Excess winter mortality: influenza or cold stress? Observational study

doi:10.1136/bmj.324.7329.89

BMJ 2002;324:89-90 ( 12 January )

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Excess winter mortality: influenza or cold stress? Observational study

G C Donaldson, senior research associate, W R Keatinge, emeritus professor.

Medical Sciences, Division of Biomedical Sciences, Queen Mary and Westfield College, London E1 4NS

Correspondence to: W R Keatinge w.r.keatinge@qmw.ac.uk

The first 150 words of the full text of this article appear below.

Epidemics of influenza are associated with increases in mortality and morbidity.¹ Health professionals and the media, therefore,have often focused their attention on influenza as a cause ofincreased mortality and demands on health services in winter.Cold weather alone causes striking short term increases in mortality,mainly from thrombotic and respiratory disease.² Non-thermalseasonal factors such as diet may also affect mortality.³ Theincreases in mortality are greater in London than in regions surveyedin continental Europe.⁴ We used multiple regression to assessthe proportion of excess winter mortality that was attributableto influenza in south eastEngland.

Methods and results

A daily record was kept of deaths that occurred in south east England from 1970 to 1999 for all causes and for influenza.We obtained daily estimates of population by linear regressionfrom mid-year values (17.2×10⁶ in 1971 and 18.4×10⁶ in 1998) and used them to calculate mortalities. We used themaximum and minimum . . . [Full text of this article]

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Rapid Responses:

Read all Rapid Responses

Method of calculation of influenza attributed mortality: Douglas M Fleming, et al.
bmj.com, 6 Mar 2002 [Full text]
Authors' reply: G C Donaldson, et al.
bmj.com, 3 May 2002 [Full text]