Abstract
Influenza circulation and mortality impact in tropical areas have not been well characterized. The authors studied the seasonality of influenza throughout Brazil, a geographically diverse country, by modeling influenza-related mortality and laboratory surveillance data. Monthly time series of pneumonia and influenza mortality were obtained from 1979 to 2001 for each of the 27 Brazilian states. Detrended time series were analyzed by Fourier decomposition to describe the amplitude and timing of annual and semiannual epidemic cycles, and the resulting seasonal parameters were compared across latitudes, ranging from the equator (+5 degrees N) to the subtropics (-35 degrees S). Seasonality in mortality was most pronounced in southern states (winter epidemics, June-July), gradually attenuated toward central states (15 degrees S) (p < 0.001), and remained low near the equator. A seasonal southward traveling wave of influenza was identified across Brazil, originating from equatorial and low-population regions in March-April and moving toward temperate and highly populous regions over a 3-month period. Laboratory surveillance data from recent years provided independent confirmation that mortality peaks coincided with influenza virus activity. The direction of the traveling wave suggests that environmental forces (temperature, humidity) play a more important role than population factors (density, travel) in driving the timing of influenza epidemics across Brazil.
Original language | English |
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Journal | American Journal of Epidemiology |
Volume | 165 |
Issue number | 12 |
Pages (from-to) | 1434–1442 |
ISSN | 0002-9262 |
DOIs | |
Publication status | Published - 2007 |
Externally published | Yes |
Bibliographical note
This article has been found as a ’Free Version’ from the Publisher on June 24 2020. When access to the article closes, please notify [email protected]Keywords
- Brazil
- climate
- geographic locations
- influenza
- human
- mortality
- pneumonia
- seasons