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Estimating Influenza-associated Mortality in Korea: 2009-2016 season
Kwan Hong , Sangho Sohn , Byung chul Chun
Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
Corresponding Author: Byung chul Chun ,Tel: +8222861169, Fax: +829277220, Email: chun@korea.ac.kr
Received: June 17, 2019;  Accepted: August 13, 2019.
Estimating the influenza-associated mortality is important since seasonal influenza affects persons of all ages and leads to severe illness or death. This study is aimed to estimate the influenza-associated mortality considering not only periodic changes but also age-specific mortality by influenza subtypes.
Using the Microdata Integrated Service from Statistics Korea, we collected weekly mortality data including the cause of death. The laboratory surveillance data of respiratory viruses from 2009 to 2016 were derived from the Korea Centers for Disease Control and Prevention. After adjusting for annual age-specific population size, we used a negative binomial regression model by age group and influenza subtype.
Overall, 1,859,890 deaths were observed and the average positivity rate of influenza virus was 14.7% (standard deviation [SD]: 20.0), consisting of A(H1N1) 5.0% (SD: 11.9), A(H3N2) 4.4% (SD: 10.0), B viruses 5.3% (SD: 11.4), respectively. As a result, among under 65 years old, 6,774 (1.3%) all-cause deaths, 2,521 (3.1%) respiratory or circulatory deaths, and 1,048 (18.2%) influenza or pneumonia deaths were estimated. In above 65 years old population, 30,414 (2.3%) all-cause deaths, 16,411 (3.4%) respiratory or circulatory deaths, and 4,906 (6.9%) influenza or pneumonia deaths were estimated. Influenza A(H3N2) virus appeared to be mostly contributed to influenza-associated all-cause and respiratory or circulatory deaths in both age groups. However, Influenza A(H1N1) virus associated influenza or pneumonia deaths were higher in under 65 years old.
The influenza-associated mortality is substantial, especially in elderly. Among different subtypes, influenza A(H3N2) virus mostly contributes to the influenza-associated mortality.
Key words: Influenza; cost of illness; mortality
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