Seasonality of tuberculosis in New York City, 1990-2007

Christina M. Parrinello, A. Crossa, T. G. Harris

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


SETTING: Several non-US-based studies have found seasonal fluctuations in the incidence of tuberculosis (TB). OBJECTIVE: The current study examined patterns of TB seasonality for New York City verified TB cases from January 1990 to December 2007. DESIGN: Autocorrelation functions and Fourier analysis were used to detect a cyclical pattern in monthly incidence rates. Analysis of variance was used to compare seasonal mean case proportions. RESULTS: A cyclical pattern was detected every 12 months. Of the 34 004 TB cases included, 21.9% were in the fall (September-November), 24.7% in winter (December-February), 27.3% in spring (March-May), and 26.1% in the summer (June-August). The proportion of cases was lowest in fall (P < 0.0001) and highest in the spring (P < 0.0002). CONCLUSION: Possible explanations for seasonal variations in TB incidence include lower vitamin D levels in winter, leading to immune suppression and subsequent reactivation of latent TB; indoor winter crowding, increasing the likelihood of TB transmission; and providers attributing TB symptoms to other respiratory illnesses in winter, resulting in a delay in TB diagnosis until spring. Understanding TB seasonality may help TB programs better plan and allocate resources for TB control activities.

Original languageEnglish (US)
Pages (from-to)32-37
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Issue number1
StatePublished - Jan 2012
Externally publishedYes


  • New York City
  • Seasonal variation
  • Statistical models
  • Trends
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases


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