Seasonal association between viral causes of hospitalised acute lower respiratory infections and meteorological factors in China: a retrospective study

Acute lower respiratory infections caused by respiratory viruses are common and persistent infectious diseases worldwide and in China, which have pronounced seasonal patterns. Meteorological factors have important roles in the seasonality of some major viruses. Our aim was to identify the dominant meteorological factors and to model their effects on common respiratory viruses in different regions of China. We analysed monthly virus data on patients from 81 sentinel hospitals in 22 provinces in mainland China from 2009 to 2013. The geographical detector method was used to quantify the explanatory power of each meteorological factor, individually and interacting in pairs. 28369 hospitalised patients with ALRI were tested, 10387 were positive for at least one virus, including RSV, influenza virus, PIV, ADV, hBoV, hCoV and hMPV. RSV and influenza virus had annual peaks in the north and biannual peaks in the south. PIV and hBoV had higher positive rates in the spring summer months. hMPV had an annual peak in winter spring, especially in the north. ADV and hCoV exhibited no clear annual seasonality. Temperature, atmospheric pressure, vapour pressure, and rainfall had most explanatory power on most respiratory viruses in each region. Relative humidity was only dominant in the north, but had no significant explanatory power for most viruses in the south. Hours of sunlight had significant explanatory power for RSV and influenza virus in the north, and for most viruses in the south. Wind speed was the only factor with significant explanatory power for human coronavirus in the south. For all viruses, interactions between any two of the paired factors resulted in enhanced explanatory power, either bivariately or non-linearly.