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Underestimation of the role of pneumonia and influenza in causing excess mortality
Abstract:
Underestimation of pneumonia and influenza (P&I) mortality during influenza epidemics was explored in 38 P&U associated deaths among a population of adults during two influenza A (H3N2) epidemics. Pneumonia or influenza was mentioned on 32 (84 per cent) of the death certificates. However, based on rules for assigning cause of death, only nine (24 per cent, SE = 7) and 23 (61 per cent, SE = 8) of the cases would have been included in P&I mortality statistics compiled by the National Center for Health Statistics and the Center for Disease Control, respectively.
Insights
Pneumonia and influenza (P&I) deaths are underestimated during epidemics. Many death certificates mention P&I, but official statistics exclude most cases due to cause-of-death rules.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- Influenza epidemics pose a significant public health burden.
- Accurate mortality statistics are crucial for understanding disease impact and resource allocation.
Purpose of the Study:
- To investigate the underestimation of pneumonia and influenza (P&I) mortality during influenza epidemics.
- To assess the discrepancy between P&I mentions on death certificates and official P&I mortality statistics.
Main Methods:
- Analysis of 38 deaths associated with P&I during two influenza A (H3N2) epidemics.
- Review of death certificates to identify mentions of pneumonia or influenza.
- Comparison of identified cases with mortality statistics compiled by the National Center for Health Statistics and the Centers for Disease Control.
Main Results:
- Pneumonia or influenza was mentioned on 84% of death certificates.
- Only 24% and 61% of cases would be included in official P&I mortality statistics by the NCHS and CDC, respectively.
- Significant underestimation of P&I mortality was observed.
Conclusions:
- Current methods for compiling P&I mortality statistics may underestimate the true burden of these diseases during epidemics.
- Revising cause-of-death assignment rules could provide a more accurate representation of P&I mortality.