Climate factors influence seasonal influenza activity in Bangkok, Thailand

PLoS One. 2020 Sep 29;15(9):e0239729. doi: 10.1371/journal.pone.0239729. eCollection 2020.

Abstract

Yearly increase in influenza activity is associated with cold and dry winter in the temperate regions, while influenza patterns in tropical countries vary significantly by regional climates and geographic locations. To examine the association between influenza activity in Thailand and local climate factors including temperature, relative humidity, and rainfall, we analyzed the influenza surveillance data from January 2010 to December 2018 obtained from a large private hospital in Bangkok. We found that approximately one in five influenza-like illness samples (21.6% or 6,678/30,852) tested positive for influenza virus. Influenza virus typing showed that 34.2% were influenza A(H1N1)pdm09, 46.0% were influenza A(H3N2), and 19.8% were influenza B virus. There were two seasonal waves of increased influenza activity. Peak influenza A(H1N1)pdm09 activity occurred in February and again in August, while influenza A(H3N2) and influenza B viruses were primarily detected in August and September. Time series analysis suggests that increased relative humidity was significantly associated with increased influenza activity in Bangkok. Months with peak influenza activity generally followed the most humid months of the year. We performed the seasonal autoregressive integrated moving average (SARIMA) multivariate analysis of all influenza activity on the 2011 to 2017 data to predict the influenza activity for 2018. The resulting model closely resembled the actual observed overall influenza detected that year. Consequently, the ability to predict seasonal pattern of influenza in a large tropical city such as Bangkok may enable better public health planning and underscores the importance of annual influenza vaccination prior to the rainy season.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cities
  • Climate*
  • Humans
  • Humidity
  • Incidence
  • Influenza A Virus, H1N1 Subtype / genetics
  • Influenza A Virus, H1N1 Subtype / isolation & purification
  • Influenza A Virus, H3N2 Subtype / genetics
  • Influenza A Virus, H3N2 Subtype / isolation & purification
  • Influenza B virus / genetics
  • Influenza B virus / isolation & purification
  • Influenza, Human / diagnosis*
  • Influenza, Human / epidemiology
  • Influenza, Human / virology
  • Multivariate Analysis
  • RNA, Viral / genetics
  • RNA, Viral / metabolism
  • Rain
  • Real-Time Polymerase Chain Reaction
  • Seasons
  • Temperature
  • Thailand / epidemiology

Substances

  • RNA, Viral

Grants and funding

This work was supported by the Research Chair Grant from the National Science and Technology Development Agency (P-15-50004) (Y.P.), Center of Excellence in Clinical Virology of Chulalongkorn University and King Chulalongkorn Memorial Hospital (Y.P.). Nungruthai Suntronwong was supported by the Royal Golden Jubilee Ph.D. Program (PHD/0084/2558) scholarship. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.