Barker and Mullooly, in this issue of the Archives (p 85), have characterized the adult patient population at greatest risk for a fatal outcome during influenza epidemics. Results of a survey in Houston (W. P. Glezen, MD, and A. Payne, DPH, unpublished data, Jan 1, 1976, through June 30,1978) are in general agreement with their description, with a few exceptions. During the intense influenza A/Victoria virus epidemic of 1976, we found that, in the judgment of the physician signing the death certificate, 18% of the patients whose deaths were attributed either to pneumonia or influenza or both did not have an underlying condition that made them vulnerable to fatal outcome. Furthermore, 38.6% of the patients dying were younger than 65 years. Therefore, the problem was not confined to the aged and infirmed. But should we limit our concern to the persons who do not survive the yearly onslaught of influenza