Impact of Influenza on Mortality in Relation to Age and Underlying Disease, 1967–1989

Abstract

Based on data from the Dutch Central Bureau of Statistics, the impact of influenza on mortality in The Netherlands was estimated for a 22.5-year period (1967-1989) in four age groups and three entities of disease, using Poisson regression techniques. Our analysis suggests that, on average, more than 2000 people died from influenza in The Netherlands each year, but in only a fraction of these deaths was influenza recognized as the cause of death. For each case of death registered as caused by influenza (registered influenza mortality), 2.6 additional cases of death registered as due to causes other than influenza, nevertheless, were influenza-related (non-registered influenza mortality). Therefore, the overall impact of influenza on mortality is estimated to be greater than registered influenza mortality by a factor of 3.6. Those under 60 years of age accounted for 5% of all non-registered influenza deaths, whereas people aged 60-69, 70-79 years and > 80 years accounted for 12%, 29% and 54% of such deaths, respectively. When extrapolating the figures for the Dutch population of 1989, we could attribute, on average per season-year, 82 deaths per 100,000 people > 60 years, 143 in people > 70 years, and 280 in people > 80 years. Of all non-registered influenza cases of death, 47% were estimated to occur in people with heart disease as a primarily reported cause of death, 23% in those with lung disease, and 30% in those with other diseases. This study stresses the serious effects of influenza, mainly in the elderly (95% of non-registered influenza mortality).(ABSTRACT TRUNCATED AT 250 WORDS)

Quantifying influenza vaccine efficacy and antigenic distance

“…Here, the binding constant is determined as K = exp(a -b〈U 〉), where a = − 18.56 and b = 1.67 are found from a comparison of the dynamics of the model with experiment [9], and U is the energy function for an antibody and is defined as (4) The parameters within the generalized block N K model represent the number of secondary structures and the total size of the variable region [9]. We have L = 5 different subdomain energy functions of the N K form (5) where a j is the amino acid type of the jth amino acid in the subdomain, and α i is the type of the ith subdomain. As in previous studies, we consider the case where the range of the interactions within a subdomain is specified by K = 4 and there are N = 10 amino acids in each subdomain [46].…”

“…Since the mutation rate of the influenza virus is rather high, vaccine efficacies are rarely 100%, and are more typically 30 -60%, against influenza-like illness. As significant as the estimated worldwide mortality is, it rises by another factor of 160% [4] to 260% [5] if influenza-induced complications to patients with other conditions are included, and the influenza vaccine on average significantly reduces such excess mortality [6]. Vaccine efficacy can even be negative, however, due to original antigenic sin [7][8][9], the tendency for antibodies produced in response to exposure to influenza vaccine antigens to suppress the creation of new, different antibodies in response to exposure to new versions of the influenza virus.…”

KLRG1—more than a marker for T cell senescence

“…The incidence and severity of infectious diseases, such as pneumonia (LaCroix et al 1989), meningitis (Gorse et al 1984), sepsis (Chattopadhyay and Al-Zahawi 1983), urinary tract infections (Ackermann and Monroe 1996), infection with respiratory syncytial virus (Barker and Mullooly 1980) or influenza (Sprenger et al 1993) all increase with age. Indeed the mortality rate of older adults suffering urinary tract infections or tuberculosis is ten-fold higher than that of young adults (Yoshikawa 1997).…”

Influenza-associated mortality in 2009 in four sentinel sites in Bangladesh

“…Advanced age and chronic medical conditions independently increase the risk of hospitalization and death from influenza in both low-and high-income countries. 2,8,18,[24][25][26] In the present study, influenza-associated deaths occurred at a lower rate among young children than among older age groups. Despite this, acute respiratory infection, including pneumonia, is the leading cause of childhood death in Bangladesh 27 and influenza is an important contributor to childhood pneumonia and hospitalization.…”