April 30, 2009

Excess mortality due to the 1918-1919 flu pandemic

On the left, excess mortality (per 10,000) due to the pandemic. The paper (and journal) is free for the time being, so, go ahead and read it for yourselves.

Influenza and Other Respiratory Viruses doi:10.1111/j.1750-2659.2009.00080.x

Mortality burden of the 1918–1919 influenza pandemic in Europe

SĂ©verine Ansar et al.


Background The origin and estimated death toll of the 1918–1919 epidemic are still debated. Europe, one of the candidate sites for pandemic emergence, has detailed pandemic mortality information.

Objective To determine the mortality impact of the 1918 pandemic in 14 European countries, accounting for approximately three-quarters of the European population (250 million in 1918).

Methods We analyzed monthly all-cause civilian mortality rates in the 14 countries, accounting for approximately three-quarters of the European population (250 million in 1918). A periodic regression model was applied to estimate excess mortality from 1906 to 1922. Using the 1906–1917 data as a training set, the method provided a non-epidemic baseline for 1918–1922. Excess mortality was the mortality observed above this baseline. It represents the upper bound of the mortality attributable to the flu pandemic.

Results Our analysis suggests that 2·64 million excess deaths occurred in Europe during the period when Spanish flu was circulating. The method provided space variation of the excess mortality: the highest and lowest cumulative excess/predicted mortality ratios were observed in Italy (+172%) and Finland (+33%). Excess-death curves showed high synchrony in 1918–1919 with peak mortality occurring in all countries during a 2-month window (Oct–Nov 1918).

Conclusions During the Spanish flu, the excess mortality was 1·1% of the European population. Our study highlights the synchrony of the mortality waves in the different countries, which pleads against a European origin of the pandemic, as was sometimes hypothesized.


1 comment:

  1. Even those who beleive that the Indus script was not closely tied to speech agree that the Indus valley was, in many respects, the msot literate civilization in the ancient world with literacy levels far beyond what was acheived in Mesopotamia or Egypt. this can be inferred from the ubiquity of the script, the presence of signboards, large number of inscriptions etc. It was a common man’s civilization and there is no known evidence of Royal Authority. They had many acheivements in Engineering and Urban development which surpassed those of Mesopotamia or Egypt.

    It was four times the size or Egypt/Mesopotamia, & had larger cities than either. About the question of whether there was an additional script or not which was used by a small number of people, for adminstrative usage, we know
    (a) less than 10% of the IVC has been excavated
    (b) There were contacts with West Asia through out the period of the IVC.
    (c) It was four times the size or Egypt/Mesopotamia and was advanced in many ways. Even those who beleive that it was not closely tied to speech beleive that cunieform was intentionally not imported. By the same reckoning, it could have been.
    (d) There was remarkable uniformity over an extremely large area and is it amazing how this uniformity was achieved in Eighty years. While pre-IVc cultures were highly localized a remarkable level of homogeneity was enforced with breathtaking rapidity in eighty years over an area that was nearly half the size of Modern India.. remember the primitive transportantion systems way back then…
    (e) It could have been used by smaller groups of people on perishable or non=perishable materials or both

    We would also hope, research on the Gangetic plains – between 1900 Bc and 600 BC becomes mainstream..
    We have opinions of large number of mainstream and western scholars that there were a large number
    of cities and towns there and there was literacy in the Gangetic plains too. There are many practical difficulties in researching the Gangetic plains and India specific research strategies must be the starting point… Unless there is a collaborative approach between western and Indian scientists, the entire field is doomed. if this is done, we will be greatly adding to human knowledge.

    (a) Logographic scripts which are not tightly bound to speech were suitable for ancient trade based civilizations
    (b) Logographic scripts which are not tightly bound to speech were suitable for multi-ethnic civilizations like the Indus
    (c) Logographic scripts can permit mass-literacy or mass quasi-literacy
    (d) Since 5-10% of the IVC is excavated and there are 4000 examples of the indus script on seals, signboards, this gives an average of one example
    per 125 people which is unheard of old world civilizations and far in excess of other civilizations
    (e) Cuneiform would have been suitable where a script was imposed by royal authority
    (f) Primarily non-linguistic systems can have a liguistic component
    (g) The ‘lost manuscript hypothesis’ can be in another script , not necessarily in the same script. It could have been used by small groups of people
    (h) An amazing fact is how a remarkable homogeneity spread over a 1.5 million square kilometres in less than 100 years. How did this happen?

    Sujay Rao Mandavilli


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