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PLoS ONE: Age-Specific Mortality During the 1918 Influenza Pandemic: Unravelling the Mystery of High Young Adult Mortality

tetano

Editor, Senior Moderator
Abstract

The worldwide spread of a novel influenza A (H1N1) virus in 2009 showed that influenza remains a significant health threat, even for individuals in the prime of life. This paper focuses on the unusually high young adult mortality observed during the Spanish flu pandemic of 1918. Using historical records from Canada and the U.S., we report a peak of mortality at the exact age of 28 during the pandemic and argue that this increased mortality resulted from an early life exposure to influenza during the previous Russian flu pandemic of 1889?90. We posit that in specific instances, development of immunological memory to an influenza virus strain in early life may lead to a dysregulated immune response to antigenically novel strains encountered in later life, thereby increasing the risk of death. Exposure during critical periods of development could also create holes in the T cell repertoire and impair fetal maturation in general, thereby increasing mortality from infectious diseases later in life. Knowledge of the age-pattern of susceptibility to mortality from influenza could improve crisis management during future influenza pandemics.

Citation: Gagnon A, Miller MS, Hallman SA, Bourbeau R, Herring DA, et al. (2013) Age-Specific Mortality During the 1918 Influenza Pandemic: Unravelling the Mystery of High Young Adult Mortality. PLoS ONE 8(8): e69586. doi:10.1371/journal.pone.0069586

Editor: Paul Digard, University of Edinburgh, United Kingdom

Received: March 6, 2013; Accepted: June 9, 2013; Published: August 5, 2013

Copyright: ? 2013 Gagnon et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: This work was supported by the Social Science and Humanity and Research council of Canada http://www.sshrc-crsh.gc.ca/home-accueil​-eng.aspx (AG, SAH, DAH, and RB), the Canadian Institutes of Health Research http://www.cihr-irsc.gc.ca/e/193.html (AG, MSM, DJDE, and JM) and the Natural Sciences and Engineering Research Council of Canada http://www.nserc-crsng.gc.ca/index_eng.a​sp (DJDE). JM holds a Tier I Canada Research Chair in Human Immunology. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.


http://www.plosone.org/article/info...6;jsessionid=19696606CB89A6B03F2FB028E2573B08
 
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