Global Geographical and Temporal Patterns of Seasonal Influenza and Associated Climatic Factors.

Understanding geographical and temporal patterns of seasonal influenza can help strengthen influenza surveillance to early detect epidemics and inform influenza prevention and control programs. This study examines variations in spatiotemporal patterns of seasonal influenza in different global regions and explores climatic factors that influence differences in influenza seasonality through a systematic review of peer-reviewed publications. The literature search was conducted to identify original studies published between January 2005 and November 2016. Studies were selected using predetermined inclusion and exclusion criteria. The primary outcome was influenza cases and additional outcomes included seasonal or temporal patterns of influenza seasonality, study regions (temperate or tropical) and associated climatic factors. Of the 2160 records identified in the selection process, 36 eligible studies were included. Results showed significant differences in influenza seasonality in terms of the time of onset, duration, number of peaks and amplitude of epidemics between temperate and tropical/subtropical regions. Different viral types, co-circulation of influenza viruses and climatic factors especially temperature and absolute humidity were found to contribute to the variations in spatiotemporal patterns of seasonal influenza. The findings of this review could inform global surveillance of seasonal influenza and influenza prevention and control measures such as vaccination recommendations for different regions.