A comparative study of the 1918-1920 influenza pandemic in Japan, USA and UK: Mortality impact and implications for pandemic planning

S. A. Richard, N. Sugaya, L. Simonsen, M. A. Miller, C. Viboud*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

52 Scopus citations

Abstract

Historical studies of influenza pandemics can provide insight into transmission and mortality patterns, and may aid in planning for a future pandemic. Here, we analyse historical vital statistics and quantify the age-specific mortality patterns associated with the 1918-1920 influenza pandemic in Japan, USA, and UK. All three countries showed highly elevated mortality risk in young adults relative to surrounding non-pandemic years. By contrast, the risk of death was low in the very young and very old. In Japan, the overall mortality impact was not limited to winter 1918-1919, and continued during winter 1919-1920. Mortality impact varied as much as threefold across the 47 Japanese prefectures, and differences in baseline mortality, population demographics, and density explained a small fraction of these variations. Our study highlights important geographical variations in timing and mortality impact of historical pandemics, in particular between the Eastern and Western hemispheres. In a future pandemic, vaccination in one region could save lives even months after the emergence of a pandemic virus in another region.

Original languageEnglish
Pages (from-to)1062-1072
Number of pages11
JournalEpidemiology and Infection
Volume137
Issue number8
DOIs
StatePublished - 2009

Keywords

  • Age patterns
  • Excess mortality
  • Geography
  • Influenza
  • Pandemic

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