| Lessons from the past: familial aggregation analysis of fatal pandemic influenza (Spanish flu) in Iceland in 1918. | |
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MedLine Citation:
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PMID: 18216264 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The pandemic influenza of 1918 (Spanish flu) killed 21-50 million people globally, including in Iceland, where the characteristics and spread of the epidemic were well documented. It has been postulated that genetic host factors may have contributed to this high mortality. We identified 455 individuals who died of the Spanish flu in Iceland during a 6-week period during the winter of 1918, representing >92% of all fatal domestic cases mentioned by historical accounts. The highest case fatality proportion was 2.8%, and peak excess mortality was 162/100,000/week. Fatality proportions were highest among infants, young adults, and the elderly. A genealogical database was used to study relatedness and relative risk (RR) of the fatal influenza victims and relatives of their unaffected mates. The significance of these RR computations was assessed by drawing samples randomly from the genealogical database matched for age, sex, and geographical distribution. Familial aggregation of fatalities was seen, with RRs for death ranging from 3.75 for first-degree relatives (P < 0.0001) to 1.82 (P = 0.005), 1.12 (P = 0.252), and 1.47 (P = 0.0001) for second- to fourth-degree relatives of fatal influenza victims, respectively. The RRs within the families of unaffected mates of fatal influenza victims were 2.95 (P < 0.0001), 1.27 (P = 0.267), 1.35 (P = 0.04), and 1.42 (P = 0.001), for first- to fourth-degree relatives, respectively. In conclusion, the risk of death from the Spanish flu was similar within families of patients who succumbed to the illness and within families of their mates who survived. Our data do not provide conclusive evidence for the role of genetic factors in susceptibility to the Spanish flu. |
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Authors:
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Magnús Gottfredsson; Bjarni V Halldórsson; Stefán Jónsson; Már Kristjánsson; Kristleifur Kristjánsson; Karl G Kristinsson; Arthur Löve; Thorsteinn Blöndal; Cécile Viboud; Sverrir Thorvaldsson; Agnar Helgason; Jeffrey R Gulcher; Kári Stefánsson; Ingileif Jónsdóttir |
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Publication Detail:
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Type: Historical Article; Journal Article; Research Support, N.I.H., Extramural Date: 2008-01-23 |
Journal Detail:
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Title: Proceedings of the National Academy of Sciences of the United States of America Volume: 105 ISSN: 1091-6490 ISO Abbreviation: Proc. Natl. Acad. Sci. U.S.A. Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2008-01-30 Completed Date: 2008-02-25 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 7505876 Medline TA: Proc Natl Acad Sci U S A Country: United States |
Other Details:
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Languages: eng Pagination: 1303-8 Citation Subset: IM |
Affiliation:
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Landspitali University Hospital, 108 Reykjavik, Iceland. magnusgo@landspitali.is |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Child Child, Preschool Disease Outbreaks Family* Female Genetic Predisposition to Disease History, 20th Century Humans Iceland / epidemiology Infant Infant, Newborn Influenza, Human / epidemiology, genetics*, history, mortality* Male Middle Aged Survival Analysis |
| Grant Support | |
ID/Acronym/Agency:
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HHSN266200400064C//PHS HHS |
| Comments/Corrections | |
Comment In:
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Proc Natl Acad Sci U S A. 2008 Jan 29;105(4):1109-10
[PMID:
18216247
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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