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Excess Deaths Attributable to Influenza in England and Wales: Age at Death and Certified Cause
Abstract
The multiple regression statistical method has already been used to estimate excess deaths attributable to influenza in England and Wales by winter period. Now we report further studies of deaths by age group and certified cause of death. During the ten winters since the influenza A/Hong Kong (H3N2) virus first arrived (1968/69 to 1977/78) there have been about 120,000 excess deaths. Of these about 82% were estimated to be in those aged 65+ years, 17% in the 40-64 year age group and 1% in younger adults. Sixty-seven per cent were certified as due to respiratory disease and 31% due to circulatory system disease. Respiratory deaths increased in all age groups during an epidemic, but of the deaths certified as due to circulatory disease, cerebrovascular deaths were mostly in the 65+ age group and ischaemic heart disease deaths in the 40-64 year age group. In this 40-64 year age group there was evidence that the effects of cold weather and epidemic influenza were multiplicative rather than additive. During the worst influenza winter of 1969/70 respiratory deaths increased by approximately 55% and circulatory system deaths by 4%. Deaths in the elderly increased by 10%, in those aged 40-60 years by 8% and in younger adults by 4%. There was no evidence that excess deaths are followed by a deficit during the following year.
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In the citing paper
“This approach for estimating excess all-cause mortality has been widely used to quantify the mortality toll of previous epidemics such as influenza6 or HIV7 and has also begun to be applied for COVID-19.1 8”
From Estimating the burden of the COVID-19 pandemic on mortality, life expectancy and lifespan inequality in England and Wales: a population-level analysis (2021) · cites this paper as [6]
In the citing paper
“Deaths in the elderly increased by 10%, in those aged 40–60 years by 8% and in younger adults by 4%.”
From Bacterial and viral infections associated with influenza (2013) · cites this paper as [29]
In the citing paper
“However, excess respiratory deaths were recorded in the second wave of the pandemic in 1969/70 and increased by approximately 55% and circulatory system deaths by 4%.”
From Bacterial and viral infections associated with influenza (2013) · cites this paper as [29]
In the citing paper
“In 1969, England and Wales saw a 55% increase in respiratory deaths, of which co/secondary bacterial infection was shown to be a major contributor (Tillett et al., 1983).”
From Secondary bacterial infections associated with influenza pandemics (2017) · cites this paper as Tillett et al., 1983
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“Overall 33,800 people died in the United States (Klimov et al., 1999) and England and Wales saw a 55% increase in respiratory deaths in 1969 (Tillett et al., 1983).”
BackgroundWarren‐Gash, C., Smeeth, L. L., & Hayward, A. C. (2009) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(09)70233-6 · Cited by 529
Metadata
- Authors
- TILLETT, H. E., SMITH, J. W. G., & GOOCH, C. D.
- Affiliations
- National Institute for Biological Standards and Control (GB)
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 1983
- Volume
- 12
- Issue
- 3
- Pages
- 344-352
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- OpenAlex
- W2137780431
- Cited by
- 146
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 5 · 2019: 1 · 2018: 4 · 2017: 5 · 2015: 4 · 2014: 8 · 2013: 6 · 2012: 1
- FWCI
- 0.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Royal College of General Practitioners
- 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, excess mortality, age at death, cerebrovascular disease, ischemic heart disease, older adults, cold weather, multiplicative effects, influenza epidemic, England and Wales
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Cardiovascular Diseases, Cerebrovascular Disorders, Coronary Disease, England, Humans, Influenza, Human, Middle Aged, Models, Biological, Respiration Disorders, Seasons, Wales
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