Estimating influenza-related excess mortality and reproduction numbers for seasonal influenza in Norway, 1975–2004

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Abstract
SUMMARY: Influenza can be a serious, sometimes deadly, disease, especially for people in high-risk groups such as the elderly and patients with underlying, severe disease. In this paper we estimated the influenza-related excess mortality in Norway for 1975–2004, comparing it with dominant virus types and estimates of the reproduction number. Analysis was done using Poisson regression, explaining the weekly all-cause mortality by rates of reported influenza-like illness, together with markers for seasonal and year-to-year variation. The estimated excess mortality was the difference between the observed and predicted mortality, removing the influenza contribution from the prediction. We estimated the overall influenza-related excess mortality as 910 deaths per season, or 2·08% of the overall deaths. Age-grouped analyses indicated that the major part of the excess mortality occurred in the ⩾65 years age group, but that there was also a significant contribution to mortality in the 0–4 years age group. Estimates of the reproduction number R, ranged from about 1 to 1·69.