Brief communication: Rethinking the impact of the 1918 influenza pandemic on sex differentials in mortality

2009 ◽  
Vol 139 (4) ◽  
pp. 584-590 ◽  
Author(s):  
L.A. Sawchuk
Keyword(s):  
Influenza Pandemic ◽  
Sex Differentials ◽  
1918 Influenza ◽  
The Impact

scholarly journals Lessons From Influenza Pandemics of the Last 100 Years

2019 ◽  
Author(s):  
Arnold S Monto ◽  
Keiji Fukuda
Keyword(s):  
Avian Influenza ◽  
Seasonal Influenza ◽  
Influenza Pandemic ◽  
Risk Groups ◽  
Influenza Viruses ◽  
Avian Influenza Viruses ◽  
Influenza Pandemics ◽  
Fundamental Difficulty ◽  
1918 Influenza ◽  
The Impact

Abstract Seasonal influenza is an annual occurrence, but it is the threat of pandemics that produces universal concern. Recurring reports of avian influenza viruses severely affecting humans have served as constant reminders of the potential for another pandemic. Review of features of the 1918 influenza pandemic and subsequent ones helps in identifying areas where attention in planning is critical. Key among such issues are likely risk groups and which interventions to employ. Past pandemics have repeatedly underscored, for example, the vulnerability of groups such as pregnant women and taught other lessons valuable for future preparedness. While a fundamental difficulty in planning for the next pandemic remains their unpredictability and infrequency, this uncertainty can be mitigated, in part, by optimizing the handling of the much more predictable occurrence of seasonal influenza. Improvements in antivirals and novel vaccine formulations are critical in lessening the impact of both pandemic and seasonal influenza.

scholarly journals News from the front: Estimation of excess mortality and life expectancy in the major epicenters of the COVID-19 pandemic in Italy

2020 ◽  
Author(s):  
Simone Ghislandi ◽  
Raya Muttarak ◽  
Markus Sauerberg ◽  
Benedetta Scotti
Keyword(s):  
Life Expectancy ◽  
Excess Mortality ◽  
Human Life ◽  
Influenza Pandemic ◽  
National Level ◽  
Years Of Life Lost ◽  
Substantial Impact ◽  
Lombardy Region ◽  
1918 Influenza ◽  
The Impact

AbstractExisting studies on the mortality impacts of the COVID-19 pandemic commonly rely on national official reports. However, in a pandemic, deaths from COVID-19 can be miscounted due to under-reporting and inaccurate death registration. Official statistics on COVID-19 mortality are sensitive to classification, estimation and reporting practice which are not consistent across countries. Likewise, the reported mortality is often provided at the national level which results in underestimation of the true scale of the human life impact given that the outbreaks are localised.This study overcomes the problem of under-reporting of COVID-19-related deaths by using all cause daily death registrations data provided by the Italian Statistical Office (ISTAT) from January 1 to April 30, 2020 in comparison with official figures reported by the Civil Protection Department. The study focuses on the five most severely hit provinces in Italy (Bergamo, Brescia, Cremona, Lodi and Piacenza) and Lombardy region. We calculate excess mortality in 2020 compared to the average of the years 2015 to 2019 and estimate life expectancy for the first wave of the epidemic and for the rest of the year 2020. Not only is life expectancy a reliable measure of a country’s health status and development, it also allows us to quantify the impact of COVID-19 on human life.The estimated excess deaths show significantly higher mortality than COVID-19 official mortality statistics, particularly during the peak of the epidemic and amongst people aged 60 years and over. We find that for the first wave of the epidemic, life expectancy in the five provinces reduced by 5.1 to 7.8 and 3.2 to 5.8 years for men and women, respectively. For annual life expectancy for the year 2020, in a scenario with no harvesting effect i.e. mortality rates resume to an average level of the years 2015-2019 after the end of the first epidemic wave, the years of life lost is equivalent to 2 to 3.5 years for men and 1.1. to 2.5 years for women in the five provinces.The COVID-19 pandemic posed a substantial impact on population health in Italy as it represents the largest decline in life expectancy after the 1918 influenza pandemic and the Second World War.

scholarly journals Stillbirth Risk during the 1918 Influenza Pandemic in Arizona, USA

Epidemiologia ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 23-30
Author(s):  
Smriti Khare ◽  
Sushma Dahal ◽  
Ruiyan Luo ◽  
Richard Rothenberg ◽  
Kenji Mizumoto ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Retrospective Study ◽  
Pandemic Influenza ◽  
Influenza Pandemic ◽  
Regression Analyses ◽  
Maricopa County ◽  
Mother’S Age ◽  
1918 Influenza ◽  
Birth Records ◽  
The Impact

The 1918 influenza pandemic, the deadliest pandemic on record, affected approximately 1/3rd of the population worldwide. The impact of this pandemic on stillbirth risk has not been studied in depth. In this study, we assessed the stillbirth risk during the 1918 influenza pandemic in Arizona, USA. We carried out a retrospective study using 21,334 birth records for Maricopa County, Arizona, for the period 1915–1925. We conducted logistic regression analyses to assess the effect of that pandemic on stillbirth risk. Though we did not find a statistically significant impact on stillbirth risk during the pandemic, there was a higher risk of stillbirth in July 1919 (42 stillbirths/1000 births), 9 months after the peak pandemic mortality, and a stillbirth risk of 1.42 (95% CI: 1.17, 1.72) in women ≥35 years compared to the women aged <35 years. The risk of stillbirth was lowest if the mother’s age was approximately 26 years at the time of birth. We also report peaks in stillbirth risk 9–10 months after the peak pandemic mortality. Our findings add to our current understanding of the link between pandemic influenza and stillbirth risk.

scholarly journals Public health interventions and epidemic intensity during the 1918 influenza pandemic

2007 ◽  
Vol 104 (18) ◽  
pp. 7582-7587 ◽  
Author(s):  
Richard J. Hatchett ◽  
Carter E. Mecher ◽  
Marc Lipsitch
Keyword(s):  
Disease Transmission ◽  
Early Phase ◽  
Influenza Pandemic ◽  
Death Rates ◽  
Viral Spread ◽  
Early Implementation ◽  
The Difference ◽  
1918 Influenza ◽  
The Impact ◽  
Multiple Interventions

Nonpharmaceutical interventions (NPIs) intended to reduce infectious contacts between persons form an integral part of plans to mitigate the impact of the next influenza pandemic. Although the potential benefits of NPIs are supported by mathematical models, the historical evidence for the impact of such interventions in past pandemics has not been systematically examined. We obtained data on the timing of 19 classes of NPI in 17 U.S. cities during the 1918 pandemic and tested the hypothesis that early implementation of multiple interventions was associated with reduced disease transmission. Consistent with this hypothesis, cities in which multiple interventions were implemented at an early phase of the epidemic had peak death rates ≈50% lower than those that did not and had less-steep epidemic curves. Cities in which multiple interventions were implemented at an early phase of the epidemic also showed a trend toward lower cumulative excess mortality, but the difference was smaller (≈20%) and less statistically significant than that for peak death rates. This finding was not unexpected, given that few cities maintained NPIs longer than 6 weeks in 1918. Early implementation of certain interventions, including closure of schools, churches, and theaters, was associated with lower peak death rates, but no single intervention showed an association with improved aggregate outcomes for the 1918 phase of the pandemic. These findings support the hypothesis that rapid implementation of multiple NPIs can significantly reduce influenza transmission, but that viral spread will be renewed upon relaxation of such measures.

scholarly journals Impact of the 1918 Influenza Pandemic in Coastal Kenya

2019 ◽  
Vol 4 (2) ◽  
pp. 91 ◽  
Author(s):  
Fred Andayi ◽  
Sandra S. Chaves ◽  
Marc-Alain Widdowson
Keyword(s):  
Quantitative Data ◽  
Influenza Pandemic ◽  
Colonial Era ◽  
Specific Data ◽  
Coastal Kenya ◽  
Crude Mortality ◽  
All Cause Mortality ◽  
1918 Influenza ◽  
Influenza Outbreaks ◽  
The Impact

The 1918 influenza pandemic was the most significant pandemic recorded in human history. Worldwide, an estimated half billion persons were infected and 20 to 100 million people died in three waves during 1918 to 1919. Yet the impact of this pandemic has been poorly documented in many countries especially those in Africa. We used colonial-era records to describe the impact of 1918 influenza pandemic in the Coast Province of Kenya. We gathered quantitative data on facility use and all-cause mortality from 1912 to 1925, and pandemic-specific data from active reporting from September 1918 to March 1919. We also extracted quotes from correspondence to complement the quantitative data and describe the societal impact of the pandemic. We found that crude mortality rates and healthcare utilization increased six- and three-fold, respectively, in 1918, and estimated a pandemic mortality rate of 25.3 deaths/1000 people/year. Impact to society and the health care system was dramatic as evidenced by correspondence. In conclusion, the 1918 pandemic profoundly affected Coastal Kenya. Preparation for the next pandemic requires continued improvement in surveillance, education about influenza vaccines, and efforts to prevent, detect and respond to novel influenza outbreaks.

scholarly journals The effect of public health measures on the 1918 influenza pandemic in U.S. cities

2007 ◽  
Vol 104 (18) ◽  
pp. 7588-7593 ◽  
Author(s):  
Martin C. J. Bootsma ◽  
Neil M. Ferguson
Keyword(s):  
Public Health ◽  
Excess Mortality ◽  
Influenza Pandemic ◽  
Total Mortality ◽  
Health Measures ◽  
Per Capita ◽  
1918 Influenza ◽  
The Impact ◽  
The U.S ◽  
Overall Mortality

During the 1918 influenza pandemic, the U.S., unlike Europe, put considerable effort into public health interventions. There was also more geographic variation in the autumn wave of the pandemic in the U.S. compared with Europe, with some cities seeing only a single large peak in mortality and others seeing double-peaked epidemics. Here we examine whether differences in the public health measures adopted by different cities can explain the variation in epidemic patterns and overall mortality observed. We show that city-specific per-capita excess mortality in 1918 was significantly correlated with 1917 per-capita mortality, indicating some intrinsic variation in overall mortality, perhaps related to sociodemographic factors. In the subset of 23 cities for which we had partial data on the timing of interventions, an even stronger correlation was found between excess mortality and how early in the epidemic interventions were introduced. We then fitted an epidemic model to weekly mortality in 16 cities with nearly complete intervention-timing data and estimated the impact of interventions. The model reproduced the observed epidemic patterns well. In line with theoretical arguments, we found the time-limited interventions used reduced total mortality only moderately (perhaps 10–30%), and that the impact was often very limited because of interventions being introduced too late and lifted too early. San Francisco, St. Louis, Milwaukee, and Kansas City had the most effective interventions, reducing transmission rates by up to 30–50%. Our analysis also suggests that individuals reactively reduced their contact rates in response to high levels of mortality during the pandemic.

scholarly journals Pollution, Infectious Disease, and Mortality: Evidence from the 1918 Spanish Influenza Pandemic

2018 ◽  
Vol 78 (4) ◽  
pp. 1179-1209 ◽  
Author(s):  
Karen Clay ◽  
Joshua Lewis ◽  
Edson Severnini
Keyword(s):  
Air Pollution ◽  
Influenza Pandemic ◽  
Influenza Infection ◽  
The United States ◽  
Socioeconomic Conditions ◽  
Medical Evidence ◽  
1918 Influenza ◽  
Timing Of Onset ◽  
The Impact ◽  
Baseline Health

The 1918 Influenza Pandemic killed millions worldwide and hundreds of thousands in the United States. This article studies the impact of air pollution on pandemic mortality. The analysis combines a panel dataset on infant and all-age mortality with a novel measure of air pollution based on the burning of coal in a large sample of U.S. cities. We estimate that air pollution contributed significantly to pandemic mortality. Cities that used more coal experienced tens of thousands of excess deaths in 1918 relative to cities that used less coal with similar pre-pandemic socioeconomic conditions and baseline health. Factors related to poverty, public health, and the timing of onset also affected pandemic mortality. The findings support recent medical evidence on the link between air pollution and influenza infection, and suggest that poor air quality was an important cause of mortality during the pandemic.

scholarly journals Spanish ’Flu in Scotland: A Lanarkshire Case Study

2021 ◽  
Vol 41 (1) ◽  
pp. 65-86
Author(s):  
Katharine Mccrossan
Keyword(s):  
Human Impact ◽  
Central Government ◽  
Medical Profession ◽  
Influenza Pandemic ◽  
State Intervention ◽  
Spanish Flu ◽  
1918 Influenza ◽  
High Level ◽  
The Impact

The purpose of this article is to explore the impact that the 1918 influenza pandemic (otherwise known as the ‘Spanish ‘Flu’) had on the Scottish county of Lanarkshire. Despite being one of the most devastating events in modern history, to date little is known about the experience of the disease in Scotland. Structured in two parts, part one of this article will examine the human impact of the Spanish ’Flu within Lanarkshire, while part two focuses on the official responses to the pandemic from both the medical profession and local civic government. In doing so, this article will demonstrate that the Spanish ’Flu generated a high level of mortality amongst the population of Lanarkshire, placed great strain on medical services, and exposed tensions between local and central government at a time of increasing state intervention.

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