Abstract

Human influenza infections exhibit a strong seasonal cycle in temperate regions. Recent laboratory and epidemiological evidence suggests that low specific humidity conditions facilitate the airborne survival and transmission of the influenza virus in temperate regions, resulting in annual winter epidemics. However, this relationship is unlikely to account for the epidemiology of influenza in tropical and subtropical regions where epidemics often occur during the rainy season or transmit year-round without a well-defined season. We assessed the role of specific humidity and other local climatic variables on influenza virus seasonality by modeling epidemiological and climatic information from 78 study sites sampled globally. We substantiated that there are two types of environmental conditions associated with seasonal influenza epidemics: “cold-dry” and “humid-rainy”. For sites where monthly average specific humidity or temperature decreases below thresholds of approximately 11–12 g/kg and 18–21°C during the year, influenza activity peaks during the cold-dry season (i.e., winter) when specific humidity and temperature are at minimal levels. For sites where specific humidity and temperature do not decrease below these thresholds, seasonal influenza activity is more likely to peak in months when average precipitation totals are maximal and greater than 150 mm per month. These findings provide a simple climate-based model rooted in empirical data that accounts for the diversity of seasonal influenza patterns observed across temperate, subtropical and tropical climates.

Highlights

  • Influenza exerts a significant health burden on human populations across temperate, subtropical and tropical regions [1]

  • Influenza seasonal characteristics are more diverse in tropical and subtropical regions; some sites experience annual epidemics coinciding with the local rainy season [7,8,9,10,11], whereas others are characterized by semi-annual epidemics or year-round influenza activity without well-defined influenza seasons [7,12,13]

  • Seasonal influenza activity in some tropical locations occurs during the rainy season, whereas other tropical locations do not experience a well-defined influenza season

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Summary

Introduction

Influenza exerts a significant health burden on human populations across temperate, subtropical and tropical regions [1]. Influenza seasonal characteristics are more diverse in tropical and subtropical regions; some sites experience annual epidemics coinciding with the local rainy season [7,8,9,10,11], whereas others are characterized by semi-annual epidemics or year-round influenza activity without well-defined influenza seasons [7,12,13]. Recent epidemiological studies indicate that low levels of specific humidity are associated with the onset of pandemic and epidemic influenza in the US [14,15], consistent with laboratory experiments and animal models suggesting that low specific humidity favors virus survival and aerosol transmission [16,17]. There are few biological explanations for the association between precipitations and influenza activity reported in some tropical and subtropical regions, rainy conditions may favor indoor crowding [4]

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