We chose to apply the Centers of Disease Control and Prevention case definition of pneumonia and influenza deaths defined by CDC's epidemiologist staff through personal communication. Therefore, the operational definition for deaths from influenza includes deaths from all types of influenza with the exception of deaths from HAEMOPHILUS INFLUENZAE infection and deaths from PARAINFLUENZAE VIRUS infection. Pneumonia deaths include deaths from all types of pneumonia including pneumonia due to H. influenza and pneumonia due to parainfluenzae virus. The exceptions include aspiration pneumonia (O74.0, O29, O89.0, J69.-and P24.-)1, pneumonitis (J84.1, J67-J70), and pneumonia due to pneumococcal meningitis (J13, G00.1) 1. Pneumonia and influenza related deaths were defined as one of the diagnoses listed in Table 1 which were reported in any cause of death field. These codes were selected through manual review of the ICD-10 version 2007 manual [23] .