Cholera dynamics and El Nino-Southern Oscillation

Analysis of a monthly 18-year cholera time series from Bangladesh shows tha t the temporal variability of cholera exhibits an interannual component at the dominant frequency of El Nino-Southern Oscillation (ENSO). Results from nonlinear time series analysis support a role for both ENSO and previous d isease Levels in the dynamics of cholera. Cholera patterns are Linked to th e previously described changes in the atmospheric circulation of south Asia and, consistent with these changes, to regional temperature anomalies.