TY - JOUR
T1 - Estimation of potential global pandemic influenza mortality on the basis of vital registry data from the 1918-20 pandemic
T2 - a quantitative analysis
AU - Murray, Christopher JL
AU - Lopez, Alan D.
AU - Chin, Brian
AU - Feehan, Dennis
AU - Hill, Kenneth H.
N1 - Funding Information:
This study was been funded by the National Institute on Aging (grant number PO1-AG17625).
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2006/12/23
Y1 - 2006/12/23
N2 - Background: The threat of an avian influenza pandemic is causing widespread public concern and health policy response, especially in high-income countries. Our aim was to use high-quality vital registration data gathered during the 1918-20 pandemic to estimate global mortality should such a pandemic occur today. Methods: We identified all countries with high-quality vital registration data for the 1918-20 pandemic and used these data to calculate excess mortality. We developed ordinary least squares regression models that related excess mortality to per-head income and absolute latitude and used these models to estimate mortality had there been an influenza pandemic in 2004. Findings: Excess mortality data show that, even in 1918-20, population mortality varied over 30-fold across countries. Per-head income explained a large fraction of this variation in mortality. Extrapolation of 1918-20 mortality rates to the worldwide population of 2004 indicates that an estimated 62 million people (10th-90th percentile range 51 million-81 million) would be killed by a similar influenza pandemic; 96% (95% CI 95-98) of these deaths would occur in the developing world. If this mortality were concentrated in a single year, it would increase global mortality by 114%. Interpretation: This analysis of the empirical record of the 1918-20 pandemic provides a plausible upper bound on pandemic mortality. Most deaths will occur in poor countries-ie, in societies whose scarce health resources are already stretched by existing health priorities.
AB - Background: The threat of an avian influenza pandemic is causing widespread public concern and health policy response, especially in high-income countries. Our aim was to use high-quality vital registration data gathered during the 1918-20 pandemic to estimate global mortality should such a pandemic occur today. Methods: We identified all countries with high-quality vital registration data for the 1918-20 pandemic and used these data to calculate excess mortality. We developed ordinary least squares regression models that related excess mortality to per-head income and absolute latitude and used these models to estimate mortality had there been an influenza pandemic in 2004. Findings: Excess mortality data show that, even in 1918-20, population mortality varied over 30-fold across countries. Per-head income explained a large fraction of this variation in mortality. Extrapolation of 1918-20 mortality rates to the worldwide population of 2004 indicates that an estimated 62 million people (10th-90th percentile range 51 million-81 million) would be killed by a similar influenza pandemic; 96% (95% CI 95-98) of these deaths would occur in the developing world. If this mortality were concentrated in a single year, it would increase global mortality by 114%. Interpretation: This analysis of the empirical record of the 1918-20 pandemic provides a plausible upper bound on pandemic mortality. Most deaths will occur in poor countries-ie, in societies whose scarce health resources are already stretched by existing health priorities.
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U2 - 10.1016/S0140-6736(06)69895-4
DO - 10.1016/S0140-6736(06)69895-4
M3 - Article
C2 - 17189032
AN - SCOPUS:33845641295
SN - 0140-6736
VL - 368
SP - 2211
EP - 2218
JO - Lancet
JF - Lancet
IS - 9554
ER -