Document Detail

Epidemiologic characterization of the 1918 influenza pandemic summer wave in Copenhagen: implications for pandemic control strategies.
MedLine Citation:
PMID:  18194088     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The 1918-1919 A/H1N1 influenza pandemic killed approximately 50 million people worldwide. Historical records suggest that an early pandemic wave struck Europe during the summer of 1918.
METHODS: We obtained surveillance data that were compiled weekly, during 1910-1919, in Copenhagen, Denmark; the records included medically treated influenza-like illnesses (ILIs), hospitalizations, and deaths by age. We used a Serfling seasonal regression model to quantify excess morbidity and mortality, and we estimated the reproductive number (R) for the summer, fall, and winter pandemic waves.
RESULTS: A large epidemic occurred in Copenhagen during the summer of 1918; the age distribution of deaths was characteristic of the 1918-1919 A/H1N1 pandemic overall. That summer wave accounted for 29%-34% of all excess ILIs and hospitalizations during 1918, whereas the case-fatality rate (0.3%) was many-fold lower than that of the fall wave (2.3%). Similar patterns were observed in 3 other Scandinavian cities. R was substantially higher in summer (2.0-5.4) than in fall (1.2-1.6) in all cities.
CONCLUSIONS: The Copenhagen summer wave may have been caused by a precursor A/H1N1 pandemic virus that transmitted efficiently but lacked extreme virulence. The R measured in the summer wave is likely a better approximation of transmissibility in a fully susceptible population and is substantially higher than that found in previous US studies. The summer wave may have provided partial protection against the lethal fall wave.
Viggo Andreasen; Cécile Viboud; Lone Simonsen
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Publication Detail:
Type:  Historical Article; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of infectious diseases     Volume:  197     ISSN:  0022-1899     ISO Abbreviation:  J. Infect. Dis.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-15     Completed Date:  2008-02-19     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  0413675     Medline TA:  J Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  270-8     Citation Subset:  AIM; IM    
Department of Sciences, Roskilde University, Roskilde, Denmark.
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MeSH Terms
Age Distribution
Age Factors
Communicable Disease Control / history*,  methods
Denmark / epidemiology
Disease Outbreaks / history*,  prevention & control,  statistics & numerical data
Evolution, Molecular
History, 20th Century
Hospitalization / statistics & numerical data
Influenza A Virus, H1N1 Subtype* / genetics
Influenza, Human / epidemiology,  history*,  mortality,  transmission
Middle Aged
Regression Analysis
Survival Analysis
Grant Support
Comment In:
J Infect Dis. 2008 Jul 15;198(2):294-5; author reply 295-6   [PMID:  18593297 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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