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Clinical Infectious Diseases
Epidemiology of 2009 Pandemic Influenza A (H1N1) Deaths in the United States, April?July 2009
1. Ashley L. Fowlkes1,
2. Paul Arguin2,
3. Matthew S. Biggerstaff1,
4. Jacqueline Gindler3,
5. Dianna Blau4,
6. Seema Jain1,
7. Roseline Dhara1,
8. Joe McLaughlin5,
9. Elizabeth Turnipseed6,
10. John J. Meyer7,
11. Janice K. Louie8,
12. Alan Siniscalchi9,
13. Janet J. Hamilton10,
14. Ariane Reeves11,
15. Sarah Y. Park12,
16. Deborah Richter13,
17. Matthew D. Ritchey14,
18. Noelle M. Cocoros15,
19. David Blythe16,
20. Susan Peters17,
21. Ruth Lynfield18,
22. Lesha Peterson19,
23. Jannifer Anderson20,
24. Zack Moore21,
25. Robin Williams22,
26. Lisa McHugh23,
27. Carmen Cruz24,
28. Christine L. Waters25,
29. Shannon L. Page26,
30. Christie K. McDonald27,
31. Meredith Vandermeer28,
32. Kirsten Waller29,
33. Utpala Bandy30,
34. Timothy F. Jones31,
35. Lesley Bullion32,
36. Valoree Vernon33,
37. Kathryn H. Lofy34,
38. Thomas Haupt35, and
39. Lyn Finelli1
+ Author Affiliations
1.
1Influenza Division, National Center for Immunization and Respiratory Diseases
2.
2Division of Parasitic Diseases, National Center for Zoonotic and Vector-borne Diseases
3.
3National Center on Birth Defects and Developmental Disabilities
4.
4Division of Viral and Rickettsial Diseases, National Center for Zoonotic and Vector-borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
5.
5Alaska Department of Health and Social Services, Anchorage, Alaska
6.
6Alabama Department of Public Health, Montgomery, Alabama
7.
7Arizona Department of Health Services, Phoenix, Arizona
8.
8California Department of Health Services, Richmond, California
9.
9Connecticut Department of Public Health, Hartford, Connecticut
10.
10Florida Department of Health, Tallahassee, Florida
11.
11Georgia Division of Public Health, Atlanta, Georgia
12.
12Hawai'i State Department of Health, Honolulu, Hawaii
13.
13Illinois Department of Public Health, Springfield, Illinois
14.
14Indiana State Department of Health, Indianapolis, Indiana
15.
15Massachusetts Department of Public Health, Boston, Massachusetts
16.
16Maryland Department of Health and Mental Hygiene, Baltimore, Maryland
17.
17Michigan Department of Community Health, Lansing, Michigan
18.
18Minnesota Department of Health, St. Paul, Minnesota
19.
19Missouri Department of Health and Senior Services, Jefferson City, Missouri
20.
20Mississippi State Department of Health, Jackson, Mississippi
21.
21North Carolina Department of Health and Human Services, Raleigh, North Carolina
22.
22Nebraska Department of Health and Human Services, Lincoln, Nebraska
23.
23New Jersey Department of Health and Senior Services, Trenton, New Jersey
24.
24Nevada Dept of Health & Human Services, Carson City, Nevada
25.
25New York State Department of Health, Albany, New York
26.
26Ohio Department of Health, Columbus, Ohio
27.
27Oklahoma State Department of Health, Oklahoma City, Oklahoma
28.
28Oregon Public Health Division, Portland, Oregon
29.
29Pennsylvania Department of Health, Harrisburg, Pennsylvania
30.
30Rhode Island Department of Health, Providence, Rhode Island
31.
31Tennessee Department of Health, Nashville, Tennessee
32.
32Texas Department of State Health Services, Austin, Texas
33.
33Utah Department of Health, Salt Lake City, Utah
34.
34Washington State Department of Health, Shoreline, Washington
35.
35Wisconsin Department of Health Services, Madison, Wisconsin
1. Correspondence: Ashley L. Fowlkes, MPH, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, MS A32, Atlanta, GA 30329 (afowlkes@cdc.gov).
Abstract
During the spring of 2009, pandemic influenza A (H1N1) virus (pH1N1) was recognized and rapidly spread worldwide. To describe the geographic distribution and patient characteristics of pH1N1-associated deaths in the United States, the Centers for Disease Control and Prevention requested information from health departments on all laboratory-confirmed pH1N1 deaths reported from 17 April through 23 July 2009. Data were collected using medical charts, medical examiner reports, and death certificates. A total of 377 pH1N1-associated deaths were identified, for a mortality rate of .12 deaths per 100 000 population. Activity was geographically localized, with the highest mortality rates in Hawaii, New York, and Utah. Seventy-six percent of deaths occurred in persons aged 18?65 years, and 9% occurred in persons aged ≥65 years. Underlying medical conditions were reported for 78% of deaths: chronic lung disease among adults (39%) and neurologic disease among children (54%). Overall mortality associated with pH1N1 was low; however, the majority of deaths occurred in persons aged <65 years with underlying medical conditions.
Epidemiology of 2009 Pandemic Influenza A (H1N1) Deaths in the United States, April?July 2009
1. Ashley L. Fowlkes1,
2. Paul Arguin2,
3. Matthew S. Biggerstaff1,
4. Jacqueline Gindler3,
5. Dianna Blau4,
6. Seema Jain1,
7. Roseline Dhara1,
8. Joe McLaughlin5,
9. Elizabeth Turnipseed6,
10. John J. Meyer7,
11. Janice K. Louie8,
12. Alan Siniscalchi9,
13. Janet J. Hamilton10,
14. Ariane Reeves11,
15. Sarah Y. Park12,
16. Deborah Richter13,
17. Matthew D. Ritchey14,
18. Noelle M. Cocoros15,
19. David Blythe16,
20. Susan Peters17,
21. Ruth Lynfield18,
22. Lesha Peterson19,
23. Jannifer Anderson20,
24. Zack Moore21,
25. Robin Williams22,
26. Lisa McHugh23,
27. Carmen Cruz24,
28. Christine L. Waters25,
29. Shannon L. Page26,
30. Christie K. McDonald27,
31. Meredith Vandermeer28,
32. Kirsten Waller29,
33. Utpala Bandy30,
34. Timothy F. Jones31,
35. Lesley Bullion32,
36. Valoree Vernon33,
37. Kathryn H. Lofy34,
38. Thomas Haupt35, and
39. Lyn Finelli1
+ Author Affiliations
1.
1Influenza Division, National Center for Immunization and Respiratory Diseases
2.
2Division of Parasitic Diseases, National Center for Zoonotic and Vector-borne Diseases
3.
3National Center on Birth Defects and Developmental Disabilities
4.
4Division of Viral and Rickettsial Diseases, National Center for Zoonotic and Vector-borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
5.
5Alaska Department of Health and Social Services, Anchorage, Alaska
6.
6Alabama Department of Public Health, Montgomery, Alabama
7.
7Arizona Department of Health Services, Phoenix, Arizona
8.
8California Department of Health Services, Richmond, California
9.
9Connecticut Department of Public Health, Hartford, Connecticut
10.
10Florida Department of Health, Tallahassee, Florida
11.
11Georgia Division of Public Health, Atlanta, Georgia
12.
12Hawai'i State Department of Health, Honolulu, Hawaii
13.
13Illinois Department of Public Health, Springfield, Illinois
14.
14Indiana State Department of Health, Indianapolis, Indiana
15.
15Massachusetts Department of Public Health, Boston, Massachusetts
16.
16Maryland Department of Health and Mental Hygiene, Baltimore, Maryland
17.
17Michigan Department of Community Health, Lansing, Michigan
18.
18Minnesota Department of Health, St. Paul, Minnesota
19.
19Missouri Department of Health and Senior Services, Jefferson City, Missouri
20.
20Mississippi State Department of Health, Jackson, Mississippi
21.
21North Carolina Department of Health and Human Services, Raleigh, North Carolina
22.
22Nebraska Department of Health and Human Services, Lincoln, Nebraska
23.
23New Jersey Department of Health and Senior Services, Trenton, New Jersey
24.
24Nevada Dept of Health & Human Services, Carson City, Nevada
25.
25New York State Department of Health, Albany, New York
26.
26Ohio Department of Health, Columbus, Ohio
27.
27Oklahoma State Department of Health, Oklahoma City, Oklahoma
28.
28Oregon Public Health Division, Portland, Oregon
29.
29Pennsylvania Department of Health, Harrisburg, Pennsylvania
30.
30Rhode Island Department of Health, Providence, Rhode Island
31.
31Tennessee Department of Health, Nashville, Tennessee
32.
32Texas Department of State Health Services, Austin, Texas
33.
33Utah Department of Health, Salt Lake City, Utah
34.
34Washington State Department of Health, Shoreline, Washington
35.
35Wisconsin Department of Health Services, Madison, Wisconsin
1. Correspondence: Ashley L. Fowlkes, MPH, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, MS A32, Atlanta, GA 30329 (afowlkes@cdc.gov).
Abstract
During the spring of 2009, pandemic influenza A (H1N1) virus (pH1N1) was recognized and rapidly spread worldwide. To describe the geographic distribution and patient characteristics of pH1N1-associated deaths in the United States, the Centers for Disease Control and Prevention requested information from health departments on all laboratory-confirmed pH1N1 deaths reported from 17 April through 23 July 2009. Data were collected using medical charts, medical examiner reports, and death certificates. A total of 377 pH1N1-associated deaths were identified, for a mortality rate of .12 deaths per 100 000 population. Activity was geographically localized, with the highest mortality rates in Hawaii, New York, and Utah. Seventy-six percent of deaths occurred in persons aged 18?65 years, and 9% occurred in persons aged ≥65 years. Underlying medical conditions were reported for 78% of deaths: chronic lung disease among adults (39%) and neurologic disease among children (54%). Overall mortality associated with pH1N1 was low; however, the majority of deaths occurred in persons aged <65 years with underlying medical conditions.
