Flu Deaths Are On The Rise- Influenza Is A Growing Problem, And An Aging Population Is Part Of The Reason

Deaths associated with influenza have increased substantially in the past two decades in the United States, according to an article published in January in the Journal of the American Medical Association (JAMA).


Using new and improved statistical models, scientists at the Centers for Disease Control estimate that an average of 36,000 people (up from 20,000 in previous estimates) die from influenza-related complications each year in the United States.

In addition, about 11,000 people die per year from respiratory syncytial virus (RSV), a virus that causes upper and lower respiratory tract infections primarily in young children and older adults. The study demonstrates that most deaths caused by RSV occur in the elderly.

“We’ve known for some time that influenza and RSV have a profound impact on public health,” said CDC Director Dr. Julie Gerberding. “However, these data indicate that the magnitude of the problem is larger than we once thought.”

Here’s a sobering thought, doctors say: drug breakthroughs in the mid-1990s helped reduce U.S. AIDS deaths from 51,000 in 1995 to about 15,000 in 2001. But the main weapon doctors have against flu — a vaccine — has proven relatively ineffective in the most susceptible population: people 65 and older.

The result? Flu now claims more lives annually than AIDS — more than double, in fact.

Crunching the Numbers

Dr. William W. Thompson, along with his colleagues at the CDC, developed a statistical model using national data on deaths caused by influenza and RSV and viral surveillance data to estimate the number of influenza and RSV-related deaths in the United States by age group for the 1990-91 and 1998-99 seasons.

The researchers found that the annual estimates of influenza-associated deaths increased significantly between the 1976-77 and 1998-99 seasons for the three categories of death they studied: underlying pneumonia and influenza, underlying respiratory and circulatory, and all causes.

For the 1990-91 through 1998-99 seasons, the greatest average numbers of deaths were associated with influenza A (H3N2) viruses, followed by RSV, influenza B, and influenza A (H1N1). Influenza viruses and RSV, respectively, were associated with annual averages of 8,097 and 2,707 underlying pneumonia and influenza deaths, 36,155 and 11,321 underlying respiratory and circulatory deaths, and 51,203 and 17,358 all-cause deaths.

The researchers also found that, for underlying respiratory and circulatory deaths, 90{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of influenza deaths and 78{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of RSV-associated deaths occurred among people 65 years or older. Influenza was associated with more deaths than RSV in all age groups except for in children younger than 1 year old. On average, influenza was associated with 3times as many deaths as RSV.

“Our results indicate that U.S. influenza-associated deaths have increased substantially from the 1976-77 through 1998-99 seasons,” wrote the authors.
“We believe this is explained in part by the aging of the U.S. population. Between 1976 and 1999, the number of persons 85 years or older doubled in the United States. We found that persons in this age group were 16 times more likely to die of an influenza-associated, all-cause death than persons aged 65 to 69 years during a period in which all-cause, age-specific death rates have remained stable.”

Vaccinations a Key Weapon

The researchers noted that, “although the importance of RSV among young children is well-recognized, we found that more than 78{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of RSV-associated underlying respiratory and circulatory deaths occurred among persons 65 years or older. This finding highlights the need for an effective RSV vaccine in both young children and elderly persons.”

They added that vaccinating elderly persons will continue to be the primary strategy for preventing influenza-associated deaths.

The CDC recommends influenza vaccinations for those at high risk for complications from the flu, including individuals age 65 and older and others with chronic medical conditions such as heart and lung disease and diabetes, as well as health care workers.

All other groups, including household members of high-risk persons, healthy people ages 50 to 64, and others who wish to decrease their risk of getting the flu, should begin receiving vaccinations each November. The CDC also encourages children aged 6 months to 23 months old to receive influenza vaccinations.
The U.S. Department of Health and Human Services (DHHS) recently announced a new policy that allows nursing homes, hospitals, and home health agencies that serve Medicare and Medicaid beneficiaries to remind patients when it is time for an annual vaccination and ask if they want to receive a shot.

“More high-risk people than ever before are getting their flu shots, and that is certainly good news,” Dr. Gerberding said. “However, it is crucial that we continue to get the message out regarding the importance of high-risk people getting their flu shots each and every year.”

Flu season usually peaks in the United States sometime between December and March. So far this year only a few states have reported widespread activity.
However, “it is still quite early in our influenza season, and we expect activity to pick up in the coming weeks,” said CDC epidemiologist Dr. Keiji Fukuda. “It is definitely not too late to get your flu shot if you have not received one.”

Information for this article was made available by the American Medical Association and the Centers for Disease Control.

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