Conjunction of factors triggering waves of seasonal influenza

Using several longitudinal datasets describing putative factors affecting influenza incidence and clinical data on the disease and health status of over 150 million human subjects observed over a decade, we investigated the source and the mechanistic triggers of influenza epidemics. We conclude that the initiation of a pan-continental influenza wave emerges from the simultaneous realization of a complex set of conditions. The strongest predictor groups are as follows, ranked by importance: (1) the host population’s socio- and ethno-demographic properties; (2) weather variables pertaining to specific humidity, temperature, and solar radiation; (3) the virus’ antigenic drift over time; (4) the host population’s land-based travel habits, and; (5) recent spatio-temporal dynamics, as reflected in the influenza wave auto-correlation. The models we infer are demonstrably predictive (area under the Receiver Operating Characteristic curve 80%) when tested with out-of-sample data, opening the door to the potential formulation of new population-level intervention and mitigation policies.