Role of Hawaii in influenza transmission patterns

Investigation into global influenza transmission patterns has been a topic of study for the past several years. Based on published studies, and supported by original research, it is evident influenza transmission involves a complex interaction of environment, social practices, human movement and viral evolution. Current literature indicates the importance of climate, including temperature and humidity, the potential importance of viral surveillance in swine and avian populations, and the role of selective pressures on influenza viral mutations. Previous studies have reported antigenic origins of flu virus initially develops in Southeast Asia, then spreads throughout the globe from there. This model specifically notes patterns of transmission through the Asian continent, and further to the Americas. However, the model does not comment on circulation of virus through the Pacific islands or the State of Hawai‘i, although Hawai‘i in particular often serves as an important crossroad between the Asian continent and the continental United States. This study explores the potential importance of the state of Hawai‘i in influenza transmission patterns. Based on travel information and peak influenza transmission periods reported by the Hawai‘i Department of Health, Hawai‘i could act as an important arena for the co-circulation of viruses from different points of origin (the United States and Asia), and specifically increase the potential for the recombination of different strains. We conclude by discussing the potential use of state surveillance information for research to further describe Pacific influenza transmission patterns.