Dushoff Jonathan, Plotkin Joshua B, Viboud Cecile, Earn David J D, Simonsen Lone
Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA.
Am J Epidemiol. 2006 Jan 15;163(2):181-7. doi: 10.1093/aje/kwj024. Epub 2005 Nov 30.
Influenza is an important cause of mortality in temperate countries, but there is substantial controversy as to the total direct and indirect mortality burden imposed by influenza viruses. The authors have extracted multiple-cause death data from public-use data files for the United States from 1979 to 2001. The current research reevaluates attribution of deaths to influenza, by use of an annualized regression approach: comparing measures of excess deaths with measures of influenza virus prevalence by subtype over entire influenza seasons and attributing deaths to influenza by a regression model. This approach is more conservative in its assumptions than is earlier work, which used weekly regression models, or models based on fitting baselines, but it produces results consistent with these other methods, supporting the conclusion that influenza is an important cause of seasonal excess deaths. The regression model attributes an annual average of 41,400 (95% confidence interval: 27,100, 55,700) deaths to influenza over the period 1979-2001. The study also uses regional death data to investigate the effects of cold weather on annualized excess deaths.
在温带国家，流感是导致死亡的一个重要原因，但对于流感病毒造成的直接和间接死亡总负担，存在很大争议。作者从1979年至2001年美国公共使用数据文件中提取了多病因死亡数据。当前研究通过使用年化回归方法重新评估死亡归因于流感的情况：在整个流感季节，比较超额死亡指标与各亚型流感病毒流行指标，并通过回归模型将死亡归因于流感。与早期使用每周回归模型或基于拟合基线的模型的研究相比，该方法在假设上更为保守，但它得出的结果与其他方法一致，支持了流感是季节性超额死亡的一个重要原因这一结论。回归模型将1979 - 2001年期间平均每年41400例（95%置信区间：27100，55700）死亡归因于流感。该研究还使用区域死亡数据来调查寒冷天气对年化超额死亡的影响。
