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Epidemiological isolation causing variable mortality in Island populations during the 1918-1920 influenza pandemic

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  • Epidemiological isolation causing variable mortality in Island populations during the 1918-1920 influenza pandemic

    Influenza Other Respi Viruses. 2012 Jan 6. doi: 10.1111/j.1750-2659.2011.00332.x. [Epub ahead of print]
    Epidemiological isolation causing variable mortality in Island populations during the 1918-1920 influenza pandemic.
    Shanks GD, Hussell T, Brundage JF.
    Source

    Australian Army Malaria Institute, Enoggera, Qld, Australia Centre for Military and Veterans' Health, School of Population Health, University of Queensland, Brisbane, Qld, Australia Leukocyte Biology Section, National Heart and Lung Institute, Imperial College London, London, UK Armed Forces Health Surveillance Center, Silver Spring, MD, USA.
    Abstract

    Please cite this paper as: Shanks et al. (2012) Epidemiological isolation causing variable mortality in Island populations during the 1918-1920 influenza pandemic. Influenza and Other Respiratory Viruses DOI: 10.1111/j.1750-2659.2011.00332.x. Background  During the 1918 pandemic period, influenza-related mortality increased worldwide; however, mortality rates varied widely across locations and demographic subgroups. Islands are isolated epidemiological situations that may elucidate why influenza pandemic mortality rates were so variable in apparently similar populations. Objectives  Our objectives were to determine and compare the patterns of pandemic influenza mortality on islands. Methods  We reviewed historical records of mortality associated with the 1918-1920 influenza pandemic in various military and civilian groups on islands. Results and Conclusions  Mortality differed more than 50-fold during pandemic-related epidemics on Pacific islands [range: 0?4% (Hawaii) to 22% (Samoa)], and on some islands, mortality sharply varied among demographic subgroups of island residents such as Saipan: Chamorros [12%] and Caroline Islanders [0?4%]. Among soldiers from island populations who had completed initial military training, influenza-related mortality rates were generally low, for example, Puerto Rico (0?7%) and French Polynesia (0?13%). The findings suggest that among island residents, those who had been exposed to multiple, antigenically diverse respiratory pathogens prior to infection with the 1918 pandemic strain (e.g., less isolated) experienced lower mortality. The continuous circulation of antigenically diverse influenza viruses and other respiratory infectious agents makes widespread high mortality during future influenza pandemics unlikely.

    ? 2012 Blackwell Publishing Ltd.

    PMID:
    22226378
    [PubMed - as supplied by publisher]

    Mortality differed more than 50-fold during pandemic-related epidemics on Pacific islands [range: 0.4% (Hawaii) to 22% (Samoa)], and on some islands, mortality sharply varied among demographic subgroups of island residents such as Saipan: Chamorros [12%] and Caroline Islanders [0.4%]. Among soldiers …
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