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

Abstract

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

Methods.
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.

Results.
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.

Conclusions.
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
Volume213
Issue number5
Pages (from-to)738-745
Number of pages8
ISSN0022-1899
DOIs
Publication statusPublished - 2016
Externally publishedYes

Keywords

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

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