title: Association of influenza epidemics with global climate variability.
abstract: The reasons for the seasonality and annual changes in the impact of influenza epidemics remain poorly understood. We investigated the covariations between a major component of climate, namely the El Niño Southern Oscillation (ENSO), and indicators of the impact of influenza, as measured by morbidity, excess mortality and viral subtypes collected in France during the period 1971-2002. We show that both the circulating subtype and the magnitude of ENSO are associated with the impact of influenza epidemics. Recognition of this association could lead to better understanding of the mechanisms of emergence of influenza epidemics.
authors.affiliation: Institut National de la Santé et de la Recherche Médicale, Unit 444, Epidemiology and Information Sciences, Centre Hospitalo-Universitaire Saint-Antoine, France. viboudc@mail.nih.gov
authors.forename: Cécile
authors.initials: C
authors.lastname: Viboud
authors.forename: Khashayar
authors.initials: K
authors.lastname: Pakdaman
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Boëlle
authors.forename: Mark L
authors.initials: ML
authors.lastname: Wilson
authors.forename: Monica F
authors.initials: MF
authors.lastname: Myers
authors.forename: Alain-Jacques
authors.initials: AJ
authors.lastname: Valleron
authors.forename: Antoine
authors.initials: A
authors.lastname: Flahault
mesh_terms: D000704:Analysis of Variance; D002980:Climate; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005602:France / Q000453:epidemiology; D006801:Humans; D009980:Influenza A virus / Q000254:growth & development; D009981:Influenza B virus / Q000254:growth & development; D007251:Influenza, Human / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D016014:Linear Models; D008962:Models, Theoretical; D012621:Seasons