Temporal Patterns of Influenza A and B in Tropical and Temperate Countries: What Are the Lessons for Influenza Vaccination?

Saverio Caini (1) , Winston Andrade (2) , Selim Badur (3) , Angel Balmaseda (4) , Amal Barakat (5) , Antonino Bella (6) , Abderrahman Bimohuen (5) , Lynnette Brammer (7) , Joseph Bresee (7) , Alfredo Bruno (8) , Leticia Castillo (9) , Meral A Ciblak (3) , Alexey W Clara (10) , Cheryl Cohen (11) , Jeffery Cutter (12) , Coulibaly Daouda (13) , Celina de Lozano (14) , Domenica de Mora (8) , Kunzang Dorji (15) , Gideon O Emukule (16) , Rodrigo A Fasce (2) , Luzhao Feng (17) , Aparecida Walquiria (18) , Raquel Guiomar (19) , Jean-Michel Heraud (20) , Olha Holubka (21) , Q. Sue Sue Huang (22) , Herve A Kadjo (13) , Lyazzat Kiyanbekova (23) , Herman Kosasih (24) , Gabriela Kusznierz (25) , Jenny Lara (26) , Ming Li (17) , Liza Lopez (22) , Mai Hoang (27) , Pessanha Henriques (18) , Maria Luisa Matute (28) , Alla Mironenko (21) , Brechla Moreno (29) , Joshua A Mott (16) , Richard Njouom (30) , N Nurhayati (24) , Akerke Ospanova (23) , Rhonda Owen (31) , Richard Pebody (32) , Kate Pennington (31) , Simona Puzelli (6) , Quynh Le (27) , Norosoa Harline Razanajatovo (20) , Ana Rodrigues (33) , Juan Manuel Rudi (25) , Raymond Tzer Pin Lin (12) , Marietjie Venter (34) , Marie-Astrid Vernet (30) , Sonam Wangchuk (15) , Juan Yang (17) , Hongjie Yu (17) , Maria Zambon (32) , François Schellevis (1) , John Paget (35)

1 Netherlands Institute for Health Services Research
2 ISP - Instituto de Salud Pública de Chile
3 Istanbul University
4 MINSA - Ministry of Health [Nicaragua]
5 Ministry of Health [Morocco]
6 Istituto Superiore di Sanita [Rome]
7 CDC - Centers for Disease Control and Prevention [Atlanta]
8 INSPI - Instituto Nacional de Investigación en Salud Pública [Guayaquil, Ecuador]
9 MSPAS - Ministerio de Salud Publica y Asistencia Social [Guatemala]
10 US Centers for Disease Control
11 WITS - University of the Witwatersrand [Johannesburg]
12 Ministry of Health
13 Institut Pasteur de Côte d'Ivoire
14 MINSAL - Ministerio de Salud de El Salvador
15 Ministry of Health [Bhoutan]
16 US Centers for Disease Control and Prevention
17 Chinese Center for Disease Control and Prevention
18 Ministry of Health
19 Instituto nacional de saude
20 IPM - Unité de Virologie [Antananarivo, Madagascar]
21 National Academy of Medical Sciences of Ukraine
22 ESR - Institute of Environmental Science and Research
23 Astana Center of Sanitary Epidemiology Expertise
24 US Naval Medical Research Unit n°2
25 Instituto Nacional de Enfermedades Respiratorias “Dr. Emilio Coni”
26 Ministry of Health [Costa Rica]
27 NIHE - National Institute of Hygiene and Epidemiology [Hanoi, Vietnam]
28 SESAL - Ministry of Health [Honduras]
29 National Influenza Center
30 Centre Pasteur du Cameroun
31 DHAISS - Office of Health Protection, Woden, ACT, Australia
32 Public Health England [London]
33 National Institute of Health
34 University of Pretoria [South Africa]
35 Netherlands Institute for Health Services Research

INTRODUCTION: Determining the optimal time to vaccinate is important for influenza vaccination programmes. Here, we assessed the temporal characteristics of influenza epidemics in the Northern and Southern hemispheres and in the tropics, and discuss their implications for vaccination programmes. METHODS: This was a retrospective analysis of surveillance data between 2000 and 2014 from the Global Influenza B Study database. The seasonal peak of influenza was defined as the week with the most reported cases (overall, A, and B) in the season. The duration of seasonal activity was assessed using the maximum proportion of influenza cases during three consecutive months and the minimum number of months with ≥80% of cases in the season. We also assessed whether co-circulation of A and B virus types affected the duration of influenza epidemics. RESULTS: 212 influenza seasons and 571,907 cases were included from 30 countries. In tropical countries, the seasonal influenza activity lasted longer and the peaks of influenza A and B coincided less frequently than in temperate countries. Temporal characteristics of influenza epidemics were heterogeneous in the tropics, with distinct seasonal epidemics observed only in some countries. Seasons with co-circulation of influenza A and B were longer than influenza A seasons, especially in the tropics. DISCUSSION: Our findings show that influenza seasonality is less well defined in the tropics than in temperate regions. This has important implications for vaccination programmes in these countries. High-quality influenza surveillance systems are needed in the tropics to enable decisions about when to vaccinate.

Domains: Life Sciences [q-bio]; Microbiology and Parasitology; Virology; Life Sciences [q-bio]; Biochemistry, Molecular Biology; Molecular biology; Life Sciences [q-bio]; Human health and pathology; Emerging diseases; Life Sciences [q-bio]; Human health and pathology; Infectious diseases; Life Sciences [q-bio]; Santé publique et épidémiologie

Saverio Caini, Winston Andrade, Selim Badur, Angel Balmaseda, Amal Barakat, et al.. Temporal Patterns of Influenza A and B in Tropical and Temperate Countries: What Are the Lessons for Influenza Vaccination?. PLoS ONE, 2016, 11 (3), pp.e0152310. ⟨10.1371/journal.pone.0152310⟩. ⟨pasteur-01675327⟩