Determinants of mortality in naval units during the 1918?19 influenza pandemic

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The Lancet Infectious Diseases, Volume 11, Issue 10, Pages 793 - 799, October 2011

doi:10.1016/S1473-3099(11)70151-7Cite or Link Using DOI
Determinants of mortality in naval units during the 1918?19 influenza pandemic
Prof G Dennis Shanks MD a b Corresponding AuthorEmail Address, Michael Waller MSc b, Alison MacKenzie MPH b, John F Brundage MD c
Summary
In 1918, two waves of epidemic influenza arose with very different clinical phenotypes. During the first wave, infection rates were high but mortality was low. During the second wave, high numbers of deaths occurred and mortality differed 30?100 times among seemingly similar groups of affected adults, but the reason for this variation is unclear. In 1918, the crews of most warships and some island populations were affected by influenza during both waves of infection and had no or very few deaths during the second wave. However, some warships and island populations were not affected during the first wave of infection and had high mortality during the second wave. These findings suggest that infection during the first wave protected against death, but not infection, during the second wave. If so, the two waves of infection were probably caused by antigenically distinct influenza viruses?not by one virus that suddenly increased in pathogenicity between the first and second waves. These findings are relevant to modern concerns that the 2009 influenza A H1N1 virus could suddenly increase in lethality.

http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(11)70151-7/abstract?rss=yes

 

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How the ?Spanish Flu? killed

How the ?Spanish Flu? killed

University of Queensland research into the world's most deadly influenza pandemic in 1918 has shed light on a major medical mystery.

The study, published a recent edition of Lancet Infectious Diseases, examined US and Commonwealth military records and controversially suggests that the presence of two different viruses is the reason the second wave of the pandemic was so much deadlier.

The conclusions highlight the importance of acquired immunity and the use of modern vaccinations, lead author and Professor at UQ's Centre for Military & Veterans' Health and Director of the Australian Army Malaria Institute, Dr G. Dennis Shanks said.

He said World War I soldiers and sailors of identical genetic and social backgrounds died at very
different rates depending on where they were located.

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http://www.sciencealert.com.au/news/20111511-22842.html