Influenza pandemics, solar activity cycles, and vitamin D

Relation of pandemics with solar cycles through ozone, cloud seeds, and vitamin D

The global records of infectious diseases, including Western and Eastern documents from 1825 to 2020, during which sunspot observations are considered reliable, show that 27 of the 34 pandemic outbreaks were coincident with sunspot number maxima or minima. There is evidence that the intensity of galactic cosmic rays is anti-correlated with solar activity and that cloud seed formation is accelerated by galactic cosmic rays. There are a substantial number of research papers showing the relationship between COVID-19 and vitamin D deficiency. The data analysis of ozone thickness measured based on NASA satellite observations revealed that ozone thickness has 11-year and 28-month cycles. Because the 11-year cycles of ozone thickness and cloud seed attenuation are anti-correlated, when either one becomes extremely thick, such as at the maximum or minimum point of solar activity, UV radiation is over-attenuated, and human vitamin D deficiency is globally increased. This finding explains the coincidence of pandemic outbreaks with the extrema of the sunspot numbers. Vitamin D supplementation can be an effective countermeasure against the spread of infectious diseases, which is a paramount importance to global society. Future pandemic forecasting should include the 11-year and 28-month cycles of UV radiation. This founding completes the relationship between solar activity and human health through the earth's environment.

Correlation analysis between the occurrence of epidemic in ancient China and solar activity

As the globe has witnessed the pandemic, epidemic diseases exert a strong impact on human beings and ecosystems. Since the Sun is the primary energy source of the Earth, some scientific pioneers attempted to search for the discernible relation between solar activity and the incidence of epidemics. In this study, the periodic changes and trends of ancient Chinese epidemic data were analyzed in comparison with those of sunspot numbers, a solar activity proxy. The results show that the epidemic and solar activity changes are in good agreement to a certain extent, especially during the Gleissberg and the de Vries cycles. The wavelet coherence shows that the frequency of the epidemic data and sunspot numbers are highly associated. In addition, results from the ensemble empirical mode decomposition illustrate consistent variations in low-frequency decompositions. This study has important implications for further understanding of the potential impact of solar activity on Earth's biosphere, the underlying mechanism of which needs further exploration.

Dating the Emergence of Human Endemic Coronaviruses

Four endemic coronaviruses infect humans and cause mild symptoms. Because previous analyses were based on a limited number of sequences and did not control for effects that affect molecular dating, we re-assessed the timing of endemic coronavirus emergence. After controlling for recombination, selective pressure, and molecular clock model, we obtained similar tMRCA (time to the most recent common ancestor) estimates for the four coronaviruses, ranging from 72 (HCoV-229E) to 54 (HCoV-NL63) years ago. The split times of HCoV-229E and HCoV-OC43 from camel alphacoronavirus and bovine coronavirus were dated ~268 and ~99 years ago. The split times of HCoV-HKU1 and HCoV-NL63 could not be calculated, as their zoonoticic sources are unknown. To compare the timing of coronavirus emergence to that of another respiratory virus, we recorded the occurrence of influenza pandemics since 1500. Although there is no clear relationship between pandemic occurrence and human population size, the frequency of influenza pandemics seems to intensify starting around 1700, which corresponds with the initial phase of exponential increase of human population and to the emergence of HCoV-229E. The frequency of flu pandemics in the 19th century also suggests that the concurrence of HCoV-OC43 emergence and the Russian flu pandemic may be due to chance.

System Complexity in Influenza Infection and Vaccination: Effects upon Excess Winter Mortality

Unexpected outcomes are usually associated with interventions in complex systems. Excess winter mortality (EWM) is a measure of the net effect of all competing forces operating each winter, including influenza(s) and non-influenza pathogens. In this study over 2400 data points from 97 countries are used to look at the net effect of influenza vaccination rates in the elderly aged 65+ against excess winter mortality (EWM) each year from the winter of 1980/81 through to 2019/20. The observed international net effect of influenza vaccination ranges from a 7.8% reduction in EWM estimated at 100% elderly vaccination for the winter of 1989/90 down to a 9.3% increase in EWM for the winter of 2018/19. The average was only a 0.3% reduction in EWM for a 100% vaccinated elderly population. Such outcomes do not contradict the known protective effect of influenza vaccination against influenza mortality per se—they merely indicate that multiple complex interactions lie behind the observed net effect against all-causes (including all pathogen causes) of winter mortality. This range from net benefit to net disbenefit is proposed to arise from system complexity which includes environmental conditions (weather, solar cycles), the antigenic distance between constantly emerging circulating influenza clades and the influenza vaccine makeup, vaccination timing, pathogen interference, and human immune diversity (including individual history of host-virus, host-antigen interactions and immunosenescence) all interacting to give the observed outcomes each year. We propose that a narrow focus on influenza vaccine effectiveness misses the far wider complexity of winter mortality. Influenza vaccines may need to be formulated in different ways, and perhaps administered over a shorter timeframe to avoid the unanticipated adverse net outcomes seen in around 40% of years.

The Possible Effect of Space Weather Factors on Various Physiological Systems of the Human Organism

A systematic review of heliobiological studies of the last 25 years devoted to the study of the potential influence of space weather factors on human health and well-being was carried out. We proposed three criteria (coordinates), according to which the work on solar–biospheric relations was systematized: the time scale of data sampling (years, days, hours, minutes); the level of organization of the biological system under study (population, group, individual, body system); and the degree of system response (norm, adaptation, failure of adaptation (illness), disaster (death)). This systematic review demonstrates that three parameters mentioned above are closely related in the existing heliobiological studies: the larger the selected time scale, the higher the level of estimated biological system organization and the stronger the potential response degree is. The long-term studies are devoted to the possible influence of solar activity on population disasters, i.e., significant increases in morbidity and mortality. On a daily scale, a probable effect of geomagnetic storms and other space weather events on short-term local outbreaks of morbidity is shown as well as on cases of deterioration in people functional state. On an intraday scale, in the regular functioning mode, the heart and brain rhythms of healthy people turn to be synchronized with geomagnetic field variations in some frequency ranges, which apparently is the necessary organism’s existence element. The applicability of different space weather indices at different data sampling rates, the need to take into account the contribution of meteorological factors, and the prospects for an individual approach in heliobiology are discussed. The modern important results of experiments on modeling the action of magnetic storms in laboratory conditions and the substantiation of possible theoreical mechanisms are described. These results provide an experimental and theoretical basis for studies of possible connections of space weather and human health.

Back to basics: review on vitamin D and respiratory viral infections including COVID-19

IMPORTANCE

As the scientific community is in a marathon in finding out the cure for COVID-19, in this crisis, it is essential for the physicians not to forget about the basics. Due to the pandemic crisis, in many nursing homes and hospitals, there established new policies on decreasing unnecessary medications to minimize cross-contamination. Sometimes these policies are making providers avoid essential drugs such as Vitamins, including Vitamin D. In this paper, we try to emphasize the importance of Vitamin D in COVID-19 and respiratory viral patients.

RELEVANCE

Vitamin D helps in decreasing the 'pro-inflammatory cytokines' in the lungs and acts in immunomodulatory function, and 'also it will increase the anti-inflammatory, antiviral responses of the respiratory epithelial cells during infection.'

CONCLUSION

Due to the highly contagious nature of COVID-19 and the increased morbidity and mortality with no appropriate therapy and vaccine, one must be cautious and do everything to help COVID-19 patients. In hospitals and other health care settings to decrease cross-contamination, holding other non-essential medications is taking place. Discontinuing Vitamins could increase the mortality and morbidity of those affected, especially in deficient/insufficient individuals. Obtaining serum 25 (OH) D levels in all patients with viral respiratory infections, especially COVID-19, could help in the detection and treatment of Vitamin D deficiency and potentially decrease recovery time and improve outcome. Even though evidence suggests that vitamin D has the anti-inflammatory, antiviral properties, randomized double-blinded controlled trials are needed to verify this further, and to understand Vitamin D and COVID-19 better.

ABBREVIATIONS

Vitamin D receptor-VDR; 25(OH)D- 25 hydroxyvitamin D; 1,25 (OH)D-1,25 dihydroxy Vitamin D; 1α,25-dihydroxy Vitamin D-1,25[OH]2 D or calcitriol; IU- International Units; Interferons stimulated genes- ISG; ARI- acute respiratory infection; RSV- respiratory syncytial virus; RTI- Respiratory tract infections; COPD-Chronic obstructive pulmonary disease; BMI-Basal metabolic index; USA-USA.

Vitamin D deficiency and supplementation in critical illness-the known knowns and known unknowns

The burgeoning literature on vitamin D deficiency and supplementation over the past decade or so has generated a greater understanding of some areas but also an appreciation of the many areas of equipoise. This is particularly relevant in the field of critical care with the heterogeneous patient populations, the severity and duration of illness and the frequency of comorbid conditions.

This review aims to summarise the current knowledge base of vitamin D deficiency within the context of critical illness—“the known knowns”—and also highlight the areas of recognised uncertainty—“the known unknowns”. It acknowledges the fact that there may well be other knowledge gaps of clinical relevance of which we are currently unaware—“the unknown unknowns”.

Sunspot activity and influenza pandemics: a statistical assessment of the purported association

Since 1978, a series of papers in the literature have claimed to find a significant association between sunspot activity and the timing of influenza pandemics. This paper examines these analyses, and attempts to recreate the three most recent statistical analyses by Ertel (1994), Tapping et al. (2001), and Yeung (2006), which all have purported to find a significant relationship between sunspot numbers and pandemic influenza. As will be discussed, each analysis had errors in the data. In addition, in each analysis arbitrary selections or assumptions were also made, and the authors did not assess the robustness of their analyses to changes in those arbitrary assumptions. Varying the arbitrary assumptions to other, equally valid, assumptions negates the claims of significance. Indeed, an arbitrary selection made in one of the analyses appears to have resulted in almost maximal apparent significance; changing it only slightly yields a null result. This analysis applies statistically rigorous methodology to examine the purported sunspot/pandemic link, using more statistically powerful un-binned analysis methods, rather than relying on arbitrarily binned data. The analyses are repeated using both the Wolf and Group sunspot numbers. In all cases, no statistically significant evidence of any association was found. However, while the focus in this particular analysis was on the purported relationship of influenza pandemics to sunspot activity, the faults found in the past analyses are common pitfalls; inattention to analysis reproducibility and robustness assessment are common problems in the sciences, that are unfortunately not noted often enough in review.

Influenza A H5N1 and H7N9 in China: A spatial risk analysis

Background

Zoonotic avian influenza poses a major risk to China, and other parts of the world. H5N1 has remained endemic in China and globally for nearly two decades, and in 2013, a novel zoonotic influenza A subtype H7N9 emerged in China. This study aimed to improve upon our current understanding of the spreading mechanisms of H7N9 and H5N1 by generating spatial risk profiles for each of the two virus subtypes across mainland China.

Methods and findings

In this study, we (i) developed a refined data set of H5N1 and H7N9 locations with consideration of animal/animal environment case data, as well as spatial accuracy and precision; (ii) used this data set along with environmental variables to build species distribution models (SDMs) for each virus subtype in high resolution spatial units of 1km² cells using Maxent; (iii) developed a risk modelling framework which integrated the results from the SDMs with human and chicken population variables, which was done to quantify the risk of zoonotic transmission; and (iv) identified areas at high risk of H5N1 and H7N9 transmission. We produced high performing SDMs (6 of 8 models with AUC > 0.9) for both H5N1 and H7N9. In all our SDMs, H7N9 consistently showed higher AUC results compared to H5N1, suggesting H7N9 suitability could be better explained by environmental variables. For both subtypes, high risk areas were primarily located in south-eastern China, with H5N1 distributions found to be more diffuse and extending more inland compared to H7N9.

Conclusions

We provide projections of our risk models to public health policy makers so that specific high risk areas can be targeted for control measures. We recommend comparing H5N1 and H7N9 prevalence rates and survivability in the natural environment to better understand the role of animal and environmental transmission in human infections.

Is sunspot activity a factor in influenza pandemics?

INTRODUCTION

The 2009 AH1N1 pandemic became a global health concern, although fortunately, its worst anticipated effects were not realised. While the origins of such outbreaks remain poorly understood, it is very important to identify the precipitating factors in their emergence so that future pandemics can be detected as quickly as possible. Methords: Descriptive epidemiology was used to analyse the association between influenza pandemics and possible pandemics and relative number of sunspots. Non-conditional logistic regression was performed to analyse the statistical association between sunspot extremes and influenza pandemics to within plus or minus 1 year.

RESULTS

Almost all recorded influenza/possible pandemics have occurred in time frames corresponding to sunspot extremes, or +/- 1 year within such extremes. These periods were identified as important risk factors in both possible and confirmed influenza pandemics (odds ratio: 3.87; 95% confidence interval: 1.08 to 13.85).

CONCLUSIONS

Extremes of sunspot activity to within plus or minus 1 year may precipitate influenza pandemics. Mechanisms of epidemic initiation and early spread are discussed including primary causation by externally derived viral variants (from space via cometary dust). Efforts to construct a comprehensive early warning system for potential influenza and other viral pandemics that include analysis of sunspot activity and stratospheric sampling for viral variants should be supported. Copyright © 2016 John Wiley & Sons, Ltd.

Does vitamin D protect against respiratory viral infections?

The active form of vitamin D has effects on both innate and adaptive immune responses that may influence the outcome in many infectious diseases. Observational studies conclusively show that a low vitamin D status is associated with an increased occurrence of respiratory viral infections, which globally represent significant health and financial burdens. However, no consistent protective effects are evident in prospective clinical trials carried out to date where vitamin D was provided as a dietary supplement, except possibly in cases where the starting vitamin D status of the individual was considered deficient. Thus far, vitamin D has not been found to enhance the immune response to vaccines. The design of future prospective clinical trials assessing a role for vitamin D in respiratory viral infections requires very careful planning to avoid the uncertainties associated with the data available currently.

The origin of novel avian influenza A (H7N9) and mutation dynamics for its human-to-human transmissible capacity

In February 2013, H7N9 (A/H7N9/2013_China), a novel avian influenza virus, broke out in eastern China and caused human death. It is a global priority to discover its origin and the point in time at which it will become transmittable between humans. We present here an interdisciplinary method to track the origin of H7N9 virus in China and to establish an evolutionary dynamics model for its human-to-human transmission via mutations. After comparing influenza viruses from China since 1983, we established an A/H7N9/2013_China virus evolutionary phylogenetic tree and found that the human instances of virus infection were of avian origin and clustered into an independent line. Comparing hemagglutinin (HA) and neuraminidase (NA) gene sequences of A/H7N9/2013_China viruses with all human-to-human, avian, and swine influenza viruses in China in the past 30 years, we found that A/H7N9/2013_China viruses originated from Baer’s Pochard H7N1 virus of Hu Nan Province 2010 (HA gene, EPI: 370846, similarity with H7N9 is 95.5%) and duck influenza viruses of Nanchang city 2000 (NA gene, EPI: 387555, similarity with H7N9 is 97%) through genetic re-assortment. HA and NA gene sequence comparison indicated that A/H7N9/2013_China virus was not similar to human-to-human transmittable influenza viruses. To simulate the evolution dynamics required for human-to-human transmission mutations of H7N9 virus, we employed the Markov model. The result of this calculation indicated that the virus would acquire properties for human-to-human transmission in 11.3 years (95% confidence interval (CI): 11.2–11.3, HA gene).

Effects of vitamin D on airway epithelial cell morphology and rhinovirus replication

Vitamin D has been linked to reduced risk of viral respiratory illness. We hypothesized that vitamin D could directly reduce rhinovirus (RV) replication in airway epithelium. Primary human bronchial epithelial cells (hBEC) were treated with vitamin D, and RV replication and gene expression were evaluated by quantitative PCR. Cytokine/chemokine secretion was measured by ELISA, and transepithelial resistance (TER) was determined using a voltohmmeter. Morphology was examined using immunohistochemistry. Vitamin D supplementation had no significant effects on RV replication, but potentiated secretion of CXCL8 and CXCL10 from infected or uninfected cells. Treatment with vitamin D in the form of 1,25(OH)₂D caused significant changes in cell morphology, including thickening of the cell layers (median of 46.5 µm [35.0–69.0] vs. 30 µm [24.5–34.2], p<0.01) and proliferation of cytokeratin-5-expressing cells, as demonstrated by immunohistochemical analysis. Similar effects were seen for 25(OH)D. In addition to altering morphology, higher concentrations of vitamin D significantly upregulated small proline-rich protein (SPRR1β) expression (6.3 fold-induction, p<0.01), suggestive of squamous metaplasia. Vitamin D treatment of hBECs did not alter repair of mechanically induced wounds. Collectively, these findings indicate that vitamin D does not directly affect RV replication in airway epithelial cells, but can influence chemokine synthesis and alters the growth and differentiation of airway epithelial cells.

Vitamin D's potential to reduce the risk of hospital-acquired infections

Health care–associated and hospital-acquired infections are two entities associated with increased morbidity and mortality. They are highly costly and constitute a great burden to the health care system. Vitamin D deficiency (< 20 ng/ml) is prevalent and may be a key contributor to both acute and chronic ill health. Vitamin D deficiency is associated with decreased innate immunity and increased risk for infections. Vitamin D can positively influence a wide variety of microbial infections.

Herein we discuss hospital-acquired infections, such as pneumonia, bacteremias, urinary tract and surgical site infections, and the potential role vitamin D may play in ameliorating them. We also discuss how vitamin D might positively influence these infections and help contain health care costs. Pending further studies, we think it is prudent to check vitamin D status at hospital admission and to take immediate steps to address existing insufficient 25-hydroxyvitamin D levels.

Vitamin D and influenza

Vitamin D has become increasingly recognized in the literature for its extra-skeletal roles, including an effect on inflammation and the immune response to infection. Our goal was to describe the role of vitamin D in the immune response and implications for the risk of influenza infection in humans. In this review, we first consider literature that provides molecular and genetic support to the idea that vitamin D is related to the adaptive and innate immune responses to influenza infection in vitro and in animal models. We then discuss observational studies and randomized controlled trials of vitamin D supplementation in humans. Finally, we consider some of the knowledge gaps surrounding vitamin D and immune response that must be filled.

Vitamin D supplementation did not prevent influenza-like illness as diagnosed retrospectively by questionnaires in subjects participating in randomized clinical trials

BACKGROUND

Vitamin D deficiency has been associated with a number of diseases, including influenza. Whether or not this reflects a causal relationship is unknown. We therefore wanted to examine if supplementation with vitamin D would affect the incidence and severity of influenza-like disease.

METHODS

Questionnaires on influenza were sent to subjects participating in ongoing placebo-controlled intervention studies with vitamin D supplementation, up until the end of April 2010.

RESULTS

Five hundred and sixty-nine subjects from 10 different clinical trials were included in the study, of whom 289 were randomized to receive vitamin D (1111-6800 IU/day) and 280 to receive placebo. Influenza-like disease during the previous fall/winter was reported in 38 subjects in the vitamin D group and 42 in the placebo group (non-significant), of whom 25 and 26 subjects, respectively, fulfilled our clinical criteria for influenza. In these latter subjects, the duration of illness was significantly longer among those in the vitamin D group than among those in the placebo group (median 7 (range 2-60) days vs median 4 (range 2-18) days; p = 0.007). However, this difference was not statistically significant if all 38 (vitamin D) and 42 (placebo) subjects who reported symptoms were included.

CONCLUSION

Our results do not support the hypothesis that high doses of vitamin D supplementation will have a pronounced effect on influenza-like disease in populations not targeted for high influenza risk.

Resveratrol and vitamin D: significant potential interpretative problems arising from their mutual processes, interactions and effects

The hypothesis is formulated and presented that resveratrol and vitamin D have important mutual processes, interactions and induced effects that if not taken into account could seriously jeopardize the interpretation of their current and future preclinical, epidemiological and clinical studies. In support of this hypothesis, evidence is presented that resveratrol and vitamin D mutually share some of the same biochemical processes and mechanisms as well as the fact that they can each affect some of the same diseases and maladies.

Influenza, solar radiation and vitamin D

The annual death numbers of influenza and pneumonia in Norway were studied for the time period 1980-2000. No direct relationships were found with the variations of the annual UVB fluences, probably due to the fact that these variations did not exceed 30%. However, there was a very pronounced seasonal variation of both influenza deaths and pneumonia deaths, the vast majority occurring during the winter. Vitamin D levels were also estimated from several publications. The data support the hypothesis that a high vitamin D level, as that found in the summer, acts in a protective manner with respect to influenza as well as pneumonia. The findings are discussed and compared with data from tropical and subtropical areas.

Sunspot dynamics are reflected in human physiology and pathophysiology

Periodic episodes of increased sunspot activity (solar electromagnetic storms) occur with 10-11 and 5-6 year periodicities and may be associated with measurable biological events. We investigated whether this sunspot periodicity characterized the incidence of Pap smear-determined cervical epithelial histopathologies and human physiologic functions. From January 1983 through December 2003, monthly averages were obtained for solar flux and sunspot numbers; six infectious, premalignant and malignant changes in the cervical epithelium from 1,182,421 consecutive, serially independent, screening Pap smears (59°9″N, 4°29″E); and six human physiologic functions of a healthy man (oral temperature, pulse, systolic and diastolic blood pressure, respiration, and peak expiratory flow), which were measured ∼5 times daily during ∼34,500 self-measurement sessions (44°56″N, 93°8″W). After determining that sunspot numbers and solar flux, which were not annually rhythmic, occurred with a prominent 10-year and a less-prominent 5.75-year periodicity during this 21-year study span, each biological data set was analyzed with the same curve-fitting procedures. All six annually rhythmic Pap smear-detected infectious, premalignant and malignant cervical epithelial pathologies showed strong 10-year and weaker 5.75-year cycles, as did all six self-measured, annually rhythmic, physiologic functions. The phases (maxima) for the six histopathologic findings and five of six physiologic measurements were very near, or within, the first two quarters following the 10-year solar maxima. These findings add to the growing evidence that solar magnetic storm periodicities are mirrored by cyclic phase-locked rhythms of similar period length or lengths in human physiology and pathophysiology.

Cancer protection related to solar ultraviolet radiation, altitude and vitamin D

A whole host of epidemiological studies have reported lower cancer rates and mortality in high-altitude regions. These studies are reviewed and discussed in detail. Evidence for the salutary role of vitamin D in protecting against cancer and other maladies will also be reviewed and discussed. The dependence of vitamin D production on sunlight and its enhancement with altitude will be demonstrated. The hypothesis is advanced and developed that the lower cancer rates observed at high altitudes arise from enhanced sunlight-induced vitamin D production levels. Protective vitamin D mechanisms which support this hypothesis as well as other supportive medical evidence are also presented.