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Determining meteorologically-favorable zones for seasonal influenza activity in Hong Kong

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Abstract

Investigations of simple and accurate meteorology classification systems for influenza epidemics, particularly in subtropical regions, are limited. To assist in preparing for potential upsurges in the demand on healthcare facilities during influenza seasons, our study aims to develop a set of meteorologically-favorable zones for epidemics of influenza A and B, defined as the intervals of meteorological variables with prediction performance optimized. We collected weekly detection rates of laboratory-confirmed influenza cases from four local major hospitals in Hong Kong between 2004 and 2019. Meteorological and air quality records for hospitals were collected from their closest monitoring stations. We employed classification and regression trees to identify zones that optimize the prediction performance of meteorological data in influenza epidemics, defined as a weekly rate > 50th percentile over a year. According to the results, a combination of temperature > 25.1℃ and relative humidity > 79% was favorable to epidemics in hot seasons, whereas either temperature < 16.4℃ or a combination of < 20.4℃ and relative humidity > 76% was favorable to epidemics in cold seasons. The area under the receiver operating characteristic curve (AUC) in model training achieved 0.80 (95% confidence interval [CI], 0.76–0.83) and was kept at 0.71 (95%CI, 0.65–0.77) in validation. The meteorologically-favorable zones for predicting influenza A or A and B epidemics together were similar, but the AUC for predicting influenza B epidemics was comparatively lower. In conclusion, we established meteorologically-favorable zones for influenza A and B epidemics with a satisfactory prediction performance, even though the influenza seasonality in this subtropical setting was weak and type-specific.

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Acknowledgements

We thank the collaborators at Prince of Wales Hospital, Queen Elizabeth Hospital, Kwong Wah Hospital, and United Christian Hospital, for providing the data for this investigation.

Funding

This work was supported by the Health and Medical Research Fund (19181132) and the National Natural Science Foundation of China (71974165). The funders have no role in the study design, collection, analysis, and interpretation of the data.

Author information

Authors and Affiliations

  1. Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China

    Ka Chun Chong, Steven Y. F. Lau, Conglu Li, Xiaoting Jiang & Yuchen Wei

  2. Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China

    Ka Chun Chong & Yuchen Wei

  3. Department of Microbiology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China

    Paul K. S. Chan & Christopher K. C. Lai

  4. Hong Kong Observatory, Hong Kong Special Administrative Region, China

    Tsz Cheung Lee

  5. School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China

    Peng Wu

  6. Department of Pathology, United Christian Hospital, Hong Kong Special Administrative Region, China

    Kitty S. C. Fung

  7. Department of Pathology, Kwong Wah Hospital, Hong Kong Special Administrative Region, China

    Cindy W. S. Tse

  8. Department of Paediatrics, Kwong Wah Hospital, Hong Kong Special Administrative Region, China

    Shuk Yu Leung & Ka Li Kwok

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  1. Ka Chun Chong
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Contributions

Ka Chun Chong: conceptualization, methodology, resources, writing–original draft, supervision, and funding acquisition

Paul KS Chan: data curation, methodology, investigation, and writing—review and editing

Tsz Cheung Lee: data curation, methodology, investigation, and writing—review and editing

Steven YF Lau: methodology, software, formal analysis, visualization, and writing—review and editing

Peng Wu: methodology and writing—review and editing

Christopher KC Lai: data curation, methodology, investigation, and writing—review and editing

Kitty SC Fung: data curation, methodology, investigation, and writing—review and editing

Cindy WS Tse: data curation, methodology, investigation, and writing—review and editing

Shuk Yu Leung: data curation, methodology, investigation, and writing—review and editing

Ka Li Kwok: data curation, methodology, investigation, and writing—review and editing

Conglu Li: methodology and writing—review and editing

Xiaoting Jiang: methodology and writing—review and editing

Yuchen Wei: methodology, software, formal analysis, investigation, writing–original draft, and visualization. The authors read and approved the final manuscript.

Corresponding author

Correspondence to Yuchen Wei.

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Ethics approval and consent to participate

The study is approved by the Joint Chinese University of Hong Kong—New Territories East Cluster Clinical Research Ethics Committee. Informed consent was exempted as only aggregated data were used in this study.

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Not applicable.

Conflict of interest

The authors declare no competing interests.

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Chong, K.C., Chan, P.K.S., Lee, T.C. et al. Determining meteorologically-favorable zones for seasonal influenza activity in Hong Kong. Int J Biometeorol 67, 609–619 (2023). https://doi.org/10.1007/s00484-023-02439-x

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