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Volume 20, Number 5—May 2014

Dispatch

Influenza-associated Hospitalizations and Deaths, Costa Rica, 2009–2012

Guiselle Guzman Saborío, Alexey Clara, Antonio Garcia, Fabio Quesada, Rakhee Palekar, Percy Minaya, Marvin Cervantes, Mariel Lopez, Jenny Lara, Jorge Jara, Natalia Blanco, Joseph Bresee, Marc-Alain Widdowson, and Eduardo Azziz-Baumgartner
Author affiliations: Caja Costarricense del Seguro Social, San Jose, Costa Rica (G. Guzman Saborío , A. Garcia, F. Quesada, M. Cervantes); US Centers for Disease Control Central American Regional, Guatemala City, Guatemala (A. Clara); Pan American Health Organization, Washington, DC, USA (R. Palekar); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (R. Palekar, J. Bresee, M-A Widdowson, E. Azziz-Baumgartner); Training of Epidemiology and Public Health Intervention Network, Guatemala City (P. Minaya); Instituto Costarricense de Investigación y Enseñanza en Nutrición y en Salud, San Jose (M. Lopez, J. Lara); Universidad del Valle de Guatemala, Guatemala City (J. Jara, N. Blanco)

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Table

Influenza-associated severe acute respiratory infections hospitalizations and deaths in Costa Rica, 2009–2012

Year and age group, y Population size No. hospitalizations for SARI† No. deaths‡ No. (%) influenza-positive respiratory samples§ Influenza-associated hospitalizations
Influenza-associated 
deaths
No. 
(95% CI)¶ Rate# 
(95% CI)¶ No. 
(95% CI)¶ Rate** 
(95% CI)¶
2009
<5 356,266 2,196 17 194/1,349 (14) 436 
(336–535) 1.2 
(0.9–1.5) 2 
(1–3) 0.6 
(0.3–0.8)
5–59 3,700,000 2,998 328 1,608/3,653 (44) 1,852 
(1,737–1,977) 0.5 
(0.47–0.53) 115 
(95–138) 3.1 
(2.6–3.7)
≥60
415,210
2,797
1,042
265/1,306 (20)
657 
(513–804)
1.6 
(1.2–1.9)

171 
(112–231)
41 
(27–56)
2010
<5 350,902 2,583 27 185/1,230 (15) 529 
(366–688) 1.5 
(1.0–2.0) 4 
(2–4) 1.1 
(0.6–1.1)
5–59 3,800,000 2,595 317 507/1,472 (34) 1,185 
(993–1,378) 0.3 
(0.3–0.4) 107 
(78–133) 2.8 
(2.1–3.5)
≥60
444,981
3,073
1,172
161/879 (18)
742 
(467–1,019)
1.7 
(1.0–2.3)

229 
(123–340)
51 
(28–76)
2011
<5 347,888 2,204 32 48/1,797 (3) 114 
(67–161) 0.3 
(0.2–0.5) 0 0
5–59 3,800,000 2,224 330 40/700 (6) 174 
(72–286) 0.05 
(0.02–0.08) 20 
(6–38) 0.5
(0.2–1.0)
≥60
463,100
3,049
1,183
27/639 (4)
163 
(53–279)
0.4 
(0.1–0.6)

52 
(12–96)
11 
(3–21)
2012
<5 344,577 1,927 22 79/1,526 (5) 164 
(109–216) 0.5 
(0.3–0.6) 1 
(0–2) 0.3 
(0.0–0.6)
5–59 3,900,000 2,016 229 162/1,034 (16) 423 
(307–540) 0.1 
(0.08–0.14) 31 
(18–46) 0.8 
(0.5–1.2)
≥60
481,557
2,695
1,051
76/1,012 (8)
260 
(145–381)
0.5 
(0.3–0.8)

71 
(27–118)
15 
(6–25)
Total 18,404,481 30,357 5,750 3,352/16,597 (20) 6,699 
(5,165–8,264) 0.4 
(0.3–0.4) 803 
(474–1,149) 4 
(3–6)

*SARI, severe acute respiratory illness. Population estimates based on Costa Rica census projections.
†Number of persons hospitalized during 2009–2012 for SARI proxy diagnoses (ICD-10 code J9–18) (8) in any of 6 discharge diagnostic fields.
‡In-hospital deaths among persons hospitalized during 2009–2012 for SARI (International Classification of Diseases, 10th Revision, code J9–18) in any of 6 discharge diagnostic fields.
§Annual number of nasal and pharyngeal specimens positive for influenza by immunofluorescence and PCR over total number tested.
¶Estimated through the product of the proportion of samples testing positive for influenza and the number of persons hospitalized for or inpatient deaths from SARI each month and sum of the products by age group, Costarricense de Seguro Social, San José, Costa Rica.
#Per 1,000 person-years.
**Per 100,000 person-years.

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