Although serological and culture evidence of influenza infection has been documented in the summer, it seldom causes community outbreaks in summer.
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If vitamin D is Hope-Simpson’s ‘seasonal stimulus’, then countries with low 25(OH)D levels+ marked wintertime troughs shd have higher excess wintertime mortality than countries with high 25(OH)D levels and little seasonal variation. Norway has highest 25(OH)D levels in Europe...
...due to its high year-round consumption of fish and cod liver oil). Levels of 25(OH)D in Scandinavia display least seasonal variation in Europe; indeed there is virtually no 25(OH)D seasonal variation among the elderly in Scandinavia. On the other hand, elderly in Great Britain
..have low 25(OH)D levels and such deficiencies are much more common during the influenza season. Excess wintertime mortality is twice as high in Great Britain as in Norway.
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