Mortality in Portugal very high over past 6 weeks

[Ronan Kelly]

Posted yesterday at 10:31
Mortality in Portugal increased in the last 3 weeks
Nuno Guedes

Mortality with numbers higher than expected. Flu and extreme cold can be the causes of this increase, but there is no certainty.
Three weeks ago there are more people dying in Portugal than would be expected for this time of year taking into account the average mortality of earlier years.

This excess mortality may be to blame the cold and a flu epidemic, but there is no certainty.

Data from the National Health Institute Dr. Ricardo Jorge (INSA), consulted by the TSF, reveal that from 2008-2009, when there was the last major flu epidemic coupled with intense cold, that there was so much death in the country.

In the last week for which data are available, 13-19 February, the mortality rate rose even more than the previous two weeks when the INSA has said that the weekly mortality figures was "above expectations".

For the third consecutive week the Surveillance System of Daily Mortality repeats the assertion, but this time adds that this mortality is observed especially among those over 65 years.

http://m.tsf.pt/m/newsArticle?contentId=2325134&page=1

From the latest surveillance bulletin, the majority of cases are Inf. A/H3 with 1 Inf B specimen.

The mortality chart is below;

http://www.insa.pt/sites/INSA/Portugues/Documents/Gripe2.pdf?cpp=1

Portuguese healthsite: http://www.dgs.pt/

[gsgs]

Re: Mortality in Portugal very high and increasing over past 3 weeks.

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19529

Vigil?ncia Di?ria da Mortalidade

http://www.eurosurveillance.org/images/dynamic/EE/V15N13/Mortality_Surveillance_Fig4.jpg

http://www.google.de/search?q=%22Vigil%C3%A2ncia+Di%C3%A1ria+da+Mortalidade%22&hl=de&gbv=2&gs_sm=3&gs_upl=2344l17750l0l18969l89l20l0l0l0l11l234l2061l1.11.2l15l0&um=1&tbm=isch&source=og&sa=N&tab=wi&oq=%22Vigil%C3%A2ncia+Di%C3%A1ria+da+Mortalidade%22&aq=f&aqi=&aql=

http://img688.imageshack.us/img688/7431/insasemana4vdm.gif

will they let me download the data and compare with other countries ?
hard to tell - I couldn't yet find it

[gsgs]

Re: Mortality in Portugal very high and increasing over past 3 weeks.

week 8:

[Ronan Kelly]

Re: Mortality in Portugal very high and increasing over past 3 weeks.

Down significantly this week but still plenty high.

ILI rates in 0-4 and other groups elevated.

http://www.insa.pt/sites/INSA/Portugues/Documents/Gripe2.pdf?cpp=1

I'm having trouble copying the pictures today.

Edit: added pictures today (4/9) -

[gsgs]

Re: Mortality in Portugal very high over past 6 weeks, ILI up significantly

[Ronan Kelly]

Re: Mortality in Portugal very high over past 6 weeks, ILI up significantly

Added Pics to yesterday's Report above.

[Ronan Kelly]

Re: Mortality in Portugal very high over past 6 weeks, ILI up significantly

http://www.insa.pt/sites/INSA/Portugues/Documents/Gripe2.pdf?cpp=1

[gsgs]

Re: Mortality in Portugal very high over past 6 weeks

~3.3% more deaths than in an average year

.. that would be ~80000 in USA ...

[Ronan Kelly]

Re: Mortality in Portugal very high over past 6 weeks

Week 11 report shows ILI down and mortality dropping back to expected levels.

http://www.insa.pt/sites/INSA/Portugues/Documents/Gripe2.pdf?cpp=1

[tetano]

Re: Mortality in Portugal very high over past 6 weeks

In three months, killed 1385 more people than in 2011 in the north


Between 1 January and 4 March this year, 1385 more people have died in the North than in period of 2011, said today the Health Administration of the region. The peak of mortality from all causes happened between week 13 and 19 February, while across the country took place a week later, shows the Administra??o Regional de Sa?de (ARS) of the North, that tomorrow will be presenting their epidemiological data on the seasonal flu.

This winter, the beginning of flu activity was more late than in previous seasons and the peak observed was 'greater magnitude' than what took place in two previous influenza seasons, ARS, citing the results of the regional programme ? influenza surveillance at national level there is a program coordinated by the Instituto Nacional de Sa?de Dr. Ricardo Jorge. According to the report, which resulted from this flu activity monitoring in emergency services took a peak in the week of 20 to 26 February and were more extreme age groups (children under 10 or fewer years or adults with 60 or more years) the most sought those services by flu syndrome. In 8.7% of cases there was no need for internment and 59 deaths were recorded for this reason. The Northern ARS notes that, according to the data released by the European Centre for disease prevention and control, there was an increase in mortality from all causes, especially in older people, in several European countries, 'is not yet possible to explain this excess mortality'.

..

http://www.publico.pt/Sociedade/em-tres-meses-morreram-mais-1385-pessoas-no-norte-1540806

[gsgs]

Re: Mortality in Portugal very high over past 6 weeks

http://ecdc.europa.eu/en/publications/Publications/120312-TER-Seasonal-influenza-risk-assessment.pdf

a rise in all-cause mortality has been reported by 3 EU countries plus Switzerland
for older age groups
EuroMOMO
page 8

Belgium,Netherlands,Portugal,Switzerland , upto week 8 , >65y
cold weather 29.Jan-12.Feb (but the winter was very mild in agerage)

http://webcache.googleusercontent.com/search?hl=en&gbv=2&gs_l=hp.3...2719l12312l0l12656l32l32l0l8l0l0l265l3875l0j22j2l24l0.frgbld.&q=cache:94CQo3jwidAJ:http://ecdc.europa.eu/en/publications/Publications/120312-TER-Seasonal-influenza-risk-assessment.pdf+%22in+belgium,+the+first+excesses%22&ct=clnk

Mortality from all causes
A number of countries undertake their own monitoring of death returns. In addition,
all-cause mortality by agegroup in 16 EU/EEA countries is monitored by the former
EuroMOMO project, using a common algorithm tostandardise excess mortality estimates
across Europe. Monitoring of early mortality data is useful for detecting theimpact on
mortality of unusual severe events like some influenza epidemics, heat waves, or cold
weather. During February 2012 (up to week 8), excess mortality was observed in the
age group >65 years in at least three EUcountries (Belgium, Netherlands, Portugal)
plus Switzerland. Both a period of cold weather that prevailed from 29 January to
12 February 2012 as well as influenza A(H3N2) may have contributed to the excess
of mortality from all causes during this period. During weeks 5, 6 and 7, a specific
all-cause excess of mortality was observed in Portugal. During and prior to this
period, Portugal experienced both low temperatures and the start of the influenza
epidemic period. As reported by the national surveillance systems, the ILI rate
increased above the baseline from week 4/2012 onwards, and as of week 8 was still
continuing to increase. At week 7/2012, influenza activity was medium with an increasing
trend.The dominant type of virus is the A(H3N2). A preliminary analysis shows that the
excess mortality was concentrated in the age group over 74 years of age. That trend
started in the northern region and then progressed to the south. Impact was observed
in the centre and in Lisbon and the Tagus valley, and there is informal information from
hospitals indicating an increase in hospitalisations [15]. In two or three other countries
an excessof mortality was also observed, especially among those older than 75 years
of age. It should be emphasised that this pattern has previously been observed with
A(H3N2) viruses, for example in Portugal in 2008−2009 [16]. In Belgium, the first excesses
of mortality were observed in December 2011 and in the beginning of January 2012
when winter weather conditions were moderate. An excess of mortality was then
reported in a period of coldweather for the period 29 January to 20 February 2012.
During this period the upper limit of mortality was exceeded in the general population,
with an excess of mortality observed in the general population of 11%. This effect was
more marked in the population aged 85 and older (19% over expected) and in the
population aged 65 to 84 years (9% over expected). The Be-MOMO model [17]
which, after corrections for delays of reporting, predicts excesses of mortality,
estimated an excess of mortality of 19% in the general population, 27% in the population
aged 85 and older, 17% in the population aged 65 to 84, and 8% in the population
aged under 65. Upto the date of this report, there is a large overlap between the
influenza epidemic and the cold wave so that no comment on the influenza epidemic
and mortality can be provided at this moment.
(Personal communication,Francoise Wuillaume, Scientific Institute of Public Health
(WIV-ISP), Brussels, Belgium, 6 March 2012.)

http://www.euromomo.eu/results/pooled.html

USA also has H3 this season, but low mortality

[Ronan Kelly]

Re: Mortality in Portugal very high over past 6 weeks

Tough Cuts In Portugal May Be Exacting High Toll
by Lauren Frayer
Apr 13, 2012 (All Things Considered) ? Portugal saw a spike in its death rate this winter, mostly among the elderly.
...
The government blames it on a nasty flu strain. But NGOs and opposition politicians say austerity measures are at least partly to blame. Fees for the public health system have doubled in most cases, and one-third of Portugal's hospitals are insolvent.
...
The new fees are especially burdensome for the elderly, many of whom survive on state pensions that average about $400 a month. Ana Figueiras runs the charity Cidadaos do Mundo, which cares for the elderly in Portugal.

"The fact that the health system is not free of charge anymore, the fact that old people, they live alone, a big percentage is poor, and even before, they would not go to the health system because they could not afford for transport," Figueiras says. "So imagine now ? they need to pay for transport, and they need to pay the fees. So people decide not to go."
...
Source: NPR
Copyright(c) 2012, NPR

http://www.northcountrypublicradio.org/news/npr/150580358/tough-cuts-in-portugal-may-be-exacting-high-toll