State of California—Health and Human Services Agency

California Department of Public Health

MARK B HORTON, MD, MSPH ARNOLD SCHWARZENEGGER

Director Governor

October 14, 2009 09-14

TO: LOCAL HEALTH OFFICERS

LOCAL REGISTRARS OF BIRTHS AND DEATHS
CHIEF DEPUTY REGISTRARS OF BIRTHS AND DEATHS

SUBJECT: REPORTING NOVEL H1N1 INFLUENZA AS A CAUSE OF DEATH ON

DEATH CERTIFICATES

As part of the Public Health response to novel H1N1 influenza, it is important that
epidemiologists at the California Department of Public Health (CDPH) and local health
departments be able to identify novel H1N1-associated fatalities from death certificates
in real time. To achieve this, CDPH recommends that physicians certifying deaths
resulting from known, presumed, or suspected novel H1N1 influenza include the
following cause of death information on the death certificate in fields 107A, 107B, 107C,
or 107D:

• In cases with a laboratory test confirming that the deceased had novel H1N1
influenza, one of the causes of death should be entered as: “H1N1 Influenza.”

• In cases where the deceased was presumed or suspected to have had H1N1
influenza but there is no confirmatory laboratory test (or a test is still pending),
one of the causes of death should be entered as: “Presumed H1N1 Influenza.”

Physicians should continue to enter other cause of death information on the death
certificate as per usual procedures.

Please forward this letter to funeral homes and physicians in your jurisdiction that
handle death certificates. Thank you for your assistance and support as CDPH
endeavors to track and respond to this emerging pandemic.

If you have any questions regarding this matter, please contact:

Scott Fujimoto, MD, MPH

Assistant Chief, Office of Health Information and Research
Scott.Fujimoto@cdph.ca.gov
(916) 324-6376

Center for Health Statistics – Office of Vital Records MS 5103 - P.O. Box 997410, Sacramento, CA 95899-7410
(916) 445-2684
Internet Address: www.cdph.ca.gov
REPORTING NOVEL H1N1 INFLUENZA AS A CAUSE OF DEATH ON DEATH
CERTIFICATES
Page 2
October 14, 2009

Ms. Laura Lund, MA

Science Advisor, Center for Health Statistics
Laura.Lund@cdph.ca.gov
(916) 552-8113

Sincerely,

Original signed by:

Linette T Scott, MD, MPH

Deputy Director
Health Information and Strategic Planning