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Am J Epidemiol
. 2024 Jul 2:kwae173.
doi: 10.1093/aje/kwae173. Online ahead of print. Death on the permafrost: Revisiting the 1918-20 influenza pandemic in Alaska using death certificates
Lisa Sattenspiel 1 , Svenn-Erik Mamelund 2 , Sushma Dahal 3 , Amanda Wissler 4 , Gerardo Chowell 2 3 , Emma Tinker-Fortel 1
Affiliations
The 1918-20 influenza pandemic devastated Alaska's Indigenous populations. We report on quantitative analyses of pandemic deaths due to pneumonia and influenza (P&I) using information from Alaska death certificates dating between 1915 and 1921 (n=7,147). Goals include a reassessment of pandemic death numbers, analysis of P&I deaths beyond 1919, estimates of excess mortality patterns overall and by age using intercensal population estimates based on Alaska's demographic history, and comparisons between Alaska Native (AN) and non-AN residents. Results indicate that ANs experienced 83% of all P&I deaths and 87% of all-cause excess deaths during the pandemic. AN mortality was 8.1 times higher than non-AN mortality. Analyses also uncovered previously unknown mortality peaks in 1920. Both subpopulations showed characteristically high mortality of young adults, possibly due to imprinting with the 1889-90 pandemic virus, but their age-specific mortality patterns were different: non-AN mortality declined after age 25-29 and stayed relatively low for the elderly, while AN mortality increased after age 25-29, peaked at age 40-44, and remained high up to age 64. This suggests a relative lack of exposure to H1-type viruses pre-1889 among AN persons. In contrast, non-AN persons, often temporary residents, may have gained immunity before moving to Alaska.
Keywords: 1918-20 influenza pandemic; Alaska; Alaska Native vs. non-Alaska Native mortality; Indigenous health; death certificates; historical analysis.
. 2024 Jul 2:kwae173.
doi: 10.1093/aje/kwae173. Online ahead of print. Death on the permafrost: Revisiting the 1918-20 influenza pandemic in Alaska using death certificates
Lisa Sattenspiel 1 , Svenn-Erik Mamelund 2 , Sushma Dahal 3 , Amanda Wissler 4 , Gerardo Chowell 2 3 , Emma Tinker-Fortel 1
Affiliations
- PMID: 38957978
- DOI: 10.1093/aje/kwae173
The 1918-20 influenza pandemic devastated Alaska's Indigenous populations. We report on quantitative analyses of pandemic deaths due to pneumonia and influenza (P&I) using information from Alaska death certificates dating between 1915 and 1921 (n=7,147). Goals include a reassessment of pandemic death numbers, analysis of P&I deaths beyond 1919, estimates of excess mortality patterns overall and by age using intercensal population estimates based on Alaska's demographic history, and comparisons between Alaska Native (AN) and non-AN residents. Results indicate that ANs experienced 83% of all P&I deaths and 87% of all-cause excess deaths during the pandemic. AN mortality was 8.1 times higher than non-AN mortality. Analyses also uncovered previously unknown mortality peaks in 1920. Both subpopulations showed characteristically high mortality of young adults, possibly due to imprinting with the 1889-90 pandemic virus, but their age-specific mortality patterns were different: non-AN mortality declined after age 25-29 and stayed relatively low for the elderly, while AN mortality increased after age 25-29, peaked at age 40-44, and remained high up to age 64. This suggests a relative lack of exposure to H1-type viruses pre-1889 among AN persons. In contrast, non-AN persons, often temporary residents, may have gained immunity before moving to Alaska.
Keywords: 1918-20 influenza pandemic; Alaska; Alaska Native vs. non-Alaska Native mortality; Indigenous health; death certificates; historical analysis.