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. 2021 Oct 15;18(20):10846.
doi: 10.3390/ijerph182010846.

Associations between Temperature and Influenza Activity: A National Time Series Study in China

Can Chen  1 , Xiaobao Zhang  1 , Daixi Jiang  1 , Danying Yan  1 , Zhou Guan  1 , Yuqing Zhou  1 , Xiaoxiao Liu  1 , Chenyang Huang  1 , Cheng Ding  1 , Lei Lan  1 , Xihui Huang  2 , Lanjuan Li  1 , Shigui Yang  1
Affiliations

Associations between Temperature and Influenza Activity: A National Time Series Study in China

Can Chen et al. Int J Environ Res Public Health. .

Abstract

Previous studies have reported that temperature is the main meteorological factor associated with influenza activity. This study used generalized additive models (GAMs) to explore the relationship between temperature and influenza activity in China. From the national perspective, the average temperature (AT) had an approximately negative linear correlation with the incidence of influenza, as well as a positive rate of influenza H1N1 virus (A/H1N1). Every degree that the monthly AT rose, the influenza cases decreased by 2.49% (95%CI: 1.24%-3.72%). The risk of influenza cases reached a peak at -5.35 °C with RRs of 2.14 (95%CI: 1.38-3.33) and the monthly AT in the range of -5.35 °C to 18.31 °C had significant effects on the incidence of influenza. Every degree that the weekly AT rose, the positive rate of A/H1N1 decreased by 5.28% (95%CI: 0.35%-9.96%). The risk of A/H1N1 reached a peak at -3.14 °C with RRs of 4.88 (95%CI: 1.01-23.75) and the weekly AT in the range of -3.14 °C to 17.25 °C had significant effects on the incidence of influenza. Our study found that AT is negatively associated with influenza activity, especially for A/H1N1. These findings indicate that temperature could be integrated into the current influenza surveillance system to develop early warning systems to better predict and prepare for the risks of influenza.

Keywords: H1N1 virus; generalized additive models; influenza activity; temperature.

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Conflict of interest statement

The authors have no conflict of interest relevant to this article to disclose.

Figures

Figure 1
Figure 1
The incidence of influenza in China. (A). Geographical distribution of influenza in China; (B). Geographical distribution of Southern and Northern China; (C). The incidence of influenza in three age group; (D). The incidence of influenza in northern and southern China.
Figure 2
Figure 2
The exposure–response and excess risk of monthly AT on the incidence of influenza. (A). The exposure–response of monthly AT on the incidence of influenza; (B). The excess risk of monthly AT on the incidence of influenza.
Figure 3
Figure 3
The activity of influenza virus in China. (A) The positive rate of influenza virus in China; (B) The activity of influenza virus in China by week.
Figure 4
Figure 4
The exposure–response and excess risk of weekly AT to the positive rate of influenza virus.
See this image and copyright information in PMC

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