title: Age- and sex-related risk factors for influenza-associated mortality in the United States between 1997-2007.
abstract: Limited information on age- and sex-specific estimates of influenza-associated death with different underlying causes is currently available. We regressed weekly age- and sex-specific US mortality outcomes underlying several causes between 1997 and 2007 to incidence proxies for influenza A/H3N2, A/H1N1, and B that combine data on influenza-like illness consultations and respiratory specimen testing, adjusting for seasonal baselines and time trends. Adults older than 75 years of age had the highest average annual rate of influenza-associated mortality, with 141.15 deaths per 100,000 people (95% confidence interval (CI): 118.3, 163.9), whereas children under 18 had the lowest average mortality rate, with 0.41 deaths per 100,000 people (95% CI: 0.23, 0.60). In addition to respiratory and circulatory causes, mortality with underlying cancer, diabetes, renal disease, and Alzheimer disease had a contribution from influenza in adult age groups, whereas mortality with underlying septicemia had a contribution from influenza in children. For adults, within several age groups and for several underlying causes, the rate of influenza-associated mortality was somewhat higher in men than in women. Of note, in men 50-64 years of age, our estimate for the average annual rate of influenza-associated cancer mortality per 100,000 persons (1.90, 95% CI: 1.20, 2.62) is similar to the corresponding rate of influenza-associated respiratory deaths (1.81, 95% CI: 1.42, 2.21). Age, sex, and underlying health conditions should be considered when planning influenza vaccination and treatment strategies.
authors.forename: Talia M
authors.initials: TM
authors.lastname: Quandelacy
authors.forename: Cecile
authors.initials: C
authors.lastname: Viboud
authors.forename: Vivek
authors.initials: V
authors.lastname: Charu
authors.forename: Marc
authors.initials: M
authors.lastname: Lipsitch
authors.forename: Edward
authors.initials: E
authors.lastname: Goldstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007251:Influenza, Human / Q000401:mortality*; D029521:Alphainfluenzavirus; D029524:Betainfluenzavirus; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000401:mortality; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: age; influenza; mortality; sex; underlying cause