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  • Title: Influenza-associated mortality in Hong Kong.
    Author: Wong CM, Chan KP, Hedley AJ, Peiris JS.
    Journal: Clin Infect Dis; 2004 Dec 01; 39(11):1611-7. PubMed ID: 15578360.
    Abstract:
    BACKGROUND: The impact of influenza on mortality in countries in subtropical and tropical regions is poorly quantified. Estimation of influenza-related illness in warm-climate regions is more difficult, because the seasonality of virus circulation is less well-defined. Partly as a result of these factors, influenza vaccine is grossly underutilized in the tropics, even for individuals >or=65 years of age. METHODS: Weekly numbers of deaths were modeled by Poisson regression, and excess deaths attributable to influenza in Hong Kong were estimated for 1996-1999. Comparison of weekly mortality during periods of influenza predominance and periods of low influenza activity was used to derive an alternative estimate of influenza-associated mortality. RESULTS: Estimates derived from the Poisson model indicated that influenza resulted in 7.3 deaths per 100,000 population per year (95% confidence interval [CI], 3.1-11.4) from cardiorespiratory disease among individuals aged 40-65 years and 102.0 deaths per 100,000 per population per year (95% CI, 61.2-142.7) among individuals aged >or=65 years. Although respiratory diseases accounted for the majority of influenza-related deaths, influenza also contributed to 13.8% (95% CI, 4.8%- 22.7%) and 5.3% (95% CI, 1.2%-9.3%) of deaths related to ischemic heart disease. CONCLUSION: Influenza is associated with deaths due to ischemic heart disease as well from respiratory diseases. Overall influenza-associated mortality in a region with a warm climate, such as Hong Kong, is comparable with that documented in temperate regions. The need for influenza vaccination in tropical regions needs to be reassessed.
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