peterosborn.com
home Blog at present experience skills contact downloads
 
Overview Severity
Map
Pandemic
History
Country
Analysis
Fatality Rate Estimates Analysis
Reports
Resources &information
Research and Estimation of Fatality Rates

Estimating fatality rates is far from easy because the quality and style of reporting varies greatly from country to country. This page brings together some of the main items of research work, and shows the unfolding picture.

The graphic on the right shows when the estimates were made, and how they compare.

The individual reports are listed below with links to the underlying documents

These are not my estimates, I am merely recording the estimates of those in the professional community..

Research and estimates of Fatality Rates:

  1. Estimate of Swline Flu death rate in Scotland reduced - 3 September 2009
    "...it is now estimated that up to 0.1% of people who become ill may die, down from the previous figure of 0.35%."

  2. PANDEMIC INFLUENZA A(H1N1)V IN NEW ZEALAND - 27 August 2009
    "Using the estimated denominator population of 323,400 symptomatic cases, this suggests a CFR of 0.005% (95% CI: 0.003–0.011). Interestingly, this estimate is in the range found for seasonal influenza in the population under the age of 65 years"

  3. Novel H1N1 Mortality Rate: Pitfalls in Calculation - 20 Aug 2009 B. Martin, MD
    "The hospitalization ratio for April 15 to July 24 was 0.114. As of August 20, there have been 522 deaths among 7,982 hospitalizations, for an in-hospital death ratio of 0.65. The case-fatality ratio in the United States is therefore 0.114 X 0.65, or 0.0075 (and the mortality rate is 0.75%)."

  4. Research published by the French Institute for Public Health Surveillance - 20 August, 2009
    "The overall 'computed CFR' (number of reported deaths per number of reported cases as of 16 July 2009) was 0.6%"

  5. Statement made by Malaysian Health Minister - 14 August, 2009
    "The death rate among those infected is 0.1% and this is not above the fatality rate in other countries"

  6. EPIDEMIOLOGICAL AND TRANSMISSIBILITY ANALYSIS OF INFLUENZA A(H1N1)V IN Peru - 13 August 2009
    "As of 17 July 2009, a total of 1,771 cases, involving eight deaths, have been confirmed. This yields a crude case fatality ratio of 0.33 %"

  7. Statement by Singapore Health Minister on Influenza A (H1N1) - 5 August, 2009
    "The data from North America suggested a case fatality rate of 0.37%"

  8. 2009 flu pandemic table - 31 July 2009
    A table containing the figures from the WHO Influenza A Situation Updates issued in July 2009 roughly three times a week, and, since 15 July, figures from ECDC (fatalities 1,152, cases 183,590) case fatality ratio= 0.63%

  9. ECDC Planning Assumptions for the First Wave of Pandemic A(H1N1) 2009 in Europe - 29 July, 2009
    "Case fatality ratio assumotion of 0.1% to 0.2% (cannot exclude up to 0.35%) of clinical cases"

  10. A/H1N1 influenza update - British Medical Journal - 23 July 2009
    "England’s chief medical officer, Liam Donaldson, said that the NHS should prepare for 0.1-0.35% of infected people dying"

  11. Research: A PRELIMINARY ANALYSIS OF INFLUENZA A(H1N1)V VIRUS INFECTION IN THAILAND - 15 July, 2009
    "A total of 690 confirmed cases with disease onset on or before 18 June gave rise to four deaths (as of 15 July) yielding a CFR of 0.58%!

  12. CDC Director's Update Brief, Novel 2009-H1N1 - 17 Jul 2009
    This "internal use only" document quotes specific fatality numbers and CFR for five age groups that range from 0.17% to 5.34%, and calculates out at a CFR of 0.73% for the population as a whole.

  13. Assessing the severity of the novel influenza A/H1N1 pandemic - 14 July, 2009 - British Medical Journal
    "At first sight, the data seem to imply that this new virus is relatively mild, with case fatality ratios around 0.5%, similar to the upper range of that seen for seasonal influenza"

  14. Panndemic Potential of a Strain of Influenza A (H1N1): Early Findings - 19 June 2009
    "Our estimates suggest that 23,000 (range 6000 to 32,000) individuals had been infected in Mexico by late April, giving an estimated case fatality ratio (CFR) of 0.4% (range: 0.3 to 1.8%) based on confirmed and suspected deaths reported to that time."

  15. WHO Situation Update, Novel Influenza A(H1N1) - 16 June 2009
    "Mexico 6241 laboratory confirmed cases, 108 deaths (CFR 1.3%), United States 17,855 laboratory confirmed cases, 45 deaths (CFR 0.3%), Canada 2978 confirmed human cases, 4 deaths (CFR 0.1%), Chile 1694 cases, 2 deaths (CFR 0.1%), Australia 1823 cases, no death, Overall case fatality rate 0.5%"

  16. ECDC Influenza A(H1N1)v Risk Assessment - 12 June, 2009
    "From the United States' experience about 7% of the confirmed cases have been hospitalised and the case fatality ratio is 0.2%"

One other research note was published on Eurosurveillance on 2 July 2009 - "THE EMERGING INFLUENZA PANDEMIC: ESTIMATING THE CASE FATALITY RATIO". I have not included this here because it aimed to model a notional "developed country" with assumptions partially derived from seasonal flu B, and produced four results by different methods with a range of 150:1. However, it is worth noting that the results published were all far below any of the estimates of fatality ratio published elsewhere.

 
 
 
   
   

© 2008, 2009 Peter G. Osborn