Zhidong Liu1, Jing Zhang1, Ying Zhang2, Jiahui Lao1, Yanyu Liu1, Hui Wang3, Baofa Jiang4. 1. Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong Province, People's Republic of China. 2. School of Public Health, China Studies Centre, The University of Sydney, New South Wales, Australia. 3. Department of Medical Administration, Second Hospital of Shandong University, Jinan, Shandong Province, People's Republic of China. Electronic address: huiwang1982@163.com. 4. Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong Province, People's Republic of China. Electronic address: bjiang@sdu.edu.cn.
Abstract
BACKGROUND: Previous studies have demonstrated that meteorological factors influence the incidence of influenza. However, little is known regarding the interactions of meteorological factors on the risk of influenza in China. OBJECTIVE: The study aimed to evaluate the associations between meteorological factors and influenza in Shaoyang of southern China, and explore the interaction of temperature with humidity and rainfall. METHODS: Weekly meteorological data and disease surveillance data of influenza in Shaoyang were collected from 2009 to 2012. According to the incubation period and infectious period of influenza virus, the maximum lag period was set as 3 weeks. A generalized additive model was conducted to evaluate the effect of meteorological factors on the weekly number of influenza cases and a stratification model was applied to investigate the interaction. RESULTS: During the study period, the total number of influenza cases that were notified in the study area was 2506, with peak times occurring from December to March. After controlling for the confounders, each 5 °C decrease in minimum temperature was related to 8% (95%CI: 1-15%) increase in the number of influenza cases at a 1-week lag. There was an interaction between minimum temperature and relative humidity and the risk of influenza was higher in cold and less humid conditions than other conditions. The interaction between minimum temperature and rainfall was not statistically significant in our study. CONCLUSIONS: The study suggests that minimum temperature is inversely associated with influenza in the study area of China, and the effect can be modified by relative humidity. Meteorological variables could be integrated in current public health surveillance system to better prepare for the risks of influenza.
BACKGROUND: Previous studies have demonstrated that meteorological factors influence the incidence of influenza. However, little is known regarding the interactions of meteorological factors on the risk of influenza in China. OBJECTIVE: The study aimed to evaluate the associations between meteorological factors and influenza in Shaoyang of southern China, and explore the interaction of temperature with humidity and rainfall. METHODS: Weekly meteorological data and disease surveillance data of influenza in Shaoyang were collected from 2009 to 2012. According to the incubation period and infectious period of influenza virus, the maximum lag period was set as 3 weeks. A generalized additive model was conducted to evaluate the effect of meteorological factors on the weekly number of influenza cases and a stratification model was applied to investigate the interaction. RESULTS: During the study period, the total number of influenza cases that were notified in the study area was 2506, with peak times occurring from December to March. After controlling for the confounders, each 5 °C decrease in minimum temperature was related to 8% (95%CI: 1-15%) increase in the number of influenza cases at a 1-week lag. There was an interaction between minimum temperature and relative humidity and the risk of influenza was higher in cold and less humid conditions than other conditions. The interaction between minimum temperature and rainfall was not statistically significant in our study. CONCLUSIONS: The study suggests that minimum temperature is inversely associated with influenza in the study area of China, and the effect can be modified by relative humidity. Meteorological variables could be integrated in current public health surveillance system to better prepare for the risks of influenza.