Air-borne diseases

Public health area

Climatic factors such as absolute humidity have been associated with risk of lower respiratory tract infection. Respiratory syncytial virus (RSV) is one of the most important viral respiratory pathogens especially for infants. The epidemic activity of RSV infection is related to meteorological conditions and thus to latitude: persistently high temperature and humidity results in epidemic peaks in summer and early autumn, while in temperate climates RSV infection peaks in the winter. A causal link with temperature seems inconsistent based on these climatic data, but the RSV infection season in England and Wales has ended earlier and its duration has shortened as the climate has become warmer. Seasonality has been documented for a number of other respiratory infections including tuberculosis, and seasonal fluctuations of El Niño-southern oscillation in California are associated with the impact of influenza epidemics (hospital admissions or mortality profiles;) but a direct link to climate change has not been established. Furthermore, increased use of cooling towers during heat waves might increase the risk for exposure to Legionella spp, although appropriate public health measures should be able to contain this risk.

On the basis of the articles reviewed here, it is not possible to draw conclusive inferences about the link between airborne diseases and climate change, but it might shorten the transmission season.

Source: Semenza JC, Menne B. Climate Change and Infectious Diseases in Europe. Lancet ID. 2009;9:365-75.


  1. Lapena S, Robles MB, Castanon L, Martinez JP, Reguero S, Alonso MP, Fernandez I. Climatic factors and lower respiratory tract infection due to respiratory syncytial virus in hospitalised infants in northern Spain. Eur J Epidemiol. 2005;20(3):271-6.
  2. Yusuf S, Piedimonte G, Auais A, Demmler G, Krishnan S, VAN Caeseele P, Singleton R, Broor S, Parveen S, Avendano L, Parra J, Chavez-Bueno S, Murguia DE Sierra T, Simoes EA, Shaha S, Welliver R. The relationship of meteorological conditions to the epidemic activity of respiratory syncytial virus. Epidemiol Infect. 2007;:1-14
  3. Donaldson GC. Climate change and the end of the respiratory syncytial virus season. Clin Infect Dis. 2006;42(5):677-9. Epub 2006 Jan 25.
  4. Thorpe LE, Frieden TR, Laserson KF, Wells C, Khatri GR. Seasonality of tuberculosis in India: is it real and what does it tell us? Lancet. 2004;364(9445):1613-4.
  5. Ebi KL, Exuzides KA, Lau E, Kelsh M, Barnston A. Association of normal weather periods and El Niño events with hospitalization for viral pneumonia in females: California, 1983-1998. Am J Public Health. 2001;91(8):1200-8.
  6. Choi KM, Christakos G, Wilson ML. El Niño effects on influenza mortality risks in the state of California. Public Health. 2006;120(6):505-16.
  7. Viboud C, Pakdaman K, Boëlle PY, Wilson ML, Myers MF, Valleron AJ, Flahault A. Association of influenza epidemics with global climate variability. Eur J Epidemiol. 2004;19(11):1055-9.
  8. Ricketts KD, Joseph C, Lee J, Wewalka G; European Working Group for Legionella Infections. Survey on legislation regarding wet cooling systems in European countries. Euro Surveill. 2008;13(38).