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Open Access Research article

Spatiotemporal characteristics of pandemic influenza

Lars Skog1*, Annika Linde2, Helena Palmgren3, Hans Hauska1 and Fredrik Elgh3

Author Affiliations

1 Division of Geodesy and Geoinformatics, Department of Urban Planning and Environment, Royal Institute of Technology (KTH), SE-100 44, Stockholm, Sweden

2 Public Health Agency of Sweden, SE-100 44, Solna, Sweden

3 Department of Clinical Microbiology, Umeå University, SE-100 44, Umeå, Sweden

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BMC Infectious Diseases 2014, 14:378  doi:10.1186/1471-2334-14-378

Published: 9 July 2014

Abstract

Background

Prediction of timing for the onset and peak of an influenza pandemic is of vital importance for preventive measures. In order to identify common spatiotemporal patterns and climate influences for pandemics in Sweden we have studied the propagation in space and time of A(H1N1)pdm09 (10,000 laboratory verified cases), the Asian Influenza 1957–1958 (275,000 cases of influenza-like illness (ILI), reported by local physicians) and the Russian Influenza 1889–1890 (32,600 ILI cases reported by physicians shortly after the end of the outbreak).

Methods

All cases were geocoded and analysed in space and time. Animated video sequences, showing weekly incidence per municipality and its geographically weighted mean (GWM), were created to depict and compare the spread of the pandemics. Daily data from 1957–1958 on temperature and precipitation from 39 weather stations were collected and analysed with the case data to examine possible climatological effects on the influenza dissemination.

Results

The epidemic period lasted 11 weeks for the Russian Influenza, 10 weeks for the Asian Influenza and 9 weeks for the A(H1N1)pdm09. The Russian Influenza arrived in Sweden during the winter and was immediately disseminated, while both the Asian Influenza and the A(H1N1)pdm09 arrived during the spring. They were seeded over the country during the summer, but did not peak until October-November. The weekly GWM of the incidence moved along a line from southwest to northeast for the Russian and Asian Influenza but northeast to southwest for the A(H1N1)pdm09. The local epidemic periods of the Asian Influenza were preceded by falling temperature in all but one of the locations analysed.

Conclusions

The power of spatiotemporal analysis and modeling for pandemic spread was clearly demonstrated. The epidemic period lasted approximately 10 weeks for all pandemics. None of the pandemics had its epidemic period before late autumn. The epidemic period of the Asian Influenza was preceded by falling temperatures. Climate influences on pandemic spread seem important and should be further investigated.

Keywords:
Russian influenza; Asian influenza; A (H1N1) pdm09; Spatiotemporal spread; Temperature dependence; Spatial modelling; GIS