: Evidence for coastal vulnerability

Background: Salmonella is a leading cause of acute gastroenteritis worldwide. Patterns of salmonellosis have been linked to weather events. However, there is a dearth of data regarding the association between extreme events and risk of salmonellosis, and how this risk may disproportionately impact coastal communities.

Methods: We obtained Salmonella case data from the Maryland Foodborne Diseases Active Surveillance Network (2002-2012), and weather data from the National Climatic Data Center (1960-2012). We developed exposure metrics related to extreme temperature and precipitation events using a 30 year baseline (1960-1989) and linked them with county-level salmonellosis data. Data were analyzed using negative binomial Generalized Estimating Equations.

Results: We observed a 4.1% increase in salmonellosis risk associated with a 1 unit increase in extreme temperature events (incidence rate ratio (IRR):1.041; 95% confidence interval (CI):1.013-1.069). This increase in risk was more pronounced in coastal versus non-coastal areas (5.1% vs 1.5%). Likewise, we observed a 5.6% increase in salmonellosis risk (IRR:1.056; CI:1.035-1.078) associated with a 1 unit increase in extreme precipitation events, with the impact disproportionately felt in coastal areas (7.1% vs 3.6%).

Conclusions: To our knowledge, this is the first empirical evidence showing that extreme temperature/precipitation events-that are expected to be more frequent and intense in coming decades-are disproportionately impacting coastal communities with regard to salmonellosis. Adaptation strategies need to account for this differential burden, particularly in light of ever increasing coastal populations.