title: Respiratory syncytial virus circulation in seven countries with Global Disease Detection Regional Centers.
abstract: BACKGROUND
  Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections in young children globally, with the highest burden in low- and middle-income countries where the association between RSV activity and climate remains unclear.
  
  
  METHODS
  Monthly laboratory-confirmed RSV cases and associations with climate data were assessed for respiratory surveillance sites in tropical and subtropical areas (Bangladesh, China, Egypt, Guatemala, Kenya, South Africa, and Thailand) during 2004-2012. Average monthly minimum and maximum temperatures, relative humidity, and precipitation were calculated using daily local weather data from the US National Climatic Data Center.
  
  
  RESULTS
  RSV circulated with 1-2 epidemic periods each year in site areas. RSV seasonal timing and duration were generally consistent within country from year to year. Associations between RSV and weather varied across years and geographic locations. RSV usually peaked in climates with high annual precipitation (Bangladesh, Guatemala, and Thailand) during wet months, whereas RSV peaked during cooler months in moderately hot (China) and arid (Egypt) regions. In South Africa, RSV peaked in autumn, whereas no associations with seasonal weather trends were observed in Kenya.
  
  
  CONCLUSIONS
  Further understanding of RSV seasonality in developing countries and various climate regions will be important to better understand the epidemiology of RSV and for timing the use of future RSV vaccines and immunoprophylaxis in low- and middle-income countries.
authors.affiliation: Division of Viral Diseases, National Center for Immunizations and Respiratory Diseases.
authors.forename: Amber K
authors.initials: AK
authors.lastname: Haynes
authors.forename: Arie P
authors.initials: AP
authors.lastname: Manangan
authors.forename: Marika K
authors.initials: MK
authors.lastname: Iwane
authors.forename: Katharine
authors.initials: K
authors.lastname: Sturm-Ramirez
authors.forename: Nusrat
authors.initials: N
authors.lastname: Homaira
authors.forename: W Abdullah
authors.initials: WA
authors.lastname: Brooks
authors.forename: Stephen
authors.initials: S
authors.lastname: Luby
authors.forename: Mahmudur
authors.initials: M
authors.lastname: Rahman
authors.forename: John D
authors.initials: JD
authors.lastname: Klena
authors.forename: Yuzhi
authors.initials: Y
authors.lastname: Zhang
authors.forename: Hongie
authors.initials: H
authors.lastname: Yu
authors.forename: Faxian
authors.initials: F
authors.lastname: Zhan
authors.forename: Erica
authors.initials: E
authors.lastname: Dueger
authors.forename: Adel Mahmoud
authors.initials: AM
authors.lastname: Mansour
authors.forename: Nahed
authors.initials: N
authors.lastname: Azazzy
authors.forename: John P
authors.initials: JP
authors.lastname: McCracken
authors.forename: Joe P
authors.initials: JP
authors.lastname: Bryan
authors.forename: Maria R
authors.initials: MR
authors.lastname: Lopez
authors.forename: Deron C
authors.initials: DC
authors.lastname: Burton
authors.forename: Godfrey
authors.initials: G
authors.lastname: Bigogo
authors.forename: Robert F
authors.initials: RF
authors.lastname: Breiman
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Feikin
authors.forename: Kariuki
authors.initials: K
authors.lastname: Njenga
authors.forename: Joel
authors.initials: J
authors.lastname: Montgomery
authors.forename: Adam L
authors.initials: AL
authors.lastname: Cohen
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Moyes
authors.forename: Marthi
authors.initials: M
authors.lastname: Pretorius
authors.forename: Cheryl
authors.initials: C
authors.lastname: Cohen
authors.forename: Marietjie
authors.initials: M
authors.lastname: Venter
authors.forename: Malinee
authors.initials: M
authors.lastname: Chittaganpitch
authors.forename: Somsak
authors.initials: S
authors.lastname: Thamthitiwat
authors.forename: Pongpun
authors.initials: P
authors.lastname: Sawatwong
authors.forename: Henry C
authors.initials: HC
authors.lastname: Baggett
authors.forename: George
authors.initials: G
authors.lastname: Luber
authors.forename: Susan I
authors.initials: SI
authors.lastname: Gerber
mesh_terms: D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D002980:Climate; D003906:Developing Countries / Q000706:statistics & numerical data*; D004196:Disease Outbreaks; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006166:Guatemala / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007390:International Agencies; D007630:Kenya / Q000453:epidemiology; D008297:Male; D011159:Population Surveillance / Q000379:methods; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology* / Q000821:virology; D018113:Respiratory Syncytial Virus, Human / Q000235:genetics / Q000302:isolation & purification*; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology; D012621:Seasons; D013019:South Africa / Q000453:epidemiology; D013785:Thailand / Q000453:epidemiology; D014481:United States; D014887:Weather
keywords: climate; humans; respiratory syncytial virus infections; respiratory tract infections; seasons