Nielsen, JVestergaard, L SRichter, LSchmid, DBustos, NAsikainen, TTrebbien, RDenissov, GInnos, KVirtanen, M JFouillet, ALytras, TGkolfinopoulou, KHeiden, M An derGrabenhenrich, LUphoff, HPaldy, ABobvos, JDomegan, LisaO'Donnell, JScortichini, Mde Martino, AMossong, JEngland, KMelillo, Jvan Asten, Lde Lange, M MaTønnessen, RWhite, R Ada Silva, Susana PRodrigues, Ana PaulaLarrauri, AmparoMazagatos, ClaraFarah, ACarnahan, A DJunker, CSinnathamby, MPebody, RichardAndrews, NReynolds, AMcMenamin, JBrown, C SAdlhoch, CPenttinen, PMølbak, KKrause, T G2023-02-072023-02-072019-10Clin Microbiol Infect. 2019 Oct;25(10):1266-1276.http://hdl.handle.net/20.500.12105/15458Objectives: Weekly monitoring of European all-cause excess mortality, the EuroMOMO network, observed high excess mortality during the influenza B/Yamagata dominated 2017/18 winter season, especially among elderly. We describe all-cause excess and influenza-attributable mortality during the season 2017/18 in Europe. Methods: Based on weekly reporting of mortality from 24 European countries or sub-national regions, representing 60% of the European population excluding the Russian and Turkish parts of Europe, we estimated age stratified all-cause excess morality using the EuroMOMO model. In addition, age stratified all-cause influenza-attributable mortality was estimated using the FluMOMO algorithm, incorporating influenza activity based on clinical and virological surveillance data, and adjusting for extreme temperatures. Results: Excess mortality was mainly attributable to influenza activity from December 2017 to April 2018, but also due to exceptionally low temperatures in February-March 2018. The pattern and extent of mortality excess was similar to the previous A(H3N2) dominated seasons, 2014/15 and 2016/17. The 2017/18 overall all-cause influenza-attributable mortality was estimated to be 25.4 (95%CI 25.0-25.8) per 100,000 population; 118.2 (116.4-119.9) for persons aged 65. Extending to the European population this translates into over-all 152,000 deaths. Conclusions: The high mortality among elderly was unexpected in an influenza B dominated season, which commonly are considered to cause mild illness, mainly among children. Even though A(H3N2) also circulated in the 2017/18 season and may have contributed to the excess mortality among the elderly, the common perception of influenza B only having a modest impact on excess mortality in the older population may need to be reconsidered.engVoRhttp://creativecommons.org/licenses/by-nc-nd/4.0/B/YamagataEuroMOMOFluMOMOInfluenzaMortalityMortalityAdolescentAdultAge FactorsAgedAttribution-NonCommercial-NoDerivatives 4.0 Internacional3079068525101266-127610.1016/j.cmi.2019.02.0111469-0691Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseasesopen access