Mortality attributable to influenza in England and Wales prior to, during and after the 2009 pandemic. 2013

Helen K Green, and Nick Andrews, and Douglas Fleming, and Maria Zambon, and Richard Pebody
Respiratory Diseases Department, Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom.

Very different influenza seasons have been observed from 2008/09-2011/12 in England and Wales, with the reported burden varying overall and by age group. The objective of this study was to estimate the impact of influenza on all-cause and cause-specific mortality during this period. Age-specific generalised linear regression models fitted with an identity link were developed, modelling weekly influenza activity through multiplying clinical influenza-like illness consultation rates with proportion of samples positive for influenza A or B. To adjust for confounding factors, a similar activity indicator was calculated for Respiratory Syncytial Virus. Extreme temperature and seasonal trend were controlled for. Following a severe influenza season in 2008/09 in 65+yr olds (estimated excess of 13,058 influenza A all-cause deaths), attributed all-cause mortality was not significant during the 2009 pandemic in this age group and comparatively low levels of influenza A mortality were seen in post-pandemic seasons. The age shift of the burden of seasonal influenza from the elderly to young adults during the pandemic continued into 2010/11; a comparatively larger impact was seen with the same circulating A(H1N1)pdm09 strain, with the burden of influenza A all-cause excess mortality in 15-64 yr olds the largest reported during 2008/09-2011/12 (436 deaths in 15-44 yr olds and 1,274 in 45-64 yr olds). On average, 76% of seasonal influenza A all-age attributable deaths had a cardiovascular or respiratory cause recorded (average of 5,849 influenza A deaths per season), with nearly a quarter reported for other causes (average of 1,770 influenza A deaths per season), highlighting the importance of all-cause as well as cause-specific estimates. No significant influenza B attributable mortality was detected by season, cause or age group. This analysis forms part of the preparatory work to establish a routine mortality monitoring system ahead of introduction of the UK universal childhood seasonal influenza vaccination programme in 2013/14.

UI MeSH Term Description Entries
D007251 Influenza, Human An acute viral infection in humans involving the respiratory tract. It is marked by inflammation of the NASAL MUCOSA; the PHARYNX; and conjunctiva, and by headache and severe, often generalized, myalgia. Grippe,Human Flu,Human Influenza,Influenza in Humans,Influenza,Flu, Human,Human Influenzas,Influenza in Human,Influenzas,Influenzas, Human
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D004739 England A part of Great Britain within the United Kingdom.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D014852 Wales A region of the United Kingdom, in the southwestern area of Great Britain.
D055815 Young Adult A person between 19 and 24 years of age. Adult, Young,Adults, Young,Young Adults

Related Publications

Helen K Green, and Nick Andrews, and Douglas Fleming, and Maria Zambon, and Richard Pebody
September 2011, Epidemiology and infection,
Helen K Green, and Nick Andrews, and Douglas Fleming, and Maria Zambon, and Richard Pebody
December 2015, Epidemiology and infection,
Helen K Green, and Nick Andrews, and Douglas Fleming, and Maria Zambon, and Richard Pebody
June 2001, Journal of epidemiology and community health,
Helen K Green, and Nick Andrews, and Douglas Fleming, and Maria Zambon, and Richard Pebody
March 2011, Influenza and other respiratory viruses,
Helen K Green, and Nick Andrews, and Douglas Fleming, and Maria Zambon, and Richard Pebody
March 2011, Influenza and other respiratory viruses,
Helen K Green, and Nick Andrews, and Douglas Fleming, and Maria Zambon, and Richard Pebody
March 2008, Proceedings. Biological sciences,
Helen K Green, and Nick Andrews, and Douglas Fleming, and Maria Zambon, and Richard Pebody
September 2012, Epidemiology and infection,
Helen K Green, and Nick Andrews, and Douglas Fleming, and Maria Zambon, and Richard Pebody
December 2009, BMJ (Clinical research ed.),
Helen K Green, and Nick Andrews, and Douglas Fleming, and Maria Zambon, and Richard Pebody
June 1977, International journal of epidemiology,
Helen K Green, and Nick Andrews, and Douglas Fleming, and Maria Zambon, and Richard Pebody
September 1983, International journal of epidemiology,
Copied contents to your clipboard!