The roles of solar radiation & vitamin D
Nearly all human diseases related to respiratory pathogens exhibit seasonal variations. However, the reasons for this seasonality are still not known. Among the tested hypotheses are: seasonality of low temperatures, absolute humidity (aerosol transmission), or of dry air, crowding together indoors during the winter, travel patterns, vacations, seasonality of ultraviolet (UV) radiation from the sun that might kill pathogens, circannual rhythms of hormones, such as the ‘dark hormone’ melatonin, etc.
Another founded hypothesis is that seasonal variations in UVB radiation and consequently vitamin D photosynthesis, causing seasonal variations in vitamin D status, which plays a role in the immune response to infections, may be responsible for the influenza seasonality.
Additionally, the question of whether it is the host or the virus/bacterium that exhibits seasonality arises. However, there are exceptions from seasonality, notably for pandemic influenzas, which often occur outside the winter influenza seasons. Furthermore, in equatorial regions the seasonal pattern is weak.
In the present work we have compared the seasonality of cases and deaths caused by both pandemic and non-pandemic influenzas with doses of UVB radiation (vitamin D photosynthesis). Influenza may cause death either directly (due to a primary complication caused by the influenza virus) or indirectly (due to secondary non-influenza complications either pulmonary or non-pulmonary in nature).
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