TY - JOUR
T1 - Mortality burden of the 2009-10 influenza pandemic in the United States
T2 - Improving the timeliness of influenza severity estimates using inpatient mortality records
AU - Charu, V.
AU - Simonsen, L.
AU - Lustig, R.
AU - Steiner, C.
AU - Viboud, Cecile
PY - 2013
Y1 - 2013
N2 -
Background
Delays in the release of national vital statistics hinder timely assessment of influenza severity, especially during pandemics. Inpatient mortality records could provide timelier estimates of influenza‐associated mortality.
Methods
We compiled weekly age‐specific deaths for various causes from US State Inpatient Databases (1990–2010) and national vital statistics (1990–2009). We calculated influenza‐attributable excess deaths by season based on Poisson regression models driven by indicators of respiratory virus activity, seasonality, and temporal trends.
Results
Extrapolations of excess mortality from inpatient data fell within 11% and 17% of vital statistics estimates for pandemic and seasonal influenza, respectively, with high year‐to‐year correlation (Spearman's rho = 0·87–0·90, P < 0·001, n = 19). We attribute 14 800 excess respiratory and cardiac deaths (95% CI: 10 000–19 650) to pandemic influenza activity during April 2009–April 2010, 79% of which occurred in people under 65 years.
Conclusions
Modeling inpatient mortality records provides useful estimates of influenza severity in advance of national vital statistics release, capturing both the magnitude and the age distribution of pandemic and epidemic deaths. We provide the first age‐ and cause‐specific estimates of the 2009 pandemic mortality burden using traditional ‘excess mortality’ methods, confirming the unusual burden of this virus in young populations. Our inpatient‐based approach could help monitor mortality trends in other infectious diseases.
AB -
Background
Delays in the release of national vital statistics hinder timely assessment of influenza severity, especially during pandemics. Inpatient mortality records could provide timelier estimates of influenza‐associated mortality.
Methods
We compiled weekly age‐specific deaths for various causes from US State Inpatient Databases (1990–2010) and national vital statistics (1990–2009). We calculated influenza‐attributable excess deaths by season based on Poisson regression models driven by indicators of respiratory virus activity, seasonality, and temporal trends.
Results
Extrapolations of excess mortality from inpatient data fell within 11% and 17% of vital statistics estimates for pandemic and seasonal influenza, respectively, with high year‐to‐year correlation (Spearman's rho = 0·87–0·90, P < 0·001, n = 19). We attribute 14 800 excess respiratory and cardiac deaths (95% CI: 10 000–19 650) to pandemic influenza activity during April 2009–April 2010, 79% of which occurred in people under 65 years.
Conclusions
Modeling inpatient mortality records provides useful estimates of influenza severity in advance of national vital statistics release, capturing both the magnitude and the age distribution of pandemic and epidemic deaths. We provide the first age‐ and cause‐specific estimates of the 2009 pandemic mortality burden using traditional ‘excess mortality’ methods, confirming the unusual burden of this virus in young populations. Our inpatient‐based approach could help monitor mortality trends in other infectious diseases.
U2 - 10.1111/irv.12096
DO - 10.1111/irv.12096
M3 - Journal article
SN - 1750-2640
VL - 7
SP - 863
EP - 871
JO - Influenza and Other Respiratory Viruses
JF - Influenza and Other Respiratory Viruses
IS - 5
ER -