Annual Number of flu deaths: it’s a guess

By Sherri Tenpenny, DO

I have received many requests for a specific reference to the following statement made in my article “The Flu Season Campaign Begins” :

“Even though less than 175 people actually died from influenza in 2003, anticipate that exponentially more messages regarding the “deadly flu” will be pushed through the news media this year.”

After weeks of intense research to locate the full source for that statement, I have unearthed some interesting and powerfully useful information.

Recapping Last Year’s Flu Season

During the 2003--2004 season, influenza activity in the United States began earlier than usual (October 2003), peaked between late November and early December, and then declined rapidly during January-February, 2004. The CDC scrambled as it was discovered that neither of the trivalent influenza vaccines used (Fluzone® or the new intranasal vaccine, FluMist®) contained the strain A/Fujian strain, the most prevalent virus in circulation. By Jan. 15, the CDC issued a press release admitting that ongoing testing showed that the year's vaccine "was not effective or had very low effectiveness" in the test subjects. [i]

As of the week ending March 27, 2004, laboratories at the World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) had tested 115,222 specimens and only 21.0% of the samples were found to be positive for influenza viruses. [ii] During the four most recent influenza seasons (1999-00, 2000-01, 2001-02, and 2002-03), the number of specimens that tested positive for influenza viruses ranged from 23.9 to 30.9% [iii] In other words, over the last 5 winters, 70-80% of the sniffles, fevers and body aches generally characterized as “the flu” were not caused by influenza viruses, but by organisms not covered by  a vaccine, regardless of the strain that was used. 

Influenza-associated pediatric deaths received considerable attention last year, prompting the CDC to request state and local health departments to report influenza-associated deaths in persons less than 18 years of age. As of May 31, 2004, 152 “influenza-associated deaths” in children had been reported by 40 states. [iv] Most of the children who died in last year's flu season were younger than 5 years of age. Because no similarnational data were collected previously, whether this numberof pediatric deaths represents a change from previous seasons is unknown. [v]  

Beginning in 2002, the Advisory Committeeon Immunization Practices (ACIP) began to recommend that all childrenaged 6-23 months and close contacts of children aged 0-23 monthsreceive annual influenza vaccination. With the increased reports of pediatric deaths in 2003, the Council of State and Territorial Epidemiologists (CSTE) approved an initiative to add “all pediatric influenza-associated deaths” to the list of nationally notifiable conditions on June of 2004. [vi] This will turn out to be a boon for flu vaccine manufacturers as the media doggedly tracts and then morbidly reports this season’s statistics, placing fear in the hearts of parents who will in turn demand the flu shot for their children.

It should be noted that this initiative was undertaken after the influenza vaccine was added to the pediatric vaccination schedule, protecting the manufacturers from liability under the rules of the National Vaccine Injury Act.

Therefore, my statement that “less than 175 people who died” was technically incorrect and should have read, “less than 175 children died” in last year’s flu season. However, as few as 175 adult deaths could have occurred too. Here’s why…

Predicting 36,000 deaths

The CDC claims that influenza is “a highly contagious virus that causes an average of 36,000 deaths and 200,000 hospitalizations in the U.S. every year.” But how does the CDC determine the number of deaths related to influenza? Where is the tangible, annual report somewhere in the CDC’s database with an actual number of reported deaths among adults, such as the 152 reported deaths among children? These questions deserve answers. Upon intense investigation, I uncovered a startling truth.

The CDC receives information on influenza cases from a several different sources. During each October to May period, the CDC receives weekly reports from approximately 120 World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories in the United States regarding influenza virus isolations. In addition, reports from several hundred “sentinel physicians” are received regarding the total number of patient visits and the number of visits for influenza-like illness (ILI). Sentinel physicians are randomly selected physicians who work in the community or for local health departments who collect nasal swabs on patients reporting flu-like symptoms. These swabs are sent to laboratories for organism identification and quantification.

A third source is the state and territorial epidemiologists who estimate the level of local influenza activity. The final source, the vital statistics offices for 122 cities across the country, report the total number of death certificates filed and the number of those in which 1) pneumonia was identified as the underlying cause of death or 2) influenza was listed anywhere on the death certificate. These reports from death certificates are filed throughout the year. From the number of positive nasal swabs and the complied data from epidemiological  death certificates, the CDC “determines” the number of deaths per year from influenza. [vii]

A CDC spokesman, Mr. Curtis Allen told Insight Magazine last year,

“There are a couple problems with determining the number of deaths related to the flu because most people don't die from influenza - they die from complications of influenza - so the numbers [of deaths] are based on mathematical formulas. We don't know exactly how many people get the flu each year because it's not a reportable disease and most physicians don't do the test [nasal swab] to indicate whether [the symptoms are caused by] influenza.” [viii]

Hence, the oft-repeated “36,000 deaths nationwide” is nothing more than a computer-generated, ominous-sounding guesstimate, rather than an actual number.


NOTE: Between Oct 1, 2003 and Apr 9, 2004, the CDC identified 863 antigenically DIFFERENT influenza viruses. [ix] Therefore, even if one assumes that the flu vaccines work for the three chosen strains, it is important to understand that the vaccineswill not provide protection against the other 860 influenza viruses known to be in circulation. 

Hence the CDC’s statement about the flu is correct:

Yearly, adults can average one to three and children three to six influenza-like illnesses (ILIs). The vaccine does not prevent influenza-like illnesses caused by infectious agents other than influenza [strains found in the shot], and many persons vaccinated against influenza will still get the flu. [x]

Special thanks to Mrs. Lujene Clark and Mrs. Dawn Richardson for help with this research.


  1. CDC fact sheet. Influenza Vaccine Effectiveness Studies. Jan. 15, 2004.
  2. MMWR. Update: Influenza Activity --- United States, 2003--04 Season. April 9, 2004 / 53(13);284-287
  3. MMWR. Surveillance for Influenza --- United States, 1997--98, 1998--99, and 1999--00 Seasons. October 25, 2002 / 51(SS07);1-10.
  5. JAMA. Vol. 292, No. 12. Sept 22-29, 2004. Also MMWR. 2004;53:547-552.
  6. JAMA. Ibid.
  7. MMWR. Surveillance for Influenza --- United States, 1997--98, 1998--99, and 1999--00 Seasons. October 25, 2002 / 51(SS07);1-10.
  8. Insight Magazine. Jan. 19, 2004. “Flu Secrets You Should Know”, by Kelly Patricia O’Meara
  9. Insight Magazine. Ibid.
  10. MMWR. November 9, 2001 / 50(44);984-6