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.
Human influenza infections have a pronounced seasonal cycle in temperate regions. Recent laboratory and epidemiological evidence suggests that low humidity conditions in the winter may increase virus survival and enable the virus to transmit efficiently between hosts. However, seasonal influenza activity in some tropical locations occurs during the rainy season, whereas other tropical locations do not experience a well-defined influenza season. The primary goal of this study was to identify the relationship between the timing of seasonal influenza epidemics and climate variability across the globe. We show the importance of thresholds in humidity, temperature and precipitation that affect the epidemiology, and potentially the transmission route, of influenza. A better understanding of the environmental, demographic and behavioral drivers of influenza seasonality is important for optimizing intervention strategies, especially in low and middle-latitude regions.