Global climate change and seasonal variation of cellulitis in hospitalized children: a 30 year retrospective study.

Abstract

Cellulitis, a common subcutaneous infection, is influenced by host, pathogen, and environmental factors. Previous studies have shown seasonal patterns in adult cellulitis, suggesting temperature as a risk factor. This study investigated seasonal patterns in paediatric cellulitis in Jerusalem's semi-arid climate. A single-center retrospective cohort study reviewed medical records of 2,219 hospitalized children under 18 with cellulitis between 1990 and 2020. Demographic, clinical, temperature, and humidity data were collected. Results revealed a significant sinusoidal pattern for limb cellulitis (LC) but for other body sites, with summer peaks and winter nadirs (P < 0.01). August showed the highest incidence, tripling that of February. Age groups 1-6 and 6-12 demonstrated the largest seasonal differences (P = 0.004, P = 0.008). Over three decades, paediatric hospitalized LC cases increased by 71% (P < 0.001), correlating with rising temperatures. Elevated ambient temperature seven days prior to diagnosis was a risk factor for LC development (OR = 1.02, P = 0.03). This study highlights the cyclic seasonal pattern of paediatric LC, peaking in summer. The significant increase in cases over time, coupled with rising temperatures, suggests climate change as a contributing factor. These findings could inform public health strategies for cellulitis prevention and management in children.