On the final size of epidemics with seasonality

We first study an SIR system of differential equations with periodic coefficients describing an epidemic in a seasonal environment. Unlike in a constant environment, the final epidemic size may not be an increasing function of the basic reproduction number R(0) or of the initial fraction of infected people. Moreover, large epidemics can happen even if R(0) < 1. But like in a constant environment, the final epidemic size tends to 0 when R(0) < 1 and the initial fraction of infected people tends to 0. When R(0) > 1, the final epidemic size is bigger than the fraction 1 - 1/R(0) of the initially nonimmune population. In summary, the basic reproduction number R(0) keeps its classical threshold property but many other properties are no longer true in a seasonal environment. These theoretical results should be kept in mind when analyzing data for emerging vector-borne diseases (West-Nile, dengue, chikungunya) or air-borne diseases (SARS, pandemic influenza); all these diseases being influenced by seasonality.