Influenza in Tropical Regions: Epidemiology, Viral Evolution, and Control Challenges

Authors

Ni Kadek Andining Vidya , Afra Ruchudinia Mufida , Shafira Adinda Putri , Lisra Naila Mangendara

DOI:

10.29303/jbt.v26i3.13127

Published:

2026-08-18

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Abstract

Influenza in tropical regions circulates throughout the year, with seasonal peaks varying according to rainfall, temperature, humidity, population mobility, and local epidemiological conditions. This narrative review aims to examine influenza viral characteristics and evolution, epidemiological patterns in tropical regions, vaccination challenges, and post-COVID-19 prevention strategies. Literature was searched through PubMed, Scopus, ScienceDirect, SpringerLink, Google Scholar, and World Health Organization sources, with emphasis on publications from 2016 to 2026. Evidence indicates substantial heterogeneity in influenza seasonality across tropical settings, suggesting that vaccination timing and strain selection should be guided by local epidemiological and virological surveillance rather than a uniform Northern or Southern Hemisphere schedule. Antigenic drift remains a major challenge to vaccine–strain matching, while reassortment in influenza A viruses continues to pose a potential pandemic threat. Since March 2020, no confirmed detection of naturally circulating influenza B/Yamagata lineage viruses has been reported, supporting the transition from quadrivalent to trivalent seasonal influenza vaccines. Post-COVID-19 strategies should prioritize integrated virological and genomic surveillance, locally tailored vaccination policies, improved vaccine uptake, and strengthened human–animal surveillance in areas with zoonotic risk. Universal influenza vaccine platforms remain under development but could ultimately reduce reliance on frequent seasonal strain updates.

Keywords:

Epidemiology Genomic surveillance One Health Seasonal influenza Tropical regions Vaccine timing

References

Agustian, D., Mutyara, K., Murad, C., Uyeki, T. M., Kartasasmita, C. B., & Simoes, E. A. (2024). Epidemiology and population-based incidence of influenza in two communities, Bandung district, West Java, Indonesia, 2008–2011. Narra J, 4(3), e981. https://doi.org/10.52225/narra.v4i3.981

Alharbi, M. H., & Kribs, C. M. (2021). A Mathematical Modeling study: Assessing impact of mismatch between influenza vaccine strains and circulating strains in Hajj. Bulletin of Mathematical Biology, 83(1), 7. https://doi.org/10.1007/s11538-020-00836-6

Bhattarai, S., Chee, H., Prasettya, A., Wiyarta, E., & Anderson, B. (2024). A Systematic Review of the Epidemiology of Human Respiratory Viruses in Indonesia. Authorea. https://doi.org/10.22541/au.170670322.25933439/v1

Chen, X., Chen, H., Tao, F., Chen, Y., Zhou, Y., Cheng, J., & Wang, X. (2024). Global analysis of influenza epidemic characteristics in the first two seasons after lifting the nonpharmaceutical interventions for COVID-19. International Journal of Infectious Diseases, 151, 107372. https://doi.org/10.1016/j.ijid.2024.107372

Fisman, D., Pérez-Rubio, A., Postma, M., Smith, D. S., & Mould-Quevedo, J. (2025). Maintaining the value of influenza vaccination – the shift from quadrivalent to trivalent vaccines: an expert review. Expert Review of Vaccines, 24(1), 499–508. https://doi.org/10.1080/14760584.2025.2515597

Guillebaud, J., Héraud, J., Razanajatovo, N. H., Livinski, A. A., & Alonso, W. J. (2017). Both hemispheric influenza vaccine recommendations would have missed near half of the circulating viruses in Madagascar. Influenza and Other Respiratory Viruses, 11(6), 473–478. https://doi.org/10.1111/irv.12517

Gutierrez, M. A., & Rohani, P. A. (2026). Identifying the viral and epidemiological factors behind the apparent global extinction of influenza B/Yamagata. medRxiv, 2026-07. https://doi.org/10.64898/2026.07.22.26358639

Hirve, S., Lambach, P., Paget, J., Vandemaele, K., Fitzner, J., & Zhang, W. (2016). Seasonal influenza vaccine policy, use and effectiveness in the tropics and subtropics – a systematic literature review. Influenza and Other Respiratory Viruses, 10(4), 254–267. https://doi.org/10.1111/irv.12374

Iuliano, A. D., Roguski, K. M., Chang, H. H., Muscatello, D. J., Palekar, R., Tempia, S., Cohen, C., Gran, J. M., Schanzer, D., Cowling, B. J., Wu, P., Kyncl, J., Ang, L. W., Park, M., Redlberger-Fritz, M., Yu, H., Espenhain, L., Krishnan, A., Emukule, G., . . . Mustaquim, D. (2017). Estimates of global seasonal influenza-associated respiratory mortality: a modelling study. The Lancet, 391(10127), 1285–1300. https://doi.org/10.1016/s0140-6736(17)33293-2

Kakkar, M., Sharma, D., Pal, M., Mohapatra, A., Sedai, T. R., Inbanathan, F. Y., Buddha, N., Salvador, E. C., & Wijesinghe, P. R. (2026). An analysis of WHO FluNet and FluID influenza surveillance data for South East Asia Region, 2015–2023. PLoS ONE, 21(2), e0341567. https://doi.org/10.1371/journal.pone.0341567

Kakoullis, L., Steffen, R., Osterhaus, A., Goeijenbier, M., Rao, S. R., Koiso, S., Hyle, E. P., Ryan, E. T., LaRocque, R. C., & Chen, L. H. (2023). Influenza: seasonality and travel-related considerations. Journal of Travel Medicine, 30(5). https://doi.org/10.1093/jtm/taad102

Koesnoe, S., & Kartasasmita, C. (2026). Transition from Quadrivalent to Trivalent Influenza Vaccination Compared with Continued Quadrivalent Vaccination for Preventing Severe Influenza Outcomes in Populations in Indonesia: Implications from the 2025–2026 Epidemiological Landscape. Acta Medica Indonesiana, 58(2), 281-281. https://pubmed.ncbi.nlm.nih.gov/42421374

Krammer, F., & Palese, P. (2018). Universal influenza virus vaccines that target the conserved hemagglutinin stalk and conserved sites in the head domain. The Journal of Infectious Diseases, 219(Supplement_1), S62–S67. https://doi.org/10.1093/infdis/jiy711

Lambach, P., Alvarez, A. M. R., Hirve, S., Ortiz, J. R., Hombach, J., Verweij, M., Hendriks, J., Palkonyay, L., & Pfleiderer, M. (2016). Considerations of strategies to provide influenza vaccine year round. Vaccine, 33(47), 6493–6498. https://doi.org/10.1016/j.vaccine.2015.08.037

Mezhenskaya, D., Isakova-Sivak, I., & Rudenko, L. (2019). M2e-based universal influenza vaccines: a historical overview and new approaches to development. Journal of Biomedical Science, 26(1), 76. https://doi.org/10.1186/s12929-019-0572-3

Nachbagauer, R., Feser, J., Naficy, A., Bernstein, D. I., Guptill, J., Walter, E. B., Berlanda-Scorza, F., Stadlbauer, D., Wilson, P. C., Aydillo, T., Behzadi, M. A., Bhavsar, D., Bliss, C., Capuano, C., Carreño, J. M., Chromikova, V., Claeys, C., Coughlan, L., Freyn, A. W., . . . Krammer, F. (2020). A chimeric hemagglutinin-based universal influenza virus vaccine approach induces broad and long-lasting immunity in a randomized, placebo-controlled phase I trial. Nature Medicine, 27(1), 106–114. https://doi.org/10.1038/s41591-020-1118-7

Padhi, A., Bhatt, P., Chauhan, J., Rajyaguru, B., Agarwal, S., Chaudhary, A., Bhise, M., & Agarwal, A. (2025). Seasonality of Influenza and Optimizing Timing of Vaccination: Systematic Review and Meta-Analysis. Cureus, 17(9), e93607. https://doi.org/10.7759/cureus.93607

Paget, J., Caini, S., Del Riccio, M., Van Waarden, W., & Meijer, A. (2022). Has influenza B/Yamagata become extinct and what implications might this have for quadrivalent influenza vaccines? Eurosurveillance, 27(39). https://doi.org/10.2807/1560-7917.es.2022.27.39.2200753

Peci, A., Winter, A., Li, Y., Gnaneshan, S., Liu, J., Mubareka, S., & Gubbay, J. B. (2019). Effects of absolute humidity, relative humidity, temperature, and wind speed on influenza activity in Toronto, Ontario, Canada. Applied and Environmental Microbiology, 85(6). https://doi.org/10.1128/aem.02426-18

Reina, J., & Iglesias, C. (2022). The role of “original antigenic sin” on influenza vaccine response. Vacunas (English Edition), 23(1), 46–54. https://doi.org/10.1016/j.vacune.2022.02.001

Spinardi, J. R., Thakkar, K. B., Welch, V. L., Jagun, O., & Kyaw, M. H. (2024). The need for novel influenza vaccines in low- and middle-income countries: A narrative review. The Brazilian Journal of Infectious Diseases, 29(1), 104465. https://doi.org/10.1016/j.bjid.2024.104465

Stamper, A. R., Yang, W., Wagner, C. E., Mahmud, A. S., & Baker, R. E. (2026). Unified climate factors predict influenza outbreak seasonality across tropical and temperate regions. PNAS Nexus, 5(6), pgag160. https://doi.org/10.1093/pnasnexus/pgag160

Wang, L., Xie, Q., Yu, P., Zhang, J., He, C., Huang, W., Wang, Y., & Zhao, C. (2025). Research progress of universal influenza vaccine. Vaccines, 13(8), 863. https://doi.org/10.3390/vaccines13080863

WHO Members. (2020). Seasonal influenza surveillance (2009–2017) for pandemic preparedness in the WHO South-East Asia Region. WHO South-East Asia Journal of Public Health, 9(1), 55. https://doi.org/10.4103/2224-3151.282999

Worobey, M., Plotkin, S., & Hensley, S. E. (2020). Influenza Vaccines Delivered in Early Childhood Could Turn Antigenic Sin into Antigenic Blessings. Cold Spring Harbor Perspectives in Medicine, 10(10), a038471. https://doi.org/10.1101/cshperspect.a038471

Xue, K. S., Moncla, L. H., Bedford, T., & Bloom, J. D. (2018). Within-Host evolution of human influenza virus. Trends in Microbiology, 26(9), 781–793. https://doi.org/10.1016/j.tim.2018.02.007

Yang, W., Cummings, M. J., Bakamutumaho, B., Kayiwa, J., Owor, N., Namagambo, B., Byaruhanga, T., Lutwama, J. J., O’Donnell, M. R., & Shaman, J. (2018). Dynamics of influenza in tropical Africa: Temperature, humidity, and co‐circulating (sub)types. Influenza and Other Respiratory Viruses, 12(4), 446–456. https://doi.org/10.1111/irv.12556

Young, B. E., & Chen, M. (2020). Influenza in temperate and tropical Asia: a review of epidemiology and vaccinology. Human Vaccines & Immunotherapeutics, 16(7), 1659 –1667. https://doi.org/10.1080/21645515.2019.1703455

Author Biographies

Ni Kadek Andining Vidya, Program Studi Kedokteran, Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Mataram, Mataram, Nusa Tenggara Barat, Indonesia

Author Origin : Indonesia

Afra Ruchudinia Mufida, Universitas Mataram

Author Origin : Indonesia

Shafira Adinda Putri, Universitas Mataram

Author Origin : Indonesia

Lisra Naila Mangendara, Universitas Mataram

Author Origin : Indonesia

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How to Cite

Vidya, N. K. A., Mufida, A. R., Putri, S. A., & Mangendara, L. N. (2026). Influenza in Tropical Regions: Epidemiology, Viral Evolution, and Control Challenges. Jurnal Biologi Tropis, 26(3), 1401–1413. https://doi.org/10.29303/jbt.v26i3.13127

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