Influenza-associated mortality in Hungary between 2009/2010 and 2016/2017

Introduction: In recent years, a significant mortality peak has been observed several times during the first months in Hungary. So far, no mortality study clarified the connection between the mortality peaks and influenza with results comparable with findings from other countries. Aim: Calculation of the influenza-related number of death and excess mortality rates in Hungary for the period between 2009/10 and 2016/17, using the statistical package FluMONO. Method: We applied the FluMOMO methods, a multivariable time series model with all-cause mortality as outcome, and with influenza-activity and extreme temperature as explanatory variables adjusting for time trend and seasonality. As an indicator of weekly influenza-activity (IA), we used the percentage of consultations for influenza-like illness (ILI) in general practices. Results: According to our estimation, 1091, 2969, 4036, 2336, 2608, 6470, 51 and 5162 deaths were attributable to influenza epidemics in the 2009/10, 2010/11, 2011/12, 2012/13, 2013/14, 2014/15, 2015/16 and 2016/17 seasons, respectively. The average annual mortality excess rate per 100,000 inhabitants ranged between 0.5 and 52.7. These results are similar to those from other countries regarding their order of magnitude. The Hungarian extra mortality, however, tends to be higher than that in countries with higher vaccination rates. Conclusions: Influenza-related mortality tends to be lower in countries with higher vaccination rates. Increase in vaccination rates seems to be necessary in Hungary.