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<p>This study investigates how extreme cold and intensified seasonal viral activity shaped mortality patterns in Vojvodina (Serbia) during the exceptionally cold winter of 2016/2017. The research addresses a regional evidence gap concerning the demographic and epidemiological mechanisms that drive excess winter mortality in South-eastern Europe. Across Europe, winter mortality remains a significant public health concern, driven by the combined effects of climatic extremes and the circulation of respiratory viruses. Despite recurring exposure to severe cold spells and influenza epidemics, there has been limited research examining their joint effects in the Western Balkan region. The analysis integrates daily age- and sex-specific mortality counts, high-resolution CHIRTS-daily temperature estimates, and monthly cause-of-death statistics. The study quantifies the individual and joint contributions of cold exposure and viral circulation, identifies cold spells using a threshold of ≤ − 10&#xa0;°C, and applies correlation analysis to assess the associations between temperature and daily mortality. Mortality during the winter of 2016/2017 increased by approximately 17% compared with surrounding winters, with the sharpest relative rise among individuals aged 75 and over. A single cold spell in early January temporally coincided with approximately 12% of the observed seasonal excess mortality. Cause-of-death data indicate that respiratory and ill-defined causes were associated with approximately 21% of the observed excess mortality, suggesting intensified viral activity. Temperature–mortality correlations confirm a moderately strong negative association, particularly for minimum temperatures. Extreme cold and viral circulation acted as compound stressors that disproportionately affected older adults, especially older men. These findings underscore the importance of integrating meteorological and epidemiological indicators when assessing winter health risks. The study highlights the need for improved early-warning systems, expanded vaccination outreach, and targeted public health interventions in regions exposed to severe winter conditions. These estimates should be interpreted as indicative approximations derived from descriptive comparisons rather than formal causal attribution.</p> Graphical Abstract <p></p> <p>The graphical abstract combines spatial, analytical, and conceptual components to illustrate how extreme winter temperatures and intensified viral circulation jointly influenced mortality patterns in Vojvodina during the 2016/2017 winter. The study area panel situates Vojvodina within the European context and highlights the spatial distribution of CHIRTS-daily temperature grid points. The Data section presents the two fundamental datasets: satellite-derived temperature estimates and daily mortality counts among adults aged 60 and above. The Analyses panel outlines the three main analytical steps: identification of cold spells using a &lt;– 10&#xa0;°C threshold, daily mortality evaluation, and Pearson correlation analysis between temperature and mortality. The Model section synthesises the conceptual framework, showing how low temperatures intensify physiological stress and how viral circulation heightens the risk of respiratory infection. Their combined action increases vulnerability, particularly among individuals aged 75 and older, ultimately leading to excess winter mortality. The Results panel displays the primary quantitative outcomes, including a 17% increase in seasonal mortality, approximately 12% of the excess mortality occurring during the January cold spell, and about 21% of excess deaths associated with respiratory and ill-defined causes consistent with intensified viral circulation. Finally, the Conclusion section emphasises the central message: extreme cold and viral circulation may act as compound stressors, increasing mortality risks in ageing populations.</p>

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Compound Winter Hazards and Excess Mortality: Cold Extremes and Viral Circulation in Vojvodina (2016/2017)

  • 期刊论文

  • 发表日期：

    2026年4月29日

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  • Ivan Marinković,
  • Ivan Potić

摘要

This study investigates how extreme cold and intensified seasonal viral activity shaped mortality patterns in Vojvodina (Serbia) during the exceptionally cold winter of 2016/2017. The research addresses a regional evidence gap concerning the demographic and epidemiological mechanisms that drive excess winter mortality in South-eastern Europe. Across Europe, winter mortality remains a significant public health concern, driven by the combined effects of climatic extremes and the circulation of respiratory viruses. Despite recurring exposure to severe cold spells and influenza epidemics, there has been limited research examining their joint effects in the Western Balkan region. The analysis integrates daily age- and sex-specific mortality counts, high-resolution CHIRTS-daily temperature estimates, and monthly cause-of-death statistics. The study quantifies the individual and joint contributions of cold exposure and viral circulation, identifies cold spells using a threshold of ≤ − 10 °C, and applies correlation analysis to assess the associations between temperature and daily mortality. Mortality during the winter of 2016/2017 increased by approximately 17% compared with surrounding winters, with the sharpest relative rise among individuals aged 75 and over. A single cold spell in early January temporally coincided with approximately 12% of the observed seasonal excess mortality. Cause-of-death data indicate that respiratory and ill-defined causes were associated with approximately 21% of the observed excess mortality, suggesting intensified viral activity. Temperature–mortality correlations confirm a moderately strong negative association, particularly for minimum temperatures. Extreme cold and viral circulation acted as compound stressors that disproportionately affected older adults, especially older men. These findings underscore the importance of integrating meteorological and epidemiological indicators when assessing winter health risks. The study highlights the need for improved early-warning systems, expanded vaccination outreach, and targeted public health interventions in regions exposed to severe winter conditions. These estimates should be interpreted as indicative approximations derived from descriptive comparisons rather than formal causal attribution.

Graphical Abstract

The graphical abstract combines spatial, analytical, and conceptual components to illustrate how extreme winter temperatures and intensified viral circulation jointly influenced mortality patterns in Vojvodina during the 2016/2017 winter. The study area panel situates Vojvodina within the European context and highlights the spatial distribution of CHIRTS-daily temperature grid points. The Data section presents the two fundamental datasets: satellite-derived temperature estimates and daily mortality counts among adults aged 60 and above. The Analyses panel outlines the three main analytical steps: identification of cold spells using a <– 10 °C threshold, daily mortality evaluation, and Pearson correlation analysis between temperature and mortality. The Model section synthesises the conceptual framework, showing how low temperatures intensify physiological stress and how viral circulation heightens the risk of respiratory infection. Their combined action increases vulnerability, particularly among individuals aged 75 and older, ultimately leading to excess winter mortality. The Results panel displays the primary quantitative outcomes, including a 17% increase in seasonal mortality, approximately 12% of the excess mortality occurring during the January cold spell, and about 21% of excess deaths associated with respiratory and ill-defined causes consistent with intensified viral circulation. Finally, the Conclusion section emphasises the central message: extreme cold and viral circulation may act as compound stressors, increasing mortality risks in ageing populations.