2009 Pandemic Influenza A (H1N1) Fatal Case Series Investigation Team members are in Appendix.
Epidemiology of influenza A (H1N1)pdm09-associated deaths in the United States, September–October 2009
Article first published online: 16 JUL 2012
© 2012 Blackwell Publishing Ltd
Influenza and Other Respiratory Viruses
Volume 6, Issue 6, pages e169–e177, November 2012
How to Cite
Regan, J., Fowlkes, A., Biggerstaff, M., Jhung, M. A., Gindler, J., Kennedy, E., Fields, V., Finelli, L. and for the 2009 Pandemic Influenza A (H1N1) Fatal Case Series Investigation Team (2012), Epidemiology of influenza A (H1N1)pdm09-associated deaths in the United States, September–October 2009. Influenza and Other Respiratory Viruses, 6: e169–e177. doi: 10.1111/j.1750-2659.2012.00408.x
- Issue published online: 16 OCT 2012
- Article first published online: 16 JUL 2012
- Accepted 5 May 2012. Published Online 16 July 2012.
- H1N1pdm09 subtype;
- influenza A virus;
- influenza antiviral agents;
- influenza fatal cases
Please cite this paper as: Regan et al. (2012) Epidemiology of influenza A (H1N1)pdm09-associated deaths in the United States, September–October 2009. Influenza and Other Respiratory Viruses 6(601), e169–e177.
Background From April to July 2009, the United States experienced a wave of influenza A (H1N1)pdm09 virus (H1N1pdm09) infection. The majority of the deaths during that period occurred in persons <65 years of age with underlying medical conditions.
Objective To describe the epidemiology of H1N1pdm09-associated deaths in the US during the fall of 2009.
Methods We collected demographic, medical history, and cause of death information on a nationally representative, stratified random sample of 323 H1N1pdm09-associated deaths that occurred during September 1–October 31, 2009.
Results Data were available for 302/323 (93%) deaths. Most cases (74%) were 18–64 years of age and had ≥1 underlying medical condition (72%). Among cases aged <18 years, 16/43 (37%) had a chronic lung disease, and 15/43 (35%) a neurological disorder; among cases aged ≥18 years, 94/254 (37%) had a chronic lung disease and 84/254 (33%) had a metabolic disorder. The median number of days between symptom onset and death was six among children (range, 1–48) and 12 among adults (range, 0–109). Influenza antiviral agents were prescribed for 187/268 (70%) of cases, but only 48/153 (31%) received treatment within 2 days of illness onset.
Conclusions The characteristics of H1N1pdm09 deaths identified during the fall of 2009 were similar to those occurring April–July 2009. While most cases had conditions that were known to increase the risk for severe outcomes and were recommended to receive antiviral therapy, a minority of cases received antivirals early in the course of illness.