Short communication: impact of climate variability on the incidence of dengue in Mexico.

We evaluated the impact of weather variables and climatic indicators associated with the incidence of dengue in two municipalities of the state of Veracruz, Mexico, from 1995 to 2003. A retrospective ecological study was conducted, using time-series analysis in which we compiled the weekly reported cases of dengue and the weather and climatic parameters: temperature, rainfall and sea-surface temperature (SST), the latter as an El Niño Southern Oscillation indicator. We statistically evaluated the data with autogressive models. The models' predictive abilities were evaluated using data collected from 1995 to 2002 and were validated with those observed for 2003. Each degree Centigrade increase in SST was followed by an increase in the number of dengue cases: 46% in San Andrés Tuxtla (P = 0.001) 16 weeks later and 42% in Veracruz 20 weeks later (P = 0.002). Increases in weekly minimum temperature and rainfall were also significant factors in the increase in the reported cases of dengue. We recommend future studies using the same method, involving larger populations with different geographic location, climate and weather. We also recommend strengthening environmental, health and entomological surveillance systems to improve preparedness and emergency responses.