In the US, death certificates are the primary data source for mortality surveillance whose findings are widely used to exemplify epidemics and measure the severity of influenza seasons [16] . Currently, there are three systems to monitor influenza-related mortality; one system in particular, the 122 Cities Mortality Reporting System, provides a rapid assessment of pneumonia and influenza mortality [6] . Each week, this system summarizes the total number of death certificates filed in 122 US cities, as well as the number of deaths due to pneumonia and influenza. However, even these data can be delayed by approximately 2-3 weeks from the times of death. This delay can be attributed to one of the following reasons: 1) timeliness of death registration and 2) reviewing of the death certificates to identify pneumonia and influenza deaths [6, 16, 17] . The registration and reviewing of death certificates varies by states and, as a result, there is variability in length of time to report a death to CDC. For instance, states with paper-based death registration system typically perform manual reviews of the death certificates which can take up to 3 weeks; however states with electronic death registration systems (EDRS) may perform automatic reviews which can decrease this time significantly.