Mortality Burden of the A/H1N1 Pandemic in Mexico: A Comparison of Deaths and Years of Life Lost to Seasonal Influenza
Mortality Burden of the A/H1N1 Pandemic in Mexico: A Comparison of Deaths and Years of Life Lost to Seasonal Influenza
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DOI：
10.1093/cid/cir644
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发表时间：
2011-11-15
影响因子：
11.8
通讯作者：
Viboud, Cecile
中科院分区：
文献类型：
--
作者：
Charu, Vivek;Chowell, Gerardo;Viboud, Cecile
背景2009年甲型H1N1流感大流行的死亡率负担仍然存在争议，部分原因是传统上用于衡量流感相关超额死亡率的生命统计数据报告延迟。在这里，我们比较了墨西哥大流行性流感和季节性流感的超额死亡率和寿命损失年数（YLL），并评估了实验室确认的死亡报告。从2000年1月到2010年4月的每月年龄和原因特异性死亡率以及基于人群的流感病毒活动监测被用来估计墨西哥的超额死亡率和YLL。从覆盖40%人口的主动监测系统获得分层实验室确认的A/H1N1死亡报告。在2009年4月至12月墨西哥的3波病毒活动期间，甲型H1N1流感大流行导致每10万人中有11.1人死亡，44.5万人死亡。大流行的死亡负担是典型流感季节的0.6-2.6倍，低于2003-2004年严重流感流行的死亡负担。5-19岁和20-59岁的个体相对于他们的季节性流感经历受到不成比例的影响。2009年，经卫生部门确认的死亡人数占大流行超额死亡总数的7分之一，但在41名60岁以上死亡者中仅占1分之一。2010年冬季，在流感和呼吸道合胞病毒共同传播的时期，观察到老年人的超额死亡率复发。墨西哥在2009年甲型H1N1流感大流行中的死亡率高于其他有估计数的国家。需要进一步分析详细的生命统计数据，以评估这一流行病死亡率模式的地理差异。
Background. The mortality burden of the 2009 A/H1N1 influenza pandemic remains controversial, in part because of delays in reporting of vital statistics that are traditionally used to measure influenza-related excess mortality. Here, we compare excess mortality rates and years of life lost (YLL) for pandemic and seasonal influenza in Mexico and evaluate laboratory-confirmed death reports.Methods. Monthly age-and cause-specific death rates from January 2000 through April 2010 and population-based surveillance of influenza virus activity were used to estimate excess mortality and YLL in Mexico. Age-stratified laboratory-confirmed A/H1N1 death reports were obtained from an active surveillance system covering 40% of the population.Results. The A/H1N1 pandemic was associated with 11.1 excess all-cause deaths per 100 000 population and 445 000 YLL during the 3 waves of virus activity in Mexico, April-December 2009. The pandemic mortality burden was 0.6-2.6 times that of a typical influenza season and lower than that of the severe 2003-2004 influenza epidemic. Individuals aged 5-19 and 20-59 years were disproportionately affected relative to their experience with seasonal influenza. Laboratory-confirmed deaths captured 1 of 7 pandemic excess deaths overall but only 1 of 41 deaths in persons >60 years of age in 2009. A recrudescence of excess mortality was observed in older persons during winter 2010, in a period when influenza and respiratory syncytial virus cocirculated.Conclusions. Mexico experienced higher 2009 A/H1N1 pandemic mortality burden than other countries for which estimates are available. Further analyses of detailed vital statistics are required to assess geographical variation in the mortality patterns of this pandemic.