Pandemic versus Epidemic Influenza Mortality: A Pattern of Changing Age Distribution

Lone Simonsen, Matthew J. Clarke, Lawrence B. Schonberger, Nancy H. Arden, Nancy J. Cox, Keiji Fukuda

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Almost all deaths related to current influenza epidemics occur among the elderly. However, mortality was greatest among the young during the 1918-1919 pandemic. This study compared the age distribution of influenza-related deaths in the United States during this century's three influenza A pandemics with that of the following epidemics. Half of influenza-related deaths during the 1968- 1969 influenza A (H3N2) pandemic and large proportions of influenza-related deaths during the 1957-1958 influenza A (H2N2) and the 1918-1919 influenza A (H1N1) pandemics occurred among persons <65 years old. However, this group accounted for decrementally smaller proportions of deaths during the first decade following each pandemic. A model suggested that this mortality pattern may be explained by selective acquisition of protection against fatal illness among younger persons. The large proportion of influenza-related deaths during each pandemic and the following decade among persons <65 years old should be considered in planning for pandemics.
TidsskriftJournal of Infectious Diseases
Udgave nummer1
Antal sider8
StatusUdgivet - 1998
Udgivet eksterntJa

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