Online Program

287469
Estimation of influenza-associated mortality stratified by age, sex, and underlying cause of death


Wednesday, November 6, 2013 : 10:56 a.m. - 11:14 a.m.

Edward Goldstein, PhD, Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard School of Public Health, Boston, MA
Vivek Charu, Johns Hopkins University School of Medicine, Baltimore, MD
Talia Quandelacy, Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard School of Public Health, Boston, MA
Cecile Viboud, PhD, Fogarty International Center, DIEPS, The National Institutes of Health, Bethesda, MD
Marc Lipsitch, Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard School of Public Health, Boston, MA
We have used proxies for disease incidence of the three influenza co-circulating subtypes (A/H3N2, A/H1N1 and B) that combine data on influenza-like illness consultations and respiratory specimen testing to estimate influenza-associated mortality in the US between 1997 and 2007, stratified by age, sex, and underlying cause of death. Elderly adults had the highest overall average flu-associated mortality rate, 140.23 (95% CI 117.20, 162.93) deaths per 100,000 people, while children under 18 had the lowest average mortality rate of 0.41(0.22, 0.58) per 100,000 people. Besides circulatory and respiratory causes, mortality underlying cancer, diabetes, renal disease and Alzheimer's had a significant contribution from influenza in several age groups. Influenza A/H1N1 had a more significant share of influenza-associated mortality in children compared to adults. For adults, within several age groups, influenza-associated mortality was somewhat higher in males than in females for several underlying causes (particularly circulatory causes). Of note, in males 50-64, our estimate 1.90 (1.17, 2.60) for the average annual rate per 100,000 persons for influenza-associated mortality underlying cancer is on par with the corresponding rate 1.82 (1.44, 2.21) of influenza-associated respiratory deaths. From the comparison of the non-influenza mortality baselines, we observed a disappearance of the “holiday season bump” in mortality in the period following the introduction of pneumococcal conjugate vaccine (PCV7). Age, sex, and underlying health conditions should be considered when planning influenza vaccination and treatment strategies.

Learning Areas:

Epidemiology
Protection of the public in relation to communicable diseases including prevention or control
Public health or related public policy
Public health or related research

Learning Objectives:
Identifying risk factors related to age, sex, and underlying health conditions should be considered when planning influenza vaccination and treatment strategies.

Keyword(s): Infectious Diseases, Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Senior Research Scientist at the Harvard School of Pubic Health and have published numerous papers on infectious disease epidemiology. My work is supported under the US National Institutes of Health K01 award 1K01AI101010-01. I work on mathematical modeling and statistical analysis of infectious disease dynamics and related control measures, drug resistance, and strain co-existence.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.