Influenza associated mortality in the subtropics and tropics: Results from three Asian cities

Lin Yang, Stefan Ma, Ping Yan Chen, Jian Feng He, King Pan Chan, Angela Chow, Chun Quan Ou, Ai Ping Deng, Anthony J. Hedley, Chit Ming Wong, J. S.Malik Peiris

Research output: Journal article publicationJournal articleAcademic researchpeer-review

53 Citations (Scopus)


Influenza has been well documented to significantly contribute to winter increase of mortality in the temperate countries, but its severity in the subtropics and tropics was not recognized until recently and geographical variations of disease burden in these regions remain poorly understood. In this study, we applied a standardized modeling strategy to the mortality and virology data from three Asian cities: subtropical Guangzhou and Hong Kong, and tropical Singapore, to estimate the disease burden of influenza in these cities. We found that influenza was associated with 10.6, 13.4 and 8.3 deaths per 100,000 population in Guangzhou, Hong Kong and Singapore, respectively. The annual rates of excess deaths in the elders were estimated highest in Guangzhou and lowest in Singapore. The excess death rate attributable to A/H1N1 subtype was found slightly higher than the rates attributable to A/H3N2 during the study period of 2004-2006 based on the data from Hong Kong and Guangzhou. Our study revealed a geographical variation in the disease burden of influenza in these subtropical and tropical cities. These results highlight a need to explore the determinants for severity of seasonal influenza.
Original languageEnglish
Pages (from-to)8909-8914
Number of pages6
Issue number48
Publication statusPublished - 8 Nov 2011
Externally publishedYes


  • Cardiorespiratory
  • Influenza
  • Mortality
  • Subtropics
  • Tropics

ASJC Scopus subject areas

  • Molecular Medicine
  • Immunology and Microbiology(all)
  • veterinary(all)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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