Document Detail

Lessons from the past: familial aggregation analysis of fatal pandemic influenza (Spanish flu) in Iceland in 1918.
MedLine Citation:
PMID:  18216264     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Historical Article; Journal Article; Research Support, N.I.H., Extramural     Date:  2008-01-23
Journal Detail:
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:
Created Date:  2008-01-30     Completed Date:  2008-02-25     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7505876     Medline TA:  Proc Natl Acad Sci U S A     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1303-8     Citation Subset:  IM    
Landspitali University Hospital, 108 Reykjavik, Iceland.
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MeSH Terms
Aged, 80 and over
Child, Preschool
Disease Outbreaks
Genetic Predisposition to Disease
History, 20th Century
Iceland / epidemiology
Infant, Newborn
Influenza, Human / epidemiology,  genetics*,  history,  mortality*
Middle Aged
Survival Analysis
Grant Support
HHSN266200400064C//PHS HHS
Comment In:
Proc Natl Acad Sci U S A. 2008 Jan 29;105(4):1109-10   [PMID:  18216247 ]

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