Abstract
The occurrence of influenza in different climates has been shown to be associated with multiple meteorological factors. The incidence of influenza has been reported to increase during rainy seasons in tropical climates and during the dry, cold months of winter in temperate climates. This study was designed to explore the role of absolute humidity (AH), relative humidity (RH), temperature, and wind speed (WS) on influenza activity in the Toronto, ON, Canada, area. Environmental data obtained from four meteorological stations in the Toronto area over the period from 1 January 2010 to 31 December 2015 were linked to patient influenza data obtained for the same locality and period. Data were analyzed using correlation, negative binomial regressions with linear predictors, and splines to capture the nonlinear relationship between exposure and outcomes. Our study found a negative association of both AH and temperature with influenza A and B virus infections. The effect of RH on influenza A and B viruses was controversial. Temperature fluctuation was associated with increased numbers of influenza B virus infections. Influenza virus was less likely to be detected from community patients than from patients tested as part of an institutional outbreak investigation. This could be more indicative of nosocomial transmission rather than climactic factors. The nonlinear nature of the relationship of influenza A virus with temperature and of influenza B virus with AH, RH, and temperature could explain the complexity and variation between influenza A and B virus infections. Predicting influenza activity is important for the timing of implementation of disease prevention and control measures as well as for resource allocation.IMPORTANCE This study examined the relationship between environmental factors and the occurrence of influenza in general. Since the seasonality of influenza A and B viruses is different in most temperate climates, we also examined each influenza virus separately. This study reports a negative association of both absolute humidity and temperature with influenza A and B viruses and tries to understand the controversial effect of RH on influenza A and B viruses. This study reports a nonlinear relation between influenza A and B viruses with temperature and influenza B virus with absolute and relative humidity. The nonlinear nature of these relations could explain the complexity and difference in seasonality between influenza A and B viruses, with the latter predominating later in the season. Separating community-based specimens from those obtained during outbreaks was also a novel approach in this research. These findings provide a further understanding of influenza virus transmission in temperate climates.
Highlights
The occurrence of influenza in different climates has been shown to be associated with multiple meteorological factors
A variety of host factors, such as inhibition of the immune system, potentially through the decreased levels of vitamin D production in winter [2] and the reduction in the clearance ability of respiratory cilia with the inhalation of cold air [11, 12], have been reported to enhance the transmission of influenza virus during winter seasons. It has been reported from animal [3] and human [13] studies that in temperate climates influenza virus transmission is more likely to occur at temperatures of 5°C and below
Of all specimens included in this study, a total of 4,485 (10%) specimens were positive for influenza virus
Summary
The occurrence of influenza in different climates has been shown to be associated with multiple meteorological factors. A variety of host factors, such as inhibition of the immune system, potentially through the decreased levels of vitamin D production in winter [2] and the reduction in the clearance ability of respiratory cilia with the inhalation of cold air [11, 12], have been reported to enhance the transmission of influenza virus during winter seasons It has been reported from animal [3] and human [13] studies that in temperate climates influenza virus transmission is more likely to occur at temperatures of 5°C and below. The impact of absolute humidity on influenza virus was reported to be about 3%, and any effects of humidity were postulated to be synergistic with other environmental and host factors [16]
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