Age-specific patterns of death from influenza vary, depending on whether the influenza season is epidemic or pandemic. We assessed age patterns and geographic trends in monthly influenza-related deaths in Italy from 1969 through 2001, focusing on differences between epidemic and pandemic seasons. We evaluated age-standardized excess deaths from pneumonia and influenza and from all causes, using a modified version of a cyclical Serfling model. Excess deaths were highest for elderly persons in all seasons except the influenza A (H3N2) pandemic season (1969-70), when rates were greater for younger persons, confirming a shift toward death of younger persons during pandemic seasons. When comparing northern, central, and southern Italy, we found a high level of synchrony in the amplitude of peaks of influenza-related deaths.
Rizzo, C., Bella, A., Viboud, C., Simonsen, L., Miller, M., Rota, M. C., Salmaso, S., & degli Atti, M. L. C. (2007). Trends for Influenza-related Deathsduring Pandemic and Epidemic Seasons, Italy, 1969–2001. Emerging Infectious Diseases , 13(5), 694-699. https://doi.org/10.3201/eid1305.061309