Influence of climatic variability and respiratory viruses on the burden of medically attended acute respiratory infections in Cuba

Background: Acute Respiratory Infections (ARI) are the leading cause of morbidity and mortality all over the world, mainly in young children, elderly and immunecompromised patients.In this paper we aimed to determine the influence of climatic variability on the burden of medically attended acute respiratory infections (MAARI) in Cuba and the contribution of RSV and Influenza to that burden.Methods: An ecological study using retrospective analyses of time series was carried out.Statistical data of MAARI were obtained through universal surveillance during the period 2011-2017.The clinical samples taken through the sentinel surveillance were sent to the National Reference Laboratory for detection of respiratory viruses using a Real-Time Polymerase Chain Reaction assay (RT-RCP).The data of climatic variables were obtained from the climate station network of the Meteorology Institute in the period 1981-2010 for the baseline and 2011-2017 for the current conditions.The complex Bultó climatic indexes were used to analyze the time series of climatic variables, applying techniques of multivariate analysis to describe inter-monthly and inter-seasonal variation.Results: A bimodal curve on MAARI is observed with a main peak in October and another small in March.The biggest increase during September-November matches with the higher circulation of Respiratory Syncytial Virus (RSV).Influenza viruses circulate more during June-August, with a higher peak in July.The largest climatic variability is observed during the months April-November, corresponding to the rainy season and the period of higher circulation of Influenza and RSV.The increasing of MAARI reports during January-March could be attributed to other respiratory viruses (ORV) circulating.Conclusion: RSV adds a great burden to health care in Cuban population, mostly in pediatric ages during September-November, months belonging to the rainy season, with increasing of climatic variability.It seems that the ORV also contributes an important burden to the MAARI. 43.