Excess mortality related to seasonal influenza and extreme temperatures in Denmark, 1994-2010
Identifieur interne : 002613 ( Main/Merge ); précédent : 002612; suivant : 002614Excess mortality related to seasonal influenza and extreme temperatures in Denmark, 1994-2010
Auteurs : Jens Nielsen [Danemark] ; Anne Mazick [Danemark] ; Steffen Glismann [Danemark] ; K Re M Lbak [Danemark]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2011.
Descripteurs français
- KwdFr :
- MESH :
- mortalité : Grippe humaine.
- épidémiologie : Danemark.
- Adolescent, Adulte, Adulte d'âge moyen, Analyse de survie, Enfant d'âge préscolaire, Femelle, Humains, Jeune adulte, Modèles statistiques, Mâle, Nourrisson, Nouveau-né, Saisons, Sujet âgé, Sujet âgé de 80 ans ou plus, Température.
- Wicri :
- geographic : Danemark.
English descriptors
- KwdEn :
- MESH :
- geographic , epidemiology : Denmark.
- mortality : Influenza, Human.
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Models, Statistical, Seasons, Survival Analysis, Temperature, Young Adult.
Abstract
In temperate zones, all-cause mortality exhibits a marked seasonality, and one of the main causes of winter excess mortality is influenza. There is a tradition of using statistical models based on mortality from respiratory illnesses (Pneumonia and Influenza: PI) or all-cause mortality for estimating the number of deaths related to influenza. Different authors have applied different estimation methodologies. We estimated mortality related to influenza and periods with extreme temperatures in Denmark over the seasons 1994/95 to 2009/10.
We applied a multivariable time-series model with all-cause mortality as outcome, activity of influenza-like illness (ILI) and excess temperatures as explanatory variables, controlling for trend, season, age, and gender. Two estimates of excess mortality related to influenza were obtained: (1) ILI-attributable mortality modelled directly on ILI-activity, and (2) influenza-associated mortality based on an influenza-index, designed to mimic the influenza transmission.
The median ILI-attributable mortality per 100,000 population was 35 (range 6 to 100) per season which corresponds to findings from comparable countries. Overall, 88% of these deaths occurred among persons ≥ 65 years of age. The median influenza-associated mortality per 100,000 population was 26 (range 0 to 73), slightly higher than estimates based on pneumonia and influenza cause-specific mortality as estimated from other countries. Further, there was a tendency of declining mortality over the years. The influenza A(H3N2) seasons of 1995/96 and 1998/99 stood out with a high mortality, whereas the A(H3N2) 2005/6 season and the 2009 A(H1N1) influenza pandemic had none or only modest impact on mortality. Variations in mortality were also related to extreme temperatures: cold winters periods and hot summers periods were associated with excess mortality.
It is doable to model influenza-related mortality based on data on all-cause mortality and ILI, data that are easily obtainable in many countries and less subject to bias and subjective interpretation than cause-of-death data. Further work is needed to understand the variations in mortality observed across seasons and in particular the impact of vaccination against influenza.
Url:
DOI: 10.1186/1471-2334-11-350
PubMed: 22176601
PubMed Central: 3264536
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PMC:3264536Le document en format XML
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sort="Nielsen, Jens" uniqKey="Nielsen J" first="Jens" last="Nielsen">Jens Nielsen</name><affiliation wicri:level="1"><nlm:aff id="I1">Statens Serum Institut, Department of Epidemiology, Artillerivej 5, DK2300 Copenhagen, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Statens Serum Institut, Department of Epidemiology, Artillerivej 5, DK2300 Copenhagen</wicri:regionArea><wicri:noRegion>DK2300 Copenhagen</wicri:noRegion></affiliation></author><author><name sortKey="Mazick, Anne" sort="Mazick, Anne" uniqKey="Mazick A" first="Anne" last="Mazick">Anne Mazick</name><affiliation wicri:level="1"><nlm:aff id="I1">Statens Serum Institut, Department of Epidemiology, Artillerivej 5, DK2300 Copenhagen, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Statens Serum Institut, Department of Epidemiology, Artillerivej 5, DK2300 Copenhagen</wicri:regionArea><wicri:noRegion>DK2300 Copenhagen</wicri:noRegion></affiliation></author><author><name sortKey="Glismann, Steffen" sort="Glismann, Steffen" uniqKey="Glismann S" first="Steffen" last="Glismann">Steffen Glismann</name><affiliation wicri:level="1"><nlm:aff id="I1">Statens Serum Institut, Department of Epidemiology, Artillerivej 5, DK2300 Copenhagen, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Statens Serum Institut, Department of Epidemiology, Artillerivej 5, DK2300 Copenhagen</wicri:regionArea><wicri:noRegion>DK2300 Copenhagen</wicri:noRegion></affiliation></author><author><name sortKey="M Lbak, K Re" sort="M Lbak, K Re" uniqKey="M Lbak K" first="K Re" last="M Lbak">K Re M Lbak</name><affiliation wicri:level="1"><nlm:aff id="I1">Statens Serum Institut, Department of Epidemiology, Artillerivej 5, DK2300 Copenhagen, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Statens Serum Institut, Department of Epidemiology, Artillerivej 5, DK2300 Copenhagen</wicri:regionArea><wicri:noRegion>DK2300 Copenhagen</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Infectious Diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Child, Preschool</term><term>Denmark (epidemiology)</term><term>Female</term><term>Humans</term><term>Infant</term><term>Infant, Newborn</term><term>Influenza, Human (mortality)</term><term>Male</term><term>Middle Aged</term><term>Models, Statistical</term><term>Seasons</term><term>Survival Analysis</term><term>Temperature</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse de survie</term><term>Danemark (épidémiologie)</term><term>Enfant d'âge préscolaire</term><term>Femelle</term><term>Grippe humaine (mortalité)</term><term>Humains</term><term>Jeune adulte</term><term>Modèles statistiques</term><term>Mâle</term><term>Nourrisson</term><term>Nouveau-né</term><term>Saisons</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Température</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Denmark</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Danemark</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Child, Preschool</term><term>Female</term><term>Humans</term><term>Infant</term><term>Infant, Newborn</term><term>Male</term><term>Middle Aged</term><term>Models, Statistical</term><term>Seasons</term><term>Survival Analysis</term><term>Temperature</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse de survie</term><term>Enfant d'âge préscolaire</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Modèles statistiques</term><term>Mâle</term><term>Nourrisson</term><term>Nouveau-né</term><term>Saisons</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Température</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Danemark</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>In temperate zones, all-cause mortality exhibits a marked seasonality, and one of the main causes of winter excess mortality is influenza. There is a tradition of using statistical models based on mortality from respiratory illnesses (Pneumonia and Influenza: PI) or all-cause mortality for estimating the number of deaths related to influenza. Different authors have applied different estimation methodologies. We estimated mortality related to influenza and periods with extreme temperatures in Denmark over the seasons 1994/95 to 2009/10.</p></sec><sec><title>Methods</title><p>We applied a multivariable time-series model with all-cause mortality as outcome, activity of influenza-like illness (ILI) and excess temperatures as explanatory variables, controlling for trend, season, age, and gender. Two estimates of excess mortality related to influenza were obtained: (1) ILI-attributable mortality modelled directly on ILI-activity, and (2) influenza-associated mortality based on an influenza-index, designed to mimic the influenza transmission.</p></sec><sec><title>Results</title><p>The median ILI-attributable mortality per 100,000 population was 35 (range 6 to 100) per season which corresponds to findings from comparable countries. Overall, 88% of these deaths occurred among persons ≥ 65 years of age. The median influenza-associated mortality per 100,000 population was 26 (range 0 to 73), slightly higher than estimates based on pneumonia and influenza cause-specific mortality as estimated from other countries. Further, there was a tendency of declining mortality over the years. The influenza A(H3N2) seasons of 1995/96 and 1998/99 stood out with a high mortality, whereas the A(H3N2) 2005/6 season and the 2009 A(H1N1) influenza pandemic had none or only modest impact on mortality. Variations in mortality were also related to extreme temperatures: cold winters periods and hot summers periods were associated with excess mortality.</p></sec><sec><title>Conclusion</title><p>It is doable to model influenza-related mortality based on data on all-cause mortality and ILI, data that are easily obtainable in many countries and less subject to bias and subjective interpretation than cause-of-death data. Further work is needed to understand the variations in mortality observed across seasons and in particular the impact of vaccination against influenza.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Philips, D" uniqKey="Philips D">D Philips</name></author><author><name sortKey="Barker, Ge" uniqKey="Barker G">GE Barker</name></author><author><name sortKey="Brewer, Km" uniqKey="Brewer K">KM Brewer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Serfling, Re" uniqKey="Serfling R">RE Serfling</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Thormpson, Ww" uniqKey="Thormpson W">WW Thormpson</name></author><author><name sortKey="Weintraub, E" uniqKey="Weintraub E">E Weintraub</name></author><author><name sortKey="Dhankhar, P" uniqKey="Dhankhar P">P Dhankhar</name></author><author><name sortKey="Cheng, Py" uniqKey="Cheng P">PY Cheng</name></author><author><name 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Arden</name></author><author><name sortKey="Schoenberger, Lb" uniqKey="Schoenberger L">LB Schoenberger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kyncl, J" uniqKey="Kyncl J">J Kyncl</name></author><author><name sortKey="Prochazka, B" uniqKey="Prochazka B">B Prochazka</name></author><author><name sortKey="Goddard, Nl" uniqKey="Goddard N">NL Goddard</name></author><author><name sortKey="Havlickova, M" uniqKey="Havlickova M">M Havlickova</name></author><author><name sortKey="Castkova, J" uniqKey="Castkova J">J Castkova</name></author><author><name sortKey="Otavova, M" uniqKey="Otavova M">M Otavova</name></author><author><name sortKey="Kriz, B" uniqKey="Kriz B">B Kriz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jansen, Agsc" uniqKey="Jansen A">AGSC Jansen</name></author><author><name sortKey="Sanders, Eam" uniqKey="Sanders E">EAM Sanders</name></author><author><name sortKey="Nicol, Kl" uniqKey="Nicol K">KL Nicol</name></author><author><name sortKey="Van Loon, Am" uniqKey="Van Loon A">AM van Loon</name></author><author><name sortKey="Hoes, Aw" uniqKey="Hoes A">AW Hoes</name></author><author><name sortKey="Hak, E" uniqKey="Hak E">E Hak</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sprenger, Mjw" uniqKey="Sprenger M">MJW Sprenger</name></author><author><name sortKey="Mulder, Pgh" uniqKey="Mulder P">PGH Mulder</name></author><author><name sortKey="Beyer, Wep" uniqKey="Beyer W">WEP Beyer</name></author><author><name sortKey="Strik, Rv" uniqKey="Strik R">RV Strik</name></author><author><name sortKey="Masurel, N" uniqKey="Masurel N">N Masurel</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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