As of May 28, 2010, the official death toll attributed directly to the novel H1N1 and seasonal influenza was 2,117.[151] This total exceeds the 849 deaths directly attributed to seasonal influenza in 2006.[152] Many of the other deaths commonly attributed to influenza are caused by complicated influenza, where a second infection causes death, usually pneumonia (of which 48,657 of 55,477 official deaths in 2006 occurred in people aged 65 years and older).[152][153] The final estimate was of over 12,000 deaths over the course of the pandemic (April 2009 – April 2010).[4]