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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Estimated global mortality associated with the first 12 months of 2009 pandemic influenza A H1N1 virus circulation: A modelling study
The Lancet Infectious Diseases, Volume 12, No. 9, Year 2012
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Description
Background: 18 500 laboratory-confirmed deaths caused by the 2009 pandemic influenza A H1N1 were reported worldwide for the period April, 2009, to August, 2010. This number is likely to be only a fraction of the true number of the deaths associated with 2009 pandemic influenza A H1N1. We aimed to estimate the global number of deaths during the first 12 months of virus circulation in each country. Methods: We calculated crude respiratory mortality rates associated with the 2009 pandemic influenza A H1N1 strain by age (0-17 years, 18-64 years, and >64 years) using the cumulative (12 months) virus-associated symptomatic attack rates from 12 countries and symptomatic case fatality ratios (sCFR) from five high-income countries. To adjust crude mortality rates for differences between countries in risk of death from influenza, we developed a respiratory mortality multiplier equal to the ratio of the median lower respiratory tract infection mortality rate in each WHO region mortality stratum to the median in countries with very low mortality. We calculated cardiovascular disease mortality rates associated with 2009 pandemic influenza A H1N1 infection with the ratio of excess deaths from cardiovascular and respiratory diseases during the pandemic in five countries and multiplied these values by the crude respiratory disease mortality rate associated with the virus. Respiratory and cardiovascular mortality rates associated with 2009 pandemic influenza A H1N1 were multiplied by age to calculate the number of associated deaths. Findings: We estimate that globally there were 201 200 respiratory deaths (range 105 700-395 600) with an additional 83 300 cardiovascular deaths (46 000-179 900) associated with 2009 pandemic influenza A H1N1. 80% of the respiratory and cardiovascular deaths were in people younger than 65 years and 51% occurred in southeast Asia and Africa. Interpretation: Our estimate of respiratory and cardiovascular mortality associated with the 2009 pandemic influenza A H1N1 was 15 times higher than reported laboratory-confirmed deaths. Although no estimates of sCFRs were available from Africa and southeast Asia, a disproportionate number of estimated pandemic deaths might have occurred in these regions. Therefore, efforts to prevent influenza need to effectively target these regions in future pandemics. Funding: None. © 2012 Elsevier Ltd.
Authors & Co-Authors
Dawood, Fatimah S.
United States, Atlanta
Centers for Disease Control and Prevention
Danielle Iuliano, Angela Danielle
United States, Atlanta
Centers for Disease Control and Prevention
Reed, Carrie
United States, Atlanta
Centers for Disease Control and Prevention
Meltzer, Martin Isaac I.
United States, Atlanta
Centers for Disease Control and Prevention
Shay, David K.
United States, Atlanta
Centers for Disease Control and Prevention
Cheng, Poyung
United States, Atlanta
Centers for Disease Control and Prevention
Bandaranayake, Don R.
New Zealand, Porirua
Esr - Environmental Science and Research
Breiman, Robert F.
Kenya, Nairobi
Kenya Medical Research Institute
Brooks, W. Abdullah
Bangladesh, Dhaka
International Centre for Diarrhoeal Disease Research Bangladesh
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Buchy, Philippe
Unknown Affiliation
Feikin, Daniel R.
Kenya, Nairobi
Kenya Medical Research Institute
Gordon, Aubree L.
United States, Berkeley
University of California, Berkeley
United States, Bethesda
Fogarty International Center
Hien, Nguyen Tran
Unknown Affiliation
Horby, Peter W.
Viet Nam, Ho Chi Minh City
Oxford University Clinical Research Unit
Huang, Qiu Sue
New Zealand, Porirua
Esr - Environmental Science and Research
Katz, Mark A.
Kenya, Nairobi
Kenya Medical Research Institute
Krishnan, Anand
India, New Delhi
All India Institute of Medical Sciences, new Delhi
Lal, Renu B.
Kenya, Nairobi
Kenya Medical Research Institute
Montgomery, Joel M.
United States, Atlanta
Centers for Disease Control and Prevention
Peru, Lima
Naval Medical Research Unit No. 6
Mølbak, Kåre
Denmark, Copenhagen
Statens Serum Institut
Pebody, Richard G.
United Kingdom, Cambridge
Mrc Biostatistics Unit
Presanis, Anne M.
United Kingdom, Cambridge
Mrc Biostatistics Unit
Steens, Anneke
Netherlands, Bilthoven
Rijksinstituut Voor Volksgezondheid en Milieu
Tinoco, Yeny O.
Peru, Lima
Naval Medical Research Unit No. 6
Yu, Hongjie
Unknown Affiliation
Vong, Sirenda
Cambodia, Phnom Penh
Institut Pasteur du Cambodge
Bresee, Joseph S.
United States, Atlanta
Centers for Disease Control and Prevention
Widdowson, Marc Alain
United States, Atlanta
Centers for Disease Control and Prevention
Statistics
Citations: 934
Authors: 28
Affiliations: 15
Identifiers
Doi:
10.1016/S1473-3099(12)70121-4
ISSN:
14744457
Research Areas
Noncommunicable Diseases