Spatio-temporal Differentiation in the Incidence of Influenza and Its Relationship with Air Pollution in China from 2004 to 2017

Abstract

The Healthy China Initiative is a major health strategy being pursued by the country. To prevent and control different types of diseases as well as their complex variants, research on the spatio-temporal differentiation among and mechanisms of influence of epidemic diseases is growing worldwide. This study analyzed monthly data on the incidence of influenza by using different methods, including Moran’s I , the hotspot analysis model, concentration analysis, and correlation analysis, to determine the characteristics of spatio-temporal differentiation in the incidence of influenza across prefecture-level cities in China from 2004 to 2017, and to examine its relationship with air pollution. According to the results, the overall incidence of influenza in China exhibited a trend of increase from 2004 to 2017, with small peaks in 2009 and 2014. More cases of influenza were recorded in the first and fourth quarters of each year. Regions with higher incidences of influenza were concentrated in northwestern and northern China, and in the coastal areas of southeastern China. Over time, the distribution of regions with a higher incidence of influenza has shifted from the west to the east of the country. A significant relationship was observed between the incidence of influenza and factors related to air pollution. The contents of five air pollutants (PM 2.5 , PM 10 , SO 2 , NO 2 , and CO) were significantly positively correlated with the incidence of influenza, with a decreasing order of contribution to it of SO 2 > CO > NO 2 > PM 2.5 > PM 10 . The content of O 3 in the air was negatively correlated with the incidence of influenza. The influence of air pollution-related factors on the incidence of influenza in different regions and seasons showed minor differences. The large-scale empirical results provided here can supply a scientific basis for governmental disease control authorities to formulate strategies for regional prevention and control.

COVID-19 and Air Pollution: Air Quality Impact in 13 Cities of the Jiangsu Province of China

“…According to the findings, the air quality in Jiangsu improved dramatically throughout the epidemic prevention and control period compared to the preceding three years. This is clearly in line with the pandemic prevention and control measures implemented in Jaingsu, namely traffic restrictions, closed community management, and enterprise production and operation control [33][34][35]. These severely limited people's production and living activities, which is closely tied to the reduction in pollution.…”

Small-scale spatiotemporal epidemiology of notifiable infectious diseases in China: a systematic review

“…The incidence and coverage of tuberculosis, human infection with H7N9 virus, rabies, hemorrhagic fever, malaria, measles, Japanese encephalitis, leptospirosis, influenza A(H1N1) virus infection, and SARS have decreased significantly in the past decade, of which, malaria has almost been eliminated [ 26 , 31 , 50 , 51 , 52 , 59 , 60 , 62 , 64 ]; this may be attributed to the extensive public disease control and ecological and health improvement in China [ 52 ]. However, dengue, syphilis, hepatitis C, AIDS, brucellosis, HFMD, and influenza showed the opposite trend because of the rapid development of tourism and the considerable increase in the migrant population in recent years [ 7 , 11 , 22 , 55 , 58 , 80 , 90 ]. Through spatiotemporal analyses of the included studies, it was found that the primary clusters of dengue, hemorrhagic fever, syphilis, Japanese encephalitis, anthrax, hepatitis C, brucellosis, HFMD, and human infection with H7N9 virus were expanding [ 11 , 22 , 24 , 26 , 31 , 43 , 65 , 80 ].…”

“…However, dengue, syphilis, hepatitis C, AIDS, brucellosis, HFMD, and influenza showed the opposite trend because of the rapid development of tourism and the considerable increase in the migrant population in recent years [ 7 , 11 , 22 , 55 , 58 , 80 , 90 ]. Through spatiotemporal analyses of the included studies, it was found that the primary clusters of dengue, hemorrhagic fever, syphilis, Japanese encephalitis, anthrax, hepatitis C, brucellosis, HFMD, and human infection with H7N9 virus were expanding [ 11 , 22 , 24 , 26 , 31 , 43 , 65 , 80 ]. These diseases have a common tendency to spread to the west and inland areas, which was explained by the included studies, as the phenomenon might be related to the increase in population mobility and improvement of transportation infrastructure that has made less developed and inland areas more closely connected with the outside world [ 64 , 91 ].…”

Improved models, improved information? Exploring how climate change impacts pollen, influenza, and mold in Berlin and its surroundings

“…Whereas in larger cities non-climate factors have a more profound influence and a milder response to climate factors is found. Outdoor, as well as indoor, air pollution are associated with higher influenza incidence, and increased severity of the health risks related to the virus, particularly in winter months with low temperatures (Meng et al, 2021;Murtas and Russo, 2019;Song et al, 2021;Su et al, 2019;Toczylowski et al, 2021;Wang et al, 2016). Studies show a positive association between higher influenza risks and people who suffer from asthma as well as other respiratory allergies, obesity, or are recipient of a treatment for a chronic disease (Guerrisi et al, 2019;Hirota et al, 1992;Jain and Chaves, 2011;Karki et al, 2018;Yang et al, 2013).…”