Dynamic patterns of avian and human influenza in east and southeast Asia.

The seasonal patterns of human influenza in temperate regions have been well documented; however, much less attention has been paid to patterns of infection in the tropical and subtropical areas of east and southeast Asia. During the period 1997-2006, this region experienced several outbreaks of highly pathogenic avian influenza A (H5N1) in hosts including wild and domestic poultry, human beings, and other mammals. H5N1 is thought to be a likely source of a pandemic strain of human influenza. Incidence of both human influenza and avian influenza in human beings shows evidence of seasonality throughout east and southeast Asia, although the seasonal patterns in tropical and subtropical areas are not as simple or as pronounced as those in temperate regions around the world. The possibility of a human being becoming co-infected with both human and avian strains of influenza is not restricted to a short season, although the risks do appear to be greatest during the winter months.