Cross-protection between successive waves of the 1918-1919 influenza pandemic:

Epidemiological evidence from US Army camps and from Britain

John Barry, Cecile Viboud, Lone Simonsen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

BACKGROUND: The current worst-case scenario for pandemic influenza planning is based on the catastrophic 1918-1919 pandemic. In this article, we examine the strength of cross-protection between successive waves of the 1918-1919 pandemic, which has remained a long-standing issue of debate. METHOD: We studied monthly hospitalization and mortality rates for respiratory illness in 37 army camps, as well as the rates of repeated episodes of influenza infection during January-December 1918 in 8 military and civilian settings in the United States and Britain. RESULTS: A first wave of respiratory illness occurred in US Army camps during March-May 1918 and in Britain during May-June, followed by a lethal second wave in the fall. The first wave was characterized by high morbidity but had a lower fatality rate than the second wave (1.1% vs. 4.7% among hospitalized soldiers; P < .001). Based on repeated illness data, the first wave provided 35%-94% protection against clinical illness during the second wave and 56%-89% protection against death (P < .001). CONCLUSION: Exposure to influenza in the spring and summer of 1918 provided mortality and morbidity protection during the fall pandemic wave. The intensity of the first wave may have differed across US cities and countries and may partly explain geographical variation in pandemic mortality rates in the fall. Pandemic preparedness plans should consider that immune protection could be naturally acquired during a first wave of mild influenza illnesses.
OriginalsprogEngelsk
TidsskriftJournal of Infectious Diseases
Vol/bind198
Udgave nummer10
Sider (fra-til)1427-1434
ISSN0022-1899
StatusUdgivet - 2008

Citer dette

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title = "Cross-protection between successive waves of the 1918-1919 influenza pandemic:: Epidemiological evidence from US Army camps and from Britain",
abstract = "BACKGROUND: The current worst-case scenario for pandemic influenza planning is based on the catastrophic 1918-1919 pandemic. In this article, we examine the strength of cross-protection between successive waves of the 1918-1919 pandemic, which has remained a long-standing issue of debate. METHOD: We studied monthly hospitalization and mortality rates for respiratory illness in 37 army camps, as well as the rates of repeated episodes of influenza infection during January-December 1918 in 8 military and civilian settings in the United States and Britain. RESULTS: A first wave of respiratory illness occurred in US Army camps during March-May 1918 and in Britain during May-June, followed by a lethal second wave in the fall. The first wave was characterized by high morbidity but had a lower fatality rate than the second wave (1.1{\%} vs. 4.7{\%} among hospitalized soldiers; P < .001). Based on repeated illness data, the first wave provided 35{\%}-94{\%} protection against clinical illness during the second wave and 56{\%}-89{\%} protection against death (P < .001). CONCLUSION: Exposure to influenza in the spring and summer of 1918 provided mortality and morbidity protection during the fall pandemic wave. The intensity of the first wave may have differed across US cities and countries and may partly explain geographical variation in pandemic mortality rates in the fall. Pandemic preparedness plans should consider that immune protection could be naturally acquired during a first wave of mild influenza illnesses.",
author = "John Barry and Cecile Viboud and Lone Simonsen",
year = "2008",
language = "English",
volume = "198",
pages = "1427--1434",
journal = "Journal of Infectious Diseases",
issn = "0022-1899",
publisher = "Oxford University Press",
number = "10",

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Cross-protection between successive waves of the 1918-1919 influenza pandemic: Epidemiological evidence from US Army camps and from Britain. / Barry, John; Viboud, Cecile; Simonsen, Lone.

I: Journal of Infectious Diseases, Bind 198, Nr. 10, 2008, s. 1427-1434.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Cross-protection between successive waves of the 1918-1919 influenza pandemic:

T2 - Epidemiological evidence from US Army camps and from Britain

AU - Barry, John

AU - Viboud, Cecile

AU - Simonsen, Lone

PY - 2008

Y1 - 2008

N2 - BACKGROUND: The current worst-case scenario for pandemic influenza planning is based on the catastrophic 1918-1919 pandemic. In this article, we examine the strength of cross-protection between successive waves of the 1918-1919 pandemic, which has remained a long-standing issue of debate. METHOD: We studied monthly hospitalization and mortality rates for respiratory illness in 37 army camps, as well as the rates of repeated episodes of influenza infection during January-December 1918 in 8 military and civilian settings in the United States and Britain. RESULTS: A first wave of respiratory illness occurred in US Army camps during March-May 1918 and in Britain during May-June, followed by a lethal second wave in the fall. The first wave was characterized by high morbidity but had a lower fatality rate than the second wave (1.1% vs. 4.7% among hospitalized soldiers; P < .001). Based on repeated illness data, the first wave provided 35%-94% protection against clinical illness during the second wave and 56%-89% protection against death (P < .001). CONCLUSION: Exposure to influenza in the spring and summer of 1918 provided mortality and morbidity protection during the fall pandemic wave. The intensity of the first wave may have differed across US cities and countries and may partly explain geographical variation in pandemic mortality rates in the fall. Pandemic preparedness plans should consider that immune protection could be naturally acquired during a first wave of mild influenza illnesses.

AB - BACKGROUND: The current worst-case scenario for pandemic influenza planning is based on the catastrophic 1918-1919 pandemic. In this article, we examine the strength of cross-protection between successive waves of the 1918-1919 pandemic, which has remained a long-standing issue of debate. METHOD: We studied monthly hospitalization and mortality rates for respiratory illness in 37 army camps, as well as the rates of repeated episodes of influenza infection during January-December 1918 in 8 military and civilian settings in the United States and Britain. RESULTS: A first wave of respiratory illness occurred in US Army camps during March-May 1918 and in Britain during May-June, followed by a lethal second wave in the fall. The first wave was characterized by high morbidity but had a lower fatality rate than the second wave (1.1% vs. 4.7% among hospitalized soldiers; P < .001). Based on repeated illness data, the first wave provided 35%-94% protection against clinical illness during the second wave and 56%-89% protection against death (P < .001). CONCLUSION: Exposure to influenza in the spring and summer of 1918 provided mortality and morbidity protection during the fall pandemic wave. The intensity of the first wave may have differed across US cities and countries and may partly explain geographical variation in pandemic mortality rates in the fall. Pandemic preparedness plans should consider that immune protection could be naturally acquired during a first wave of mild influenza illnesses.

M3 - Journal article

VL - 198

SP - 1427

EP - 1434

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

SN - 0022-1899

IS - 10

ER -