Global mortality impact of the 1957-1959 influenza pandemic

Cécile Viboud, L. Simonsen, Rodrigo Fuentes, Jose Flores, Mark A. Miller, Gerardo Chowell

Research output: Contribution to journalJournal articleResearchpeer-review


Quantitative estimates of the global burden of the 1957 influenza pandemic are lacking. Here wefill this gap bymodeling historical mortality statistics.

We used annual rates of age- and cause-specific deaths to estimate pandemic-related mortality in excess of backgroundlevels in 39 countries in Europe, the Asia-Pacific region, and the Americas. We modeled the relationship between excess mortalityand development indicators to extrapolate the global burden of the pandemic.

The pandemic-associated excess respiratory mortality rate was 1.9/10 000 population (95% confidence interval [CI],1.2–2.6 cases/10 000 population) on average during 1957–1959. Excess mortality rates varied 70-fold across countries; Europeand Latin America experienced the lowest and highest rates, respectively. Excess mortality was delayed by 1–2 years in 18 countries(46%). Increases in the mortality rate relative to baseline were greatest in school-aged children and young adults, with no evidencethat elderly population was spared from excess mortality. Development indicators were moderate predictors of excess mortality, ex-plaining 35%–77% of the variance. Overall, we attribute 1.1 million excess deaths (95% CI, .7 million–1.5 million excess deaths)globally to the 1957–1959 pandemic.

The global mortality rate of the 1957–1959 influenza pandemic was moderate relative to that of the 1918 pandemicbut was approximately 10-fold greater than that of the 2009 pandemic. The impact of the pandemic on mortality was delayed inseveral countries, pointing to a window of opportunity for vaccination in a future pandemic.
Original languageEnglish
JournalJournal of Infectious Diseases
Issue number5
Pages (from-to)738-745
Number of pages8
Publication statusPublished - 2016
Externally publishedYes


  • Mortality rates
  • Pandemic influenza
  • Historical studies
  • Vital statistics
  • Severity
  • Models
  • Global disease burden
  • Development indicators
  • Health indicators
  • Pandemic planning

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