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Short-term impact of ambient temperature on the incidence of influenza in Wuhan, China


Few studies have estimated the nonlinear association of ambient temperature with the risk of influenza. We therefore applied a time-series analysis to explore the short-term effect of ambient temperature on the incidence of influenza in Wuhan, China. Daily influenza cases were collected from Hubei Provincial Center for Disease Control and Prevention (Hubei CDC) from January 1, 2014, to December 31, 2017. The meteorological and daily pollutant data was obtained from the Hubei Meteorological Service Center and National Air Quality Monitoring Stations, respectively. We used a generalized additive model (GAM) coupled with the distributed lag nonlinear model (DLNM) to explore the exposure-lag-response relationship between the short-term risk of influenza and daily average ambient temperature. Analyses were also performed to assess the extreme cold and hot temperature effects. We observed that the ambient temperature was statistically significant, and the exposure–response curve is approximately S-shaped, with a peak observed at 23.57 ℃. The single-day lag curve showed that extreme hot and cold temperatures were both significantly associated with influenza. The extreme hot temperature has an acute effect on influenza, with the most significant effect observed at lag 0–1. The extreme cold temperature has a relatively smaller effect but lasts longer, with the effect exerted continuously during a lag of 2–4 days. Our study found significant nonlinear and delayed associations between ambient temperature and the incidence of influenza. Our finding contributes to the establishment of an early warning system for airborne infectious diseases.

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Data and material availability

The datasets generated and/or analyzed during the current study are not publicly available. The case data was obtained from Hubei Provincial Center for Disease Control and Prevention (Hubei CDC), and we were not authorized to share.


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The author is grateful to the editor and the anonymous reviewers for their valuable comments that substantially improved this manuscript.

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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [Suyang Liu], [Hao Xiang], [Jiayuan Hao], and [Qiujun Dou]. The first draft of the manuscript was written by [Yanbing Li] and [Jingtao Wu]. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Suyang Liu.

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Li, Y., Wu, J., Hao, J. et al. Short-term impact of ambient temperature on the incidence of influenza in Wuhan, China. Environ Sci Pollut Res 29, 18116–18125 (2022).

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  • Temperature
  • Influenza
  • Generalized additive model
  • Distributed lag nonlinear model
  • Extreme Temperature effect
  • Nonlinear relationship