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Age- and sex-related risk factors for influenza-associated mortality in the United States between 1997-2007
Open accessAbstract
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.
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“Risk factors for hospitalisation and death, including age and comorbidities, are consistent with those previously identified for respiratory viruses.121”
From Severe acute respiratory syndrome (SARS) mathematical models and disease parameters: a systematic review (2025) · cites this paper as [121]
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Metadata
- Authors
- Quandelacy, T. M., Viboud, C., Charu, V., Lipsitch, M., & Goldstein, E.
- Affiliations
- Harvard University (US)
- Corresponding author
- Goldstein, Edward
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-11-04
- Volume
- 179
- Issue
- 2
- Pages
- 156-167
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- PMC
- PMC3873104
- OpenAlex
- W2144402463
- Semantic Scholar
- b13ae7df58f22e0addb72022d1045095838faca0
- Cited by
- 144
- References
- 34
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 12 · 2023: 13 · 2022: 14 · 2021: 15 · 2020: 13 · 2019: 14 · 2018: 10 · 2017: 14 · 2016: 9 · 2015: 13 · 2014: 5 · 2013: 1
- FWCI
- 6.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Epidemiology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer
- Johns Hopkins University
- National Institutes of Health
- School of Medicine, Johns Hopkins University
- National Institute of General Medical Sciences (U54GM088558, T32GM007309, award number U54GM088558)
- National Institute of Allergy and Infectious Diseases (K01AI101010)
- Fogarty International Center
- Topics
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Keywords
- influenza-associated deaths, age-specific mortality, sex differences, H3N2, H1N1 influenza, influenza B, influenza-like illness, underlying cause of death, cancer mortality, respiratory mortality, septicemia, children, older adults
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Child, Female, Humans, Influenza, Human, Male, Middle Aged, Pneumonia, Risk Factors, Sex Factors, United States, Alphainfluenzavirus, Betainfluenzavirus, Young Adult
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