A cohort of 136 children from Shanghai with insulin dependent diabetes mellitus (IDDM) (0.7-15 years) were analyzed for the month of onset of disease and month of birth. In contradistinction to populations with a medium or high incidence of IDDM, no seasonality was registered in the month of onset. On the other hand there was a significant (p < 0.026) seasonality in the month of birth (peak November to January), but which differed in pattern to that observed in populations with medium or high incidence. Our findings support the hypothesis that the initiation of IDDM is due to a viral infection and that one cause for the low incidence of childhood IDDM in certain populations is immunization against infectious pathogens in their early life.