title: [Excess mortality in Spain during transmission of pandemic influenza in 2009].
abstract: BACKGROUND
  The Spanish daily mortality monitoring system and the program «European monitoring of excess mortality for public health action» found two excesses of mortality in Spain in November and December 2009.
  
  
  METHODS
  We analyzed the evolution of mortality in Spain during those months using time-series analysis methods based on historical mortality series and compared it in the time with influenza transmission.
  
  
  RESULTS
  Observed mortality for the total population was higher than expected in two periods: weeks 46-47/2009 with 5.75% excess and weeks 51-52/2009 with 7.35% excess. Observed mortality higher than expected, was also observed in children 5-14 years old during weeks 46-48/2009 with 41 deaths vs 21 expected. Exces mortality in November occurred before or was concomitant with highest influenza incidence rates. Excess mortality in December occurred five weeks after the influenza incidence peak and along with dramatic drop in temperatures. RSV and traffic accidents were ruled out as factor associated to these excesses.
  
  
  CONCLUSIONS
  While temperatures could explain most of the excess mortality observed in December, no single factor could be associated with observed excess mortality in November.
authors.affiliation: Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain. vflores@iscii.es
authors.forename: Imaculada
authors.initials: I
authors.lastname: León Gómez
authors.forename: Víctor Manuel
authors.initials: VM
authors.lastname: Flores Segovia
authors.forename: Silvia
authors.initials: S
authors.lastname: Jiménez Jorge
authors.forename: Amparo
authors.initials: A
authors.lastname: Larrauri Cámara
authors.forename: Rocío
authors.initials: R
authors.lastname: Palmera Suárez
authors.forename: Fernando
authors.initials: F
authors.lastname: Simón Soria
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology / Q000401:mortality* / Q000635:transmission; D008875:Middle Aged; D058873:Pandemics; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult