Influenza and pneumonia mortality in 66 large cities in the United States in years surrounding the 1918 pandemic.

The 1918 influenza pandemic was a major epidemiological event of the twentieth century resulting in at least twenty million deaths worldwide; however, despite its historical, epidemiological, and biological relevance, it remains poorly understood. Here we examine the relationship between annual pneu...

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Autores principales:	Rodolfo Acuna-Soto, Cécile Viboud, Gerardo Chowell
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d79db006f9d44486aec1099150916df0
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spelling	oai:doaj.org-article:d79db006f9d44486aec1099150916df02021-11-18T06:47:37ZInfluenza and pneumonia mortality in 66 large cities in the United States in years surrounding the 1918 pandemic.1932-620310.1371/journal.pone.0023467https://doaj.org/article/d79db006f9d44486aec1099150916df02011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21886792/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203The 1918 influenza pandemic was a major epidemiological event of the twentieth century resulting in at least twenty million deaths worldwide; however, despite its historical, epidemiological, and biological relevance, it remains poorly understood. Here we examine the relationship between annual pneumonia and influenza death rates in the pre-pandemic (1910-17) and pandemic (1918-20) periods and the scaling of mortality with latitude, longitude and population size, using data from 66 large cities of the United States. The mean pre-pandemic pneumonia death rates were highly associated with pneumonia death rates during the pandemic period (Spearman ρ = 0.64-0.72; P<0.001). By contrast, there was a weak correlation between pre-pandemic and pandemic influenza mortality rates. Pneumonia mortality rates partially explained influenza mortality rates in 1918 (ρ = 0.34, P = 0.005) but not during any other year. Pneumonia death counts followed a linear relationship with population size in all study years, suggesting that pneumonia death rates were homogeneous across the range of population sizes studied. By contrast, influenza death counts followed a power law relationship with a scaling exponent of ∼0.81 (95%CI: 0.71, 0.91) in 1918, suggesting that smaller cities experienced worst outcomes during the pandemic. A linear relationship was observed for all other years. Our study suggests that mortality associated with the 1918-20 influenza pandemic was in part predetermined by pre-pandemic pneumonia death rates in 66 large US cities, perhaps through the impact of the physical and social structure of each city. Smaller cities suffered a disproportionately high per capita influenza mortality burden than larger ones in 1918, while city size did not affect pneumonia mortality rates in the pre-pandemic and pandemic periods.Rodolfo Acuna-SotoCécile ViboudGerardo ChowellPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 8, p e23467 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Rodolfo Acuna-Soto Cécile Viboud Gerardo Chowell Influenza and pneumonia mortality in 66 large cities in the United States in years surrounding the 1918 pandemic.
description	The 1918 influenza pandemic was a major epidemiological event of the twentieth century resulting in at least twenty million deaths worldwide; however, despite its historical, epidemiological, and biological relevance, it remains poorly understood. Here we examine the relationship between annual pneumonia and influenza death rates in the pre-pandemic (1910-17) and pandemic (1918-20) periods and the scaling of mortality with latitude, longitude and population size, using data from 66 large cities of the United States. The mean pre-pandemic pneumonia death rates were highly associated with pneumonia death rates during the pandemic period (Spearman ρ = 0.64-0.72; P<0.001). By contrast, there was a weak correlation between pre-pandemic and pandemic influenza mortality rates. Pneumonia mortality rates partially explained influenza mortality rates in 1918 (ρ = 0.34, P = 0.005) but not during any other year. Pneumonia death counts followed a linear relationship with population size in all study years, suggesting that pneumonia death rates were homogeneous across the range of population sizes studied. By contrast, influenza death counts followed a power law relationship with a scaling exponent of ∼0.81 (95%CI: 0.71, 0.91) in 1918, suggesting that smaller cities experienced worst outcomes during the pandemic. A linear relationship was observed for all other years. Our study suggests that mortality associated with the 1918-20 influenza pandemic was in part predetermined by pre-pandemic pneumonia death rates in 66 large US cities, perhaps through the impact of the physical and social structure of each city. Smaller cities suffered a disproportionately high per capita influenza mortality burden than larger ones in 1918, while city size did not affect pneumonia mortality rates in the pre-pandemic and pandemic periods.
format	article
author	Rodolfo Acuna-Soto Cécile Viboud Gerardo Chowell
author_facet	Rodolfo Acuna-Soto Cécile Viboud Gerardo Chowell
author_sort	Rodolfo Acuna-Soto
title	Influenza and pneumonia mortality in 66 large cities in the United States in years surrounding the 1918 pandemic.
title_short	Influenza and pneumonia mortality in 66 large cities in the United States in years surrounding the 1918 pandemic.
title_full	Influenza and pneumonia mortality in 66 large cities in the United States in years surrounding the 1918 pandemic.
title_fullStr	Influenza and pneumonia mortality in 66 large cities in the United States in years surrounding the 1918 pandemic.
title_full_unstemmed	Influenza and pneumonia mortality in 66 large cities in the United States in years surrounding the 1918 pandemic.
title_sort	influenza and pneumonia mortality in 66 large cities in the united states in years surrounding the 1918 pandemic.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/d79db006f9d44486aec1099150916df0
work_keys_str_mv	AT rodolfoacunasoto influenzaandpneumoniamortalityin66largecitiesintheunitedstatesinyearssurroundingthe1918pandemic AT cecileviboud influenzaandpneumoniamortalityin66largecitiesintheunitedstatesinyearssurroundingthe1918pandemic AT gerardochowell influenzaandpneumoniamortalityin66largecitiesintheunitedstatesinyearssurroundingthe1918pandemic
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Influenza and pneumonia mortality in 66 large cities in the United States in years surrounding the 1918 pandemic.

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