Osteomyelitis in Children More Common in the Summer, Spring

Study assessed the effects of weather trends on the occurrence and severity of acute hematogenous osteomyelitis in affected children.

Acute hematogenous osteomyelitis occurred most commonly in the summer among children, according to research published in the Journal of the Pediatric Infectious Diseases Society.

To evaluate the effects of weather trends on the occurrence and severity of osteomyelitis, children admitted to a Dallas, Texas, hospital with osteomyelitis were retrospectively evaluated for illness severity. Weather data from the National Weather Service for the dates of symptom onset and admission were collected and analyzed.

A total of 209 children with osteomyelitis were admitted a mean (SD) of 5.0 (3.8) days after symptom onset and had an average illness severity of 3.2 (3.2) on a scale of 0 to 10.

Osteomyelitis onset occurred most frequently in the summer (34.9%), followed by the spring (25.8%). Winter had the lowest rate of osteomyelitis symptom onset (17.7%).

No difference in the severity was noted between seasons (P =.785). However, high disease severity occurred more frequently than mild disease severity in the summer season (40% vs 33%). Furthermore, illness severity was correlated with the minimum temperature at symptom onset during the summer season (P =.020).

In an interview with Infectious Disease Advisor, Lawson Copley, MD, professor of orthopaedic surgery and pediatrics at University of Texas Southwestern Medical Center and senior author on the paper, noted that the results aligned with clinical observation that “weather changes seem to precede episodic bursts of hospital admissions for osteomyelitis.”

Related Articles

Dr Copley noted that future investigations should focus on “basic science investigations to see if simulated weather changes impact the bacterial transcriptome and trigger the expression of genes leading to invasion.” Clinically, a “larger multicenter study from various geographic regions in the United States focusing only on culture-positive cases of acute hematogenous osteomyelitis” would also be informative.


Lindsay EA, Tareen N, Jo CH, Copley LA. Seasonal variation and weather changes related to the occurrence and severity of acute hematogenous osteomyelitis in children [published online October 13, 2017]J Pediatric Infect Dis Soc. doi: 10.1093/jpids/pix085