Pediatric Influenza-Associated Deaths in New York State: Death Certificate Coding and Comparison to Laboratory-Confirmed DeathsReport as inadecuate

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Influenza Research and TreatmentVolume 2012 2012, Article ID 397890, 7 pages

Research Article

Bureau of Communicable Disease Control, New York State Department of Health, Corning Tower Room 651, Albany, Empire State Plaza, NY 12237, USA

Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, NY 12144, USA

Department of Family Medicine, Albany Medical College, 47 New Scotland Avenue, MC-34, Albany, NY 12208, USA

Received 15 June 2012; Accepted 7 August 2012

Academic Editor: Gio Baracco

Copyright © 2012 Dina Hoefer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Surveillance for laboratory-confirmed influenza-associated deaths in children is used to monitor the severity of influenza at the population level and to inform influenza prevention and control policies. The goal of this study was to better estimate pediatric influenza mortality in New York state NYS. Methods. Death certificate data were requested for all passively reported deaths and any pneumonia and influenza P&I coded pediatric deaths occurring between October 2004 and April 2010, excluding New York City NYC residents. A matching algorithm and capture-recapture analysis were used to estimate the total number of influenza-associated deaths among NYS children. Results. Thirty-four laboratory-confirmed influenza-associated pediatric deaths were reported and 67 death certificates had a P&I coded death; 16 deaths matched. No laboratory-confirmed influenza-associated death had a pneumonia code and no pneumonia coded deaths had laboratory evidence of influenza infection in their medical record. The capture-recapture analysis estimated between 38 and 126 influenza-associated pediatric deaths occurred in NYS during the study period. Conclusion. Passive surveillance for influenza-associated deaths continues to be the gold standard methodology for characterizing influenza mortality in children. Review of death certificates can complement but not replace passive reporting, by providing better estimates and detecting any missed laboratory-confirmed deaths.

Author: Dina Hoefer, Bryan Cherry, Marilyn Kacica, Kristi McClamroch, and Kimberly Kilby



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