Beijing Center for Disease Prevention and Control, Beijing, China.
Beijing Research Center for Preventive Medicine, Beijing, China.
Influenza Other Respir Viruses. 2018 Jan;12(1):88-97. doi: 10.1111/irv.12515. Epub 2017 Dec 2.
Data about influenza mortality burden in northern China are limited. This study estimated mortality burden in Beijing associated with seasonal influenza from 2007 to 2013 and the 2009 H1N1 pandemic.
We estimated influenza-associated excess mortality by fitting a negative binomial model using weekly mortality data as the outcome of interest with the percent of influenza-positive samples by type/subtype as predictor variables.
From 2007 to 2013, an average of 2375 (CI 1002-8688) deaths was attributed to influenza per season, accounting for 3% of all deaths. Overall, 81% of the deaths attributed to influenza occurred in adults aged ≥65 years, and the influenza-associated mortality rate in this age group was higher than the rate among those aged <65 years (113.6 [CI 49.5-397.4] versus 4.4 [CI 1.7-18.6] per 100 000, P < .05). The mortality rate associated with the 2009 H1N1 pandemic in 2009/2010 was comparable to that of seasonal influenza during the seasonal years (19.9 [CI 10.4-33.1] vs 17.2 [CI 7.2-67.5] per 100 000). People aged <65 years represented a greater proportion of all deaths during the influenza A(H1N1)pdm09 pandemic period than during the seasonal epidemics (27.0% vs 17.7%, P < .05).
Influenza is an important contributor to mortality in Beijing, especially among those aged ≥65 years. These results support current policies to give priority to older adults for seasonal influenza vaccination and help to define the populations at highest risk for death that could be targeted for pandemic influenza vaccination.
中国北方地区流感死亡负担的数据有限。本研究旨在评估 2007 年至 2013 年北京季节性流感和 2009 年 H1N1 大流行期间的流感相关死亡负担。
我们通过拟合负二项模型,使用每周死亡率数据作为感兴趣的结果,以各型别/亚型流感阳性样本的百分比作为预测变量,估计流感相关的超额死亡率。
2007 年至 2013 年,每个季节平均有 2375 例(95%CI,1002-8688)死亡归因于流感,占总死亡人数的 3%。总体而言,81%的流感相关死亡发生在年龄≥65 岁的成年人中,该年龄组的流感相关死亡率高于<65 岁年龄组(113.6 [95%CI,49.5-397.4] 比 4.4 [95%CI,1.7-18.6] /10 万,P<0.05)。2009/2010 年 2009 年 H1N1 大流行的死亡率与季节性年份的季节性流感相当(19.9 [95%CI,10.4-33.1] 比 17.2 [95%CI,7.2-67.5] /10 万)。在 A(H1N1)pdm09 流感大流行期间,<65 岁人群在所有死亡人数中的比例高于季节性流行期间(27.0%比 17.7%,P<0.05)。
流感是北京地区死亡的一个重要原因,特别是在年龄≥65 岁的人群中。这些结果支持目前为季节性流感接种疫苗优先考虑老年人的政策,并有助于确定最有可能死于流感的高危人群,以便为大流行流感接种疫苗。