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Incidence of common respiratory viral infections related to climate factors in hospitalized children in Hong Kong

  • J. W. TANG (a1), F. Y. L. LAI (a2), F. WONG (a1) and K. L. E. HON (a3)

Hong Kong has a subtropical climate and an influenza seasonality lying approximately mid-way (March–June) between those of the Northern (November–March) and Southern (June–September) hemispheres. Respiratory syncytial virus (RSV) shares a similar seasonality to that of influenza in Hong Kong and is another important respiratory infection of childhood. Daily virus incidence data from public hospitals in Hong Kong's New Territory East Cluster, together with Hong Kong climate data were obtained for 2000–2007. Statistical time-series analysis using monthly time windows showed that influenza A and RSV incidence increased with higher environmental relative humidity, whereas influenza B incidence decreased with higher environmental temperatures. The other climate variables (including vapour pressure as a measure of absolute humidity) were not significantly related to the incidence of these respiratory viruses. Data from this study further reinforces the concept that the relationship between climate factors and respiratory virus incidence differ between subtropical/tropical and temperate countries.

Corresponding author
*Author for correspondence: Dr J. W. Tang, Department of Laboratory MedicineNational University Hospital, 5 Lower Kent Ridge Road, Singapore119074. (Email:
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1. M Reyes , Regular pattern of respiratory syncytial virus and rotavirus infections and relation to weather in Stockholm, 1984–1993. Clinical Microbiology and Infection 1997; 3: 640646.

2. FT Chew , Seasonal trends of viral respiratory tract infections in the tropics. Epidemiology and Infection 1998; 121: 121128.

3. PK Chan , Epidemiology of respiratory syncytial virus infection among paediatric patients in Hong Kong: seasonality and disease impact. Epidemiology and Infection 1999; 123: 257262.

4. PW Chan , Seasonal variation in respiratory syncytial virus chest infection in the tropics. Pediatric Pulmonology 2002; 34: 4751.

5. M Viegas , Respiratory viruses seasonality in children under five years of age in Buenos Aires, Argentina: a five-year analysis. Journal of Infection 2004; 49: 222228.

6. S Lapeña , Climatic factors and lower respiratory tract infection due to respiratory syncytial virus in hospitalised infants in northern Spain. European Journal of Epidemiology 2005; 20: 271276.

7. GC Donaldson . Climate change and the end of the respiratory syncytial virus season. Clinical Infectious Diseases 2006; 42: 677679.

9. RC Welliver Sr.. Temperature, humidity, and ultraviolet B radiation predict community respiratory syncytial virus activity. Pediatric Infectious Diseases Journal 2007; 26 (11 Suppl.): S2935.

12. J Tan , An initial investigation of the association between the SARS outbreak and weather: with the view of the environmental temperature and its variation. Journal of Epidemiology and Community Health 2005; 59: 186192.

13. J Yuan , A climatologic investigation of the SARS-CoV outbreak in Beijing, China. American Journal of Infection Control 2006; 34: 234236.

16. WJ Alonso , Seasonality of influenza in Brazil: a traveling wave from the Amazon to the subtropics. American Journal of Epidemiology 2007; 165: 14341442.

19. MW Weber , EK Mulholland , BM Greenwood . Respiratory syncytial virus infection in tropical and developing countries. Tropical Medicine & International Health 1998; 3: 268280.

20. LG Stensballe , JK Devasundaram , EA Simoes . Respiratory syncytial virus epidemics: the ups and downs of a seasonal virus. Pediatric Infectious Diseases Journal 2003; 22 (2 Suppl.): S21–32.

23. TA Reichert , Influenza and the winter increase in mortality in the United States, 1959–1999. American Journal of Epidemiology 2004; 160: 492502.

24. JL Antunes , Effectiveness of influenza vaccination and its impact on health inequalities. International Journal of Epidemiology 2007; 36: 13191326.

25. PC Wu , Weather as an effective predictor for occurrence of dengue fever in Taiwan. Acta Tropica. 2007; 103: 5057.

28. J Shaman , M Kohn . Absolute humidity modulates influenza survival, transmission, and seasonality. Proceedings of the National Academy of Sciences USA 2009; 106: 32433248.

30. H Jin , Two residues in the hemagglutinin of A/Fujian/411/02-like influenza viruses are responsible for antigenic drift from A/Panama/2007/99. Virology 2005; 336: 113119.

32. GA Herrera , Influenza vaccine effectiveness among 50–64-year-old persons during a season of poor antigenic match between vaccine and circulating influenza virus strains: Colorado, United States, 2003–2004. Vaccine 2007; 25: 154160.

34. N Lee , A major outbreak of severe acute respiratory syndrome in Hong Kong. New England Journal of Medicine 2003; 348: 19861994.

35. KW Tsang , A cluster of cases of severe acute respiratory syndrome in Hong Kong. New England Journal of Medicine 2003; 348: 19771985.

37. EC Cole , CE Cook . Characterization of infectious aerosols in health care facilities: an aid to effective engineering controls and preventive strategies. American Journal of Infection Control 1998; 26: 453464.

38. DA Edwards , Inhaling to mitigate exhaled bioaerosols. Proceedings of the National Academy of Sciences USA 2004; 101: 1738317388.

39. KP Fennelly , Cough-generated aerosols of Mycobacterium tuberculosis: a new method to study infectiousness. American Journal of Respiratory and Critical Care Medicine 2004; 169: 604609.

40. M Nicas , WW Nazaroff , A Hubbard . Toward understanding the risk of secondary airborne infection: emission of respirable pathogens. Journal of Occupational and Environmental Hygiene 2005; 2: 143154.

41. JW Tang , Factors involved in the aerosol transmission of infection and control of ventilation in healthcare premises. Journal of Hospital Infection 2006; 64: 100114.

42. JH Hemmes , KC Winkler , SM Kool . Virus survival as a seasonal factor in influenza and polimyelitis. Nature 1960; 188: 430431.

43. FL Schaffer , ME Soergel , DC Straube . Survival of airborne influenza virus: effects of propagating host, relative humidity, and composition of spray fluids. Archives of Virology 1976; 51: 263273.

45. AC Lowen , High temperature (30 degrees C) blocks aerosol but not contact transmission of influenza virus. Journal of Virology 2008; 82: 56505652.

46. R Tellier . Review of aerosol transmission of influenza A virus. Emerging Infectious Diseases 2006; 12: 16571662.

47. J Ji , Domestic air-conditioner and integrated water heater for subtropical climate. Applied Thermal Engineering 2003; 23: 581592.

48. MB Rothberg , Management of influenza symptoms in healthy children: cost-effectiveness of rapid testing and antiviral therapy. Archives of Pediatric and Adolescent Medicine 2005; 159: 10551062.

49. M Iskander , R Booy , S Lambert . The burden of influenza in children. Current Opinion in Infectious Diseases 2007; 20: 259263.

50. S Hollinghurst , Measuring the financial burden of acute cough in pre-school children: a cost of illness study. BMC Family Practice 2008; 9: 10.

51. E Gerard . Infectious diseases in air travellers arriving in the UK. Journal of the Royal Society of Health 2002; 122: 8688.

52. A Mangili , MA Gendreau . Transmission of infectious diseases during commercial air travel. Lancet 2005; 365: 989996.

53. K Leder , D Newman . Respiratory infections during air travel. Internal Medicine Journal 2005; 35: 5055.

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