Abstract

We explored the association between influenza epidemic and suicide mortality rates in a large population using a time-series regression of 13-year mortality data in South Korea. Weekly suicide mortalities and influenza-like illness (ILI) were analyzed using time series regression. Regression coefficient for suicide mortality based on percentage change of ILI was calculated using a quasi-Poisson regression. Non-linear distributed lag models with quadratic function up to 24 weeks were constructed. The association between ILI and suicide mortality increased significantly up to 8 weeks post-influenza diagnosis. A significant positive association between ILI and suicide mortality was observed from 2009, when a novel influenza A(H1N1)pdm09 virus provoked a worldwide pandemic. No meaningful association between these factors was observed before 2009. There was a significant positive relationship between ILI and suicide mortality after 2009, when a novel influenza A(H1N1)pdm09 virus provoked a worldwide pandemic.

Highlights

  • As the information regarding virus genotyping was unavailable, we could not distinguish between H1N1 infection and other flu-like illness, we obtained information about influenza-like illness (ILI) outpatient visits weekly ranging from the 35th International Organization for Standardization (ISO) week in 2004 to the 52th ISO week in 2017

  • In our study using population data, we identified a significant positive association between ILI and suicide mortality only after the 2009 pandemic, the year in which a novel influenza A (H1N1)pdm09 virus provoked a worldwide pandemic

  • We found lags shorter than 8 weeks with significantly positive association between ILI and suicidal behavior, and the result from Denmark study [8] did not apply any lag, which could imply that their result represent more immediate effect of infection and suicide death

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Summary

Introduction

Influenza monitoring data from 2004 to 2018 was available from KCDC website without any requirement for permission (http://www.cdc.go.kr/ npt/biz/npp/iss/influenzaStatisticsMain.do)

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