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Glob Heart. 2014 Sep;9(3):325-36. doi: 10.1016/j.gheart.2014.08.004. Epub 2014 Oct 31.

Global burden of influenza as a cause of cardiopulmonary morbidity and mortality.

Author information

Division of Pulmonary and Critical Care Medicine, Department of Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA; The Center for Environmental Medicine, Asthma and Lung Biology, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA. Electronic address:
Albert Einstein College of Medicine, Bronx, NY, USA.
Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.
Division of Pulmonary, Allergy and Critical Care Medicine, Emory University, Atlanta, GA, USA.


Severe acute respiratory infections, including influenza, are a leading cause of cardiopulmonary morbidity and mortality worldwide. Until recently, the epidemiology of influenza was limited to resource-rich countries. Emerging epidemiological reports characterizing the 2009 H1N1 pandemic, however, suggest that influenza exerts an even greater toll in low-income, resource-constrained environments where it is the cause of 5% to 27% of all severe acute respiratory infections. The increased burden of disease in this setting is multifactorial and likely is the result of higher rates of comorbidities such as human immunodeficiency virus, decreased access to health care, including vaccinations and antiviral medications, and limited healthcare infrastructure, including oxygen therapy or critical care support. Improved global epidemiology of influenza is desperately needed to guide allocation of life-saving resources, including vaccines, antiviral medications, and direct the improvement of basic health care to mitigate the impact of influenza infection on the most vulnerable populations.

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