Our study found that the proportion of decedents with positive 2009 H1N1 samples (66%) was significantly higher than that of hospitalized SARI case-patients (42%) and ILI case-patients (25%). Such a finding suggests that while influenza was identified in a fraction of ILI case-patients [15] and community acquired pneumonias [19, 20] , influenza can be identified among a significant proportion (1/3-2/3) of severe hospitalized illness case-patients and decedents in during epidemic periods. If consistent among other surveillance platforms, such findings could have implications for countries exploring whether to empirically treat SARI case-patients with oseltamivir or other antivirals during influenza epidemic periods [21] .