Association of climatic variables with risk of transmission of influenza in Guangzhou, China, 2005-2021

Background: Climatic variables constitute important extrinsic determinants of transmission and seasonality of influenza. Yet quantitative evidence of independent associations of viral transmissibility with climatic factors has thus far been scarce and little is known about the potential effects of interactions between climatic factors on transmission. Objective: This study aimed to examine the associations of key climatic factors with risk of influenza transmission in subtropical Guangzhou. Methods: Influenza epidemics were identified over a 17-year period using the moving epidemic method (MEM) from a dataset of N = 295,981 clinically- and laboratory-confirmed cases of influenza in Guangzhou. Data on eight key climatic variables were collected from China Meteorological Data Service Centre. Generalized additive model combined with the distributed lag non-linear model (DLNM) were developed to estimate the exposure-lagresponse curve showing the trajectory of instantaneous reproduction number (Rt) across the distribution of each climatic variable after adjusting for depletion of susceptible, inter-epidemic effect and school holidays. The potential interaction effects of temperature, humidity and rainfall on influenza transmission were also examined. Results: Over the study period (2005-21), 21 distinct influenza epidemics with varying peak timings and durations were identified. Increasing air temperature, sunshine, absolute and relative humidity were significantly associated with lower Rt, while the associations were opposite in the case of ambient pressure, wind speed and rainfall. Rainfall, relative humidity, and ambient temperature were the top three climatic contributors to variance in transmissibility. Interaction models found that the detrimental association between high relative humidity and transmissibility was more pronounced at high temperature and rainfall. Conclusion: Our findings are likely to help understand the complex role of climatic factors in influenza transmission, guiding informed climate-related mitigation and adaptation policies to reduce transmission in high density subtropical cities.

Automated summary

This study aimed to examine the associations between key climatic factors and the risk of influenza transmission in subtropical Guangzhou. The results showed that increasing air temperature, sunshine, absolute and relative humidity were associated with lower transmission risk, while ambient pressure, wind speed, and rainfall were associated with higher transmission risk. Rainfall, relative humidity, and ambient temperature were the top three contributors to variance in transmissibility. The study also found that the interaction between high relative humidity and transmissibility was more pronounced at high temperature and rainfall. These findings can guide climate-related mitigation and adaptation policies to reduce influenza transmission risk in high density subtropical cities.