ArticleEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin2019
Mortality attributable to seasonal influenza in Greece, 2013 to 2017: variation by type/subtype and age, and a possible harvesting effect.
Article in Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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28 citing papers in PubMed, 50 citations in OpenAlex.
- Attitudes, Motivation, and Predictors of Influenza Vaccination Uptake Among Primary Healthcare Professionals in Greece.Vaccines · 2026Article
- The mediating role of acute respiratory infections in temperature-mortality associations in the Czech Republic, 1982-2019.International journal of biometeorology · 2026Article
- Harvesting Effect and Extreme Temperature-Related Mortality in Italy.European journal of population = Revue europeenne de demographie · 2026Article
- Links between influenza epidemics, weather characteristics and all-cause mortality in the Czech Republic, 1982-2020.BMC public health · 2025Article
- Extreme temperatures, recent warming and seasonal influenza-linking human exposures to respiratory health in southern Germany.International archives of occupational and environmental health · 2025Article
- Decomposing life expectancy changes in Spain in the COVID-19 pandemic and post-pandemic periods.BMC public health · 2025Article
- Changes in influenza-associated excess mortality in China between 2012-2019 and 2020-2021: a population-based statistical modelling study.Infectious diseases of poverty · 2025Article
- Extreme Weather Events Interact With Local Contexts to Alter the Frequency of Firearm Violence and Child Maltreatment in Wayne County, Michigan.GeoHealth · 2025Article
- Direct and indirect burden of COVID-19 on mortality in Spain (2020 to 2022).BMC public health · 2025Article
- Compilation of open access time-series datasets for studying temperature-mortality association.Data in brief · 2024Article
- Multilayer factors associated with excess all-cause mortality during the omicron and non-omicron waves of the COVID-19 pandemic: time series analysis in 29 countries.BMC public health · 2024Article
- Influenza-Associated Excess Mortality by Age, Sex, and Subtype/Lineage: Population-Based Time-Series Study With a Distributed-Lag Nonlinear Model.JMIR public health and surveillance · 2023Article
- Greece since the 1960s: the mortality transition revisited: a joinpoint regression analysis.Journal of population research (Canberra, A.C.T.) · 2023Article
- ANTICIPATING RACIAL/ETHNIC MORTALITY DISPLACEMENT FROM COVID-19.American journal of epidemiology · 2022Article
- Underestimation in Reporting Excess COVID-19 Death Data in Poland during the First Three Pandemic Waves.International journal of environmental research and public health · 2022Article
- Short-term impact of ambient temperature on the incidence of influenza in Wuhan, China.Environmental science and pollution research international · 2022Article
- Evaluation of the Clinical Effectiveness of Oseltamivir for Influenza Treatment in Children.Frontiers in pharmacology · 2022Article
- An exploratory study to assess patterns of influenza- and pneumonia-related mortality among the Italian elderly.Human vaccines & immunotherapeutics · 2021Article
- Weight of risk factors for mortality and short-term mortality displacement during the COVID-19 pandemic.Journal of preventive medicine and hygiene · 2021Article
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
IntroductionEstimating the contribution of influenza to excess mortality in the population presents substantial methodological challenges.AimIn a modelling study we combined environmental, epidemiological and laboratory surveillance data to estimate influenza-attributable mortality in Greece, over four seasons (2013/14 to 2016/17), specifically addressing the lag dimension and the confounding effect of temperature.MethodsAssociations of influenza type/subtype-specific incidence proxies and of daily mean temperature with mortality were estimated with a distributed-lag nonlinear model with 30 days of maximum lag, separately by age group (all ages, 15-64 and ≥ 65 years old). Total and weekly deaths attributable to influenza and cold temperatures were calculated.ResultsOverall influenza-attributable mortality was 23.6 deaths per 100,000 population per year (95% confidence interval (CI): 17.8 to 29.2), and varied greatly between seasons, by influenza type/subtype and by age group, with the vast majority occurring in persons aged ≥ 65 years. Most deaths were attributable to A(H3N2), followed by influenza B. During periods of A(H1N1)pdm09 circulation, weekly attributable mortality to this subtype among people ≥ 65 years old increased rapidly at first, but then fell to zero and even negative, suggesting a mortality displacement (harvesting) effect. Mortality attributable to cold temperatures was much higher than that attributable to influenza.ConclusionsStudies of influenza-attributable mortality need to consider distributed-lag effects, stratify by age group and adjust both for circulating influenza virus types/subtypes and daily mean temperatures, in order to produce reliable estimates. Our approach addresses these issues, is readily applicable in the context of influenza surveillance, and can be useful for other countries.
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