The unusually diverse mortality patterns in the Pacific region during the 1918-21 influenza pandemic: reflections at the pandemic's centenary

The Lancet Infectious Diseases
G Dennis ShanksJohn F Brundage

Abstract

The 1918-21 influenza pandemic was the most lethal natural event in recent history. In the Pacific region, the pandemic's effects varied greatly across different populations and settings. In this region, the pandemic's lethal effects extended over 3 years, from November, 1918, in New Zealand to as late as July, 1921, in New Caledonia. Although a single virus strain probably affected all the islands, mortality varied from less than 0·1% in Tasmania, to 22% in Western Samoa. The varied expressions of the pandemic across the islands reflected the nature and timing of past influenza epidemics, degrees of social isolation, ethnicity and sex-related effects, and the likelihood of exposures to pathogenic respiratory bacteria during influenza illnesses. The high case-fatality rate associated with this pandemic seems unlikely to recur in future influenza pandemics; however, understanding the critical determinants of the mass mortality associated with the 1918-21 pandemic is essential to prepare for future pandemics.

Citations

Jul 12, 2019·Internal Medicine Journal·G Dennis Shanks
Jul 16, 2019·Open Forum Infectious Diseases·G Dennis Shanks, Melissa Eslinger
Oct 24, 2018·Frontiers in Cellular and Infection Microbiology·Kirsty R ShortCarolien E van de Sandt
Dec 21, 2018·Virologica Sinica·William J LiuGeorge F Gao
Nov 14, 2018·Influenza and Other Respiratory Viruses·Juan CristinaAdela Pellegrino
Aug 14, 2019·Tropical Medicine and Infectious Disease·Arnaud TarantolaVincent Richard
Jun 25, 2019·Revue neurologique·P S SpencerW Camu
Sep 27, 2021·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Philippe BuchyEskild Petersen

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