Objectives. Data from the Tecumseh Community Health Study were used to
estimate excess morbidity owing to influenza, and results were compar
ed with estimates made previously using different methodology for an I
nstitute of Medicine report. Methods. Study participants from Tecumseh
, Michigan, were classified as infected or noninfected based on labora
tory results. The excess numbers of respiratory illnesses, respiratory
illness days, and bed and restricted activity days experienced by the
infected compared with the noninfected were estimated. Results. The n
umber of excess influenza-related respiratory illnesses was lower than
that estimated in the Institute of Medicine report, in which all illn
esses of certain characteristics occurring during an influenza season
were attributed to influenza. It is now estimated that the US populati
on under 20 years of age experiences a yearly average of 13.8 to 16.0
million influenza-related excess respiratory illnesses; for older indi
viduals, the yearly estimate is 4.1 to 4.4 million excess illnesses. C
onclusions. For public health purposes, estimates of excess morbidity
as well as of total morbidity associated with influenza should be used
in setting health priorities.