Revisiting the Relationship between Weather and Interannual Variation in Human Plague Cases in the Southwestern United States.

Plague is a rare, potentially fatal flea-borne zoonosis endemic in the western United States. A previous model described interannual variation in human cases based on temperature and lagged precipitation. We recreated this model in northeastern Arizona (1960-1997) to evaluate its capacity to predict recent cases (1998-2022). In recreating the original model, we found that future instead of concurrent temperature had inadvertently been used for the presented fit. Prediction from our revised models with lagged precipitation and temporally plausible temperature relationships aligned with low observed cases in 1998-2022. Elevated precipitation associated with high cases in historical data (>6 inches combined precipitation over two previous springs) was only observed once in the last quarter century, so we could not assess if these conditions were reliably associated with elevated (four or more) human plague cases. Observed weather conditions were similar to those previously associated with low (fewer than or equal to two) case counts, suggesting "baseline" conditions in the last quarter century.