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The 1918 Influenza Pandemic and Its Legacy

tetano

Editor, Senior Moderator
Cold Spring Harb Perspect Med. 2019 Dec 23. pii: a038695. doi: 10.1101/cshperspect.a038695. [Epub ahead of print] [h=1]The 1918 Influenza Pandemic and Its Legacy.[/h]
Taubenberger JK[SUP]1[/SUP], Morens DM[SUP]2[/SUP].
[h=3]Author information[/h] 1 Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA. 2 Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA.

[h=3]Abstract[/h] Just over a century ago in 1918-1919, the "Spanish" influenza pandemic appeared nearly simultaneously around the world and caused extraordinary mortality-estimated at 50-100 million fatalities-associated with unexpected clinical and epidemiological features. The pandemic's sudden appearance and high fatality rate were unprecedented, and 100 years later still serve as a stark reminder of the continual threat influenza poses. Sequencing and reconstruction of the 1918 virus have allowed scientists to answer many questions about its origin and pathogenicity, although many questions remain. Several of the unusual features of the 1918-1919 pandemic, including age-specific mortality patterns and the high frequency of severe pneumonias, are still not fully understood. The 1918 pandemic virus initiated a pandemic era still ongoing. The descendants of the 1918 virus remain today as annually circulating and evolving influenza viruses causing significant mortality each year. This review summarizes key findings and unanswered questions about this deadliest of human events.
Copyright ? 2019 Cold Spring Harbor Laboratory Press; all rights reserved.


PMID: 31871232 DOI: 10.1101/cshperspect.a038695
 
17 pages .pdf : http://perspectivesinmedicine.cshlp....t.a038695.long





> causing, over the course of a year,
> symptomatic disease in approximately one-third of
> the world’s population, with evidence that a
> significant percentage had been asymptomatically
> or subclinically infected



> Phylogenetic analyses have also been used to model

> the origin of the 1918 virus but have generated different dates
> for the estimated origin of the pandemic virus
> (Reid et al. 2004a; Taubenberger et al. 2005;
> Smith et al. 2009; Worobey et al. 2014).



not so much different. Only ~10 years



> It appears highly unlikely on epidemiological
> and biological grounds that a virus expressing
> the pandemic H1 HA, with its inherent viru-
> lence, could have widely circulated in humans
> much before 1918.



... as Worobey et. al. 2014 suggest.

A reassorted virus i.e. without E627K in PB2

could have been much less virulent.



> Avian influenza A viruses expressing
> H1 subtype HAs that are similar to those that
> existed in 1918 still circulate in nature today.



Yes, but that H1 is very different from 1918's H1. Reassortment in birds is quite frequent.

The 1918 HA is quite different from any known avian H1 and has a common ancestry with

with avian H1 of before ~1860.

Smith et. al write :

> Ages of the H1 and NP genes at node 1 could not be calculated because of uncertainty

> in the phylogenies

The 1918 H1 may have been in mammals for a long time. It could even be the

equine HA from 1872, who knows.





https://flutrackers.com/forum/forum/...s-for-1918-flu





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