The magnitude of variation in temperature within a year has an effect on the seasonal variations of chickenpox incidence in Japan.

We investigated the epidemic pattern of chickenpox incidence among 47 prefectures in Japan. There were two peaks in chickenpox incidence in all prefectures. The first peaks appear at almost the same time in a year, while the second peaks occur at different times with relatively different types of size and shape. The feature of the second peak might characterize the epidemic pattern of chickenpox. We first introduced the second peak index, that is, the ratio of the difference between the incidence at the point of the second peak and the minimum incidence between the first and second peaks to the difference between the incidence at the point of the second peak and the minimum incidence in the year. There was a close correlation between the second peak index and the magnitude of variation in temperature within a year corresponding to the difference between the maximum and the minimum of the monthly mean of the highest daily temperature. This is the first article focusing on the close relationship between the second peak of epidemic pattern of chickenpox incidence and the variation of temperature within a year.