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William W. Thompson, PhD, Matthew R. Moore, MD, MPH, Eric Weintraub, MPH, Po-Yung Cheng, PhD, Xiaoping Jin, MPH, Carolyn B. Bridges, MD, Joseph S. Bresee, MD, MPH and David K. Shay, MD, MPH

William W. Thompson, Po-Yung Cheng, Xiaoping Jin, Carolyn B. Bridges, Joseph S. Bresee, and David K. Shay are with the Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA. Matthew R. Moore is with the Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta. Eric Weintraub is with the Immunization Safety Office, Office of the Chief Science Officer, Centers for Disease Control and Prevention, Atlanta.

Correspondence: Requests for reprints should be sent to William W. Thompson, PhD, Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, MS A32, 1600 Clifton Rd NE, Atlanta, GA, 30333 (e-mail: wct2{at}cdc.gov).

Most estimates of US deaths associated with influenza circulation have been similar despite the use of different approaches. However, a recently published estimate suggested that previous estimates substantially overestimated deaths associated with influenza, and concluded that substantial numbers of deaths during a future pandemic could be prevented because of improvements in medical care.

We reviewed the data sources and methods used to estimate influenza-associated deaths. We suggest that discrepancies between the recent estimate and previous estimates of the number of influenza-associated deaths are attributable primarily to the use of different outcomes and methods. We also believe that secondary bacterial infections will likely result in substantial morbidity and mortality during a future influenza pandemic, despite medical progress.