Vaccination News Home Page                                            subscribe Vaccination NewsLetter

http://www.nytimes.com/2003/01/08/health/08FLU.html

Elderly Linked to a Marked Rise in Flu Deaths

By GINA KOLATA

he death rate from influenza rose markedly in the 1990's, federal scientists reported yesterday. The explanation, they said, is that a greater proportion of the population is elderly and thus particularly susceptible to flu.

There was an average of 36,000 flu deaths a year in the 1990's as compared to 20,000 a year in previous decades, the investigators, from the Centers for Disease Control and Prevention, reported in a paper being published today in the Journal of the American Medical Association.

Ninety percent of influenza deaths were in people 65 and older, said Dr. Keiji Fukuda, the principal researcher for the study. But Dr. Fukuda and his colleagues reported that the virus was especially deadly in people over 85, who might be up to 32 times more likely than those 65 to 69 to die from a flu infection.

Some questions were raised because the scientists used one statistical model to estimate influenza deaths in the 1990's and cited data for deaths in previous years that came from other studies using a different model.

They said that the different methods did not alter the conclusion that there were many more flu deaths in the 1990's

"The increase from 20,000 to 36,000 is a true increase," Dr. Fukuda said in a telephone briefing.

He added that the group had unpublished data, from applying the older statistical model to the 1990's data, that confirmed the recent increase in deaths.

Dr. Fukuda emphasized that the increase did not mean that the virus was deadlier, noting that the odds that it would kill a person of any particular age had not changed. Rather, he said, there are more people living to very old ages when they are extremely susceptible.

"We are seeing this tremendous increase in older people in the United States," Dr. Fukuda said. "People 85 and above is the fastest-growing group in the elderly population."

The paper did not reveal the details of the statistical analysis, nor did it provide influenza death rates for people of different ages. That, in particular, was a serious drawback, said Dr. David Freedman, a statistician at the University of California.

"It is startling to see a paper without age-specific death rates," Dr. Freedman said, because without them it is impossible to assess the scientists' conclusions that the increased deaths were solely because of more elderly people.

The researchers also concluded that there were large numbers of deaths among the elderly from another virus, respiratory syncytial virus, known as R.S.V. As many as 78 percent of the 11,000 people who died from R.S.V. each year were 65 and older, the researchers concluded.

In an editorial accompanying the paper, Dr. David M. Morens of the National Institute of Allergy and Infectious Diseases, said that many people who were particularly vulnerable to influenza did not get flu vaccines, the only method of preventing the disease. Many mistakenly believe that the vaccine, which is made from a killed virus, can give them the flu.

Over the last few years, Dr. Fukuda said, just 65 percent to 67 percent of people 65 and older were immunized. Even when they do get the vaccine, he added, it is less effective in the elderly than it is in younger people. And there is no vaccine to protect against R.S.V.

Dr. Morens was not optimistic about the immediate future.

The best hope, he said, is for improved flu vaccines and a vaccine for R.S.V. But for now, he said, doctors must do a better job of persuading older people to be vaccinated.

Vaccination News Home Page

ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.