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J Infect Dis. Mortality Risk Factors During the 1918-1919 Influenza Pandemic in the Australian Army.

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  • J Infect Dis. Mortality Risk Factors During the 1918-1919 Influenza Pandemic in the Australian Army.

    [Source: US National Library of Medicine, (LINK). Edited.]

    J Infect Dis. 2010 May 7. [Epub ahead of print]

    Mortality Risk Factors During the 1918-1919 Influenza Pandemic in the Australian Army.

    Shanks GD, Mackenzie A, McLaughlin R, Waller M, Dennis P, Lee SE, Brundage JF. - Australian Army Malaria Institute, Enoggera, 2School of Population Health and 3Centre for Military and Veteran's Health, University of Queensland, and 4Queensland Institute for Medical Research, Brisbane, and 5University of New South Wales at the Australian Defence Force Academy, Canberra, Australia; 6Armed Forces Health Surveillance Center, Silver Spring, Maryland.

    Background.
    Understanding the risk of mortality during the 1918-1919 influenza pandemic could inform preparations for a future pandemic.

    Methods.
    Prospectively collected demographic, hospitalization, and death data from all individuals who served in the Australian Imperial Force from 1914 through 1919 in Europe and the Middle East were abstracted from archived records. Analyses were conducted to determine mortality risk factors.

    Results.
    Hospitalization with a respiratory illness during the spring-summer of 1918 protected soldiers from death (odds ratio, 0.37 [95% confidence interval, 0.25-0.53]; [Formula: see text]) but not from hospitalization during the fall-winter of 1918-1919. During the fall-winter of 1918-1919, there was a strong inverse relationship between risk of dying of pneumonia-influenza and time in military service. The pneumonia-influenza death rate among men who enlisted in 1918 (6.33 deaths per 100 person-years) was 9 times higher than that among the 1917 enlistment cohort (0.72 deaths per 100 person-years) and >14 times higher than that among the 1916 cohort (0.43 deaths per 100 person-years), 1915 cohort (0.29 deaths per 100 person-years), and 1914 cohort (0.28 deaths per 100 person-years). Conclusion. There was a strong inverse relationship between length of service in the Australian Imperial Force and mortality risk from pneumonia-influenza during the fall-winter of 1918-1919. The protective effect of increased service likely reflected increased acquired immunity to influenza viruses and endemic bacterial strains that caused secondary pneumonia and most of the deaths during the 1918-1919 influenza pandemic.

    PMID: 20450336 [PubMed - as supplied by publisher]
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