Reassessing the global mortality burden of the 1918 influenza pandemic

[tetano]

Am J Epidemiol. 2018 Sep 7. doi: 10.1093/aje/kwy191. [Epub ahead of print]
[h=1]Reassessing the global mortality burden of the 1918 influenza pandemic.[/h] Spreeuwenberg P[SUP]1[/SUP], Kroneman M[SUP]1[/SUP], Paget J[SUP]1[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] Mortality estimates of the 1918 influenza pandemic vary considerably, and recent estimates have suggested that there were 50-100 million deaths worldwide. We investigated the global mortality burden using an indirect estimation approach and two publically available datasets: the Human Mortality Database (13 countries) and data extracted from the records of the Statistical Abstract for British India. The all-cause Human Mortality Database allowed us to estimate mortality annually in 1916-1921 for detailed age groups. Three different calculation methods were applied to the data (low, medium and high scenarios) and we used a multilevel regression model to control for distorting factors (e.g. war and the underlying time trend in mortality). We found that total pandemic mortality was an estimated 15 million deaths worldwide in 1918 (2.5 million in 1919), after including the rates for British India and controlling for wars and the underlying mortality trend. Our validity analysis showed that simulations of total mortality above 25 million are not realistic based on the underlying mortality rates included in Human Mortality Database and in British India. Our results suggest that the global mortality impact of the 1918 pandemic was important (17.4 million) but not as severe as most frequently cited estimates.


PMID: 30202996 DOI: 10.1093/aje/kwy191

 

[gsgs]

I remember 2006 , some Harvard-paper , deaths by country , suggesting 12% of India dies
[ --edit-- I think, it was Murray et.al.]

I wonder what those people and others with theur 50M estimates have to say to this new paper.
Sadly, the scientific system doesn't encourage to include such direct comments and discussion.

There should be a forum-discussion-thread associated with each paper ....
Well, there is , I once found it (link ?) but very little traffic


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-- The unusually diverse mortality patterns in the Pacific region during the 1918?21 influenza pandemic: reflections at the pandemic's centenary

GD Shanks, N Wilson, R Kippen? - The Lancet Infectious ?, 2018 - Elsevier
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from the Murray paper (which I can't refind now), quoted in a 2009-thread here
excess mortality in 1918 in India:

India: 4.39%
Bengal/Sikkim: 2.33%
Bihar/Orissa:3.60%
Bombay:6.18%
Burma:2.12%
Central/Berar:7.82%
Coorg:3.44%
Madras:2.59%
Punjab/Delhi:4.57%
United Provinces:7.09%
----------------------------------------------------

• 18. Murray CJ, Lopez AD, Chin B, Feehan D, Hill KH (2006) Estimation of potential global pandemic influenza mortality on the basis of vital registry data from the 1918–20 pandemic: a quantitative analysis. Lancet 368: 2211–2218.
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  from the Murray-2006-paper
  
  and what were then described as provinces
  of pre-partition India.36,37
  
  36 Marten JT. Census of India 1921, vol 1, part I. Calcutta:
  Superintendent of Government Printing, 1924.
  37 Hutton JH, Vaidyanathan LS. Census of India 1931, vol 1, part I.
  Delhi: Manager of Publications, 1933.

 

[gsgs]

also in a recent paper Spatio-temporal Patterns and Diffusion of the 1918 Influenza Pandemic in British India
they re-iterate the 50M figure and don't mention this paper of this thread