Global Mortality Impact of the 1957-1959 Influenza Pandemic

TY - JOUR

T1 - Global Mortality Impact of the 1957-1959 Influenza Pandemic

AU - Viboud, Cécile

AU - Simonsen, Lone

AU - Fuentes, Rodrigo

AU - Flores, Jose

AU - Miller, Mark A.

AU - Chowell, Gerardo

N1 - Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

PY - 2015

Y1 - 2015

N2 - BACKGROUND: Quantitative estimates of the global burden of the 1957 influenza pandemic are lacking. Here we fill this gap by modeling historical mortality statistics.METHODS: We used annual rates of age- and cause-specific deaths to estimate pandemic-related mortality in excess of background levels in 39 countries in Europe, the Asia-Pacific region, and the Americas. We modeled the relationship between excess mortality and 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; Europe and 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 evidence that elderly population was spared from excess mortality. Development indicators were moderate predictors of excess mortality, explaining 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 pandemic but was approximately 10-fold greater than that of the 2009 pandemic. The impact of the pandemic on mortality was delayed in several countries, pointing to a window of opportunity for vaccination in a future pandemic.

AB - BACKGROUND: Quantitative estimates of the global burden of the 1957 influenza pandemic are lacking. Here we fill this gap by modeling historical mortality statistics.METHODS: We used annual rates of age- and cause-specific deaths to estimate pandemic-related mortality in excess of background levels in 39 countries in Europe, the Asia-Pacific region, and the Americas. We modeled the relationship between excess mortality and 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; Europe and 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 evidence that elderly population was spared from excess mortality. Development indicators were moderate predictors of excess mortality, explaining 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 pandemic but was approximately 10-fold greater than that of the 2009 pandemic. The impact of the pandemic on mortality was delayed in several countries, pointing to a window of opportunity for vaccination in a future pandemic.

KW - Adolescent

KW - Adult

KW - Child

KW - Child, Preschool

KW - Global Health

KW - History, 20th Century

KW - Humans

KW - Infant

KW - Influenza A Virus, H2N2 Subtype

KW - Influenza, Human

KW - Middle Aged

KW - Pandemics

KW - Young Adult

KW - Historical Article

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

KW - Research Support, U.S. Gov't, P.H.S.

U2 - 10.1093/infdis/jiv534

DO - 10.1093/infdis/jiv534

M3 - Journal article

C2 - 26908781

SN - 0022-1899

VL - 213

SP - 738

EP - 745

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

IS - 5

ER -