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Int J Infect Dis
. 2026 Feb 23:108498.
doi: 10.1016/j.ijid.2026.108498. Online ahead of print.
Seasonal Dynamics of Influenza and RSV in the Caribbean: A Call for Regionally Tailored Preventive Measures
Charlene Maria 1 , Jayant Kalpoe 2 , Angelino Tromp 3 , Fleur Koene 4 , Dennis Souverein 5 , Sonja van Roeden 6 , Martijn Tilanus 6 , Juldany Juliet 6 , Marquita Euson 6 , Sherryl Carty 6 , Shanna Holaman 6 , Sharda Baboe-Kalpoe 7 , Fazal Baboe 7 , Rianne Plaisier 8 , Claudy Oliveira Dos Santos 9 , Anneke Visser 10 , Winny van Luling 10 , Felix Holiday 6 , Chérina Fleming 11 , Josephine van de Maat 12 , Peter Klein Klouwenberg 9 , Radjinkoemar Steingrover 13 , Lilly M Verhagen 14
Affiliations
Objective: Respiratory tract infections remain a major cause of morbidity, with a disproportionate burden in the Caribbean. We aimed to characterize the seasonality and burden of key respiratory viruses across the Caribbean region of the Kingdom of the Netherlands.
Methods: We analysed virological detection data from 2018-2024 collected across all six islands. Seasonal patterns of rhinovirus, influenza virus, respiratory syncytial viruses (RSV) and human metapneumovirus (hMPV) were modelled using generalised additive models. Associations with climate, tourism, age, and disease severity were assessed.
Results: Rhinovirus was most frequently detected. Influenza peaked between November and March (p < 0.001), coinciding with periods of high tourism (e.g., Aruba: OR 8.72; 95% CI: 6.37-12.10). In contrast, RSV peaked between June and December (p<0.001), closely aligning with the rainy season (e.g., Aruba: OR 6.42; 95% CI: 4.26-9.75). HMPV showed a distinct seasonal peak between November and December (p<0,001), partially overlapping with both RSV and influenza circulation. Rhinovirus detection was significantly associated with increased disease severity, including oxygen therapy need (OR 2.78; 95% CI: 1.72-4.50) and respiratory distress (OR 2.26; 95% CI: 1.42-3.67).
Conclusions: RSV seasonality in the Caribbean differs substantially from that observed in temperate rgions such as Europe, indicating that prevention schedules developed for temperate climates may be systematically misaligned with local transmission dynamics. Our region-wide data offer insights to guide locally tailored prevention strategies and underscore the need for climate- and mobility-aware respiratory virus preparedness in tropical island regions.
Keywords: Disease Burden; Respiratory Virus Surveillance; Seasonal patterns; Tourism; Tropical Epidemiology.
. 2026 Feb 23:108498.
doi: 10.1016/j.ijid.2026.108498. Online ahead of print.
Seasonal Dynamics of Influenza and RSV in the Caribbean: A Call for Regionally Tailored Preventive Measures
Charlene Maria 1 , Jayant Kalpoe 2 , Angelino Tromp 3 , Fleur Koene 4 , Dennis Souverein 5 , Sonja van Roeden 6 , Martijn Tilanus 6 , Juldany Juliet 6 , Marquita Euson 6 , Sherryl Carty 6 , Shanna Holaman 6 , Sharda Baboe-Kalpoe 7 , Fazal Baboe 7 , Rianne Plaisier 8 , Claudy Oliveira Dos Santos 9 , Anneke Visser 10 , Winny van Luling 10 , Felix Holiday 6 , Chérina Fleming 11 , Josephine van de Maat 12 , Peter Klein Klouwenberg 9 , Radjinkoemar Steingrover 13 , Lilly M Verhagen 14
Affiliations
- PMID: 41740733
- DOI: 10.1016/j.ijid.2026.108498
Objective: Respiratory tract infections remain a major cause of morbidity, with a disproportionate burden in the Caribbean. We aimed to characterize the seasonality and burden of key respiratory viruses across the Caribbean region of the Kingdom of the Netherlands.
Methods: We analysed virological detection data from 2018-2024 collected across all six islands. Seasonal patterns of rhinovirus, influenza virus, respiratory syncytial viruses (RSV) and human metapneumovirus (hMPV) were modelled using generalised additive models. Associations with climate, tourism, age, and disease severity were assessed.
Results: Rhinovirus was most frequently detected. Influenza peaked between November and March (p < 0.001), coinciding with periods of high tourism (e.g., Aruba: OR 8.72; 95% CI: 6.37-12.10). In contrast, RSV peaked between June and December (p<0.001), closely aligning with the rainy season (e.g., Aruba: OR 6.42; 95% CI: 4.26-9.75). HMPV showed a distinct seasonal peak between November and December (p<0,001), partially overlapping with both RSV and influenza circulation. Rhinovirus detection was significantly associated with increased disease severity, including oxygen therapy need (OR 2.78; 95% CI: 1.72-4.50) and respiratory distress (OR 2.26; 95% CI: 1.42-3.67).
Conclusions: RSV seasonality in the Caribbean differs substantially from that observed in temperate rgions such as Europe, indicating that prevention schedules developed for temperate climates may be systematically misaligned with local transmission dynamics. Our region-wide data offer insights to guide locally tailored prevention strategies and underscore the need for climate- and mobility-aware respiratory virus preparedness in tropical island regions.
Keywords: Disease Burden; Respiratory Virus Surveillance; Seasonal patterns; Tourism; Tropical Epidemiology.