Impact of influenza and respiratory syncytial virus on mortality in England and Wales from January 1975 to December 1990
Impact of influenza and respiratory syncytial virus on mortality in England and Wales from January 1975 to December 1990
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DOI：
10.1017/s0950268800058957
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发表时间：
1996-02-01
影响因子：
4.2
通讯作者：
Nicholson, KG
中科院分区：
文献类型：
--
作者：
Nicholson, KG
通过回归分析评估了1975-90年间英格兰和威尔士甲型和乙型流感以及呼吸道合胞病毒对死亡率的影响。来自哨兵实践的发病率数据被用来计算4周累计上呼吸道感染(URTI)率；PHLS实验室报告被用作感染指数，4周所有原因死亡率(不包括分娩)被用来研究与死亡率的关系。死亡与甲型和乙型流感报告、温度、聚合的URTI和温度以及RSV暴发和温度之间的相互作用密切相关。通过将URTI的年低谷就诊率的平均值和RSV和流感的基准值代入主回归模型中，估计了与URTI相关的季节性的4周死亡率。在1975年至2006年和1989年至1990年的流感和呼吸道合胞病毒综合流行期间，与URTIs有关的四周死亡率估计分别为约24000人和约28000人。二次回归分析以估计的与URTI相关的季节性4周死亡为因变量，实验室数据为回归变量。即使在没有大流行的年份，与流感相关的估计超额死亡率也相当可观。总体而言，在这15个冬季中，与RSV有关的估计死亡率比与流感有关的死亡率高60-80%。该模型只允许对RSV相关死亡率进行粗略估计。然而，这表明RSV是冬季死亡的一个重要原因。
The effects of influenza A and B and RSV on mortality in England and Wales were assessed by regression analysis for the period 1975-90. Morbidity data from sentinel practices were used to calculate 4-weekly rates of aggregated upper respiratory tract infections (URTI); PHLS laboratory reports were used as indices of infection, and 4-weekly death rates from all causes, excluding childbirths, were used to study relationships with mortality. Deaths correlated strongly with influenza A and B reports, temperature, and interactions between aggregated URTI and temperature, and RSV outbreaks and temperature. Estimates of 'seasonal' 4-weekly mortality associated with URTI were made by substituting into primary regression models the mean of annual trough consultation rates for aggregated URTI and baseline values for RSV and influenza. Peak 4-weekly mortality associated with URTIs was estimated at c. 24000 and c. 28000 during combined influenza and RSV epidemics of 1975-6 and 1989-90 respectively. Secondary regression analysis was carried out with the estimated 'seasonal' 4-weekly deaths associated with URTI as dependant variable and laboratory data as regressors. Estimated excess mortality associated with influenza was considerable even during years without major epidemics. Overall during the 15 winters the estimated mortality associated with RSV was 60-80 % more than that associated with influenza. The modelling permits only a crude estimate of RSV associated mortality. None the less it suggests that RSV is an important cause of winter mortality.