Global environmental drivers of influenza

Significance Patterns of influenza outbreak are different in the tropics than in temperate regions. Although considerable experimental progress has been made in identifying climate-related drivers of influenza, the apparent latitudinal differences in outbreak patterns raise basic questions as to how potential environmental variables combine and act across the globe. Adopting an empirical dynamic modeling framework, we clarify that absolute humidity drives influenza outbreaks across latitudes, find that the effect of absolute humidity on influenza is U-shaped, and show that this U-shaped pattern is mediated by temperature. These findings offer a unifying synthesis that explains why experiments and analyses disagree on this relationship. In temperate countries, influenza outbreaks are well correlated to seasonal changes in temperature and absolute humidity. However, tropical countries have much weaker annual climate cycles, and outbreaks show less seasonality and are more difficult to explain with environmental correlations. Here, we use convergent cross mapping, a robust test for causality that does not require correlation, to test alternative hypotheses about the global environmental drivers of influenza outbreaks from country-level epidemic time series. By moving beyond correlation, we show that despite the apparent differences in outbreak patterns between temperate and tropical countries, absolute humidity and, to a lesser extent, temperature drive influenza outbreaks globally. We also find a hypothesized U-shaped relationship between absolute humidity and influenza that is predicted by theory and experiment, but hitherto has not been documented at the population level. The balance between positive and negative effects of absolute humidity appears to be mediated by temperature, and the analysis reveals a key threshold around 75 °F. The results indicate a unified explanation for environmental drivers of influenza that applies globally.