Age-Specific Excess Mortality Patterns During the 1918–1920 Influenza Pandemic in Madrid, Spain
Identifieur interne : 000180 ( Pmc/Checkpoint ); précédent : 000179; suivant : 000181Age-Specific Excess Mortality Patterns During the 1918–1920 Influenza Pandemic in Madrid, Spain
Auteurs : Laura Cilek [Espagne] ; Gerardo Chowell [Géorgie (pays), États-Unis] ; Diego Ramiro Fari As [Espagne]Source :
- American Journal of Epidemiology [ 0002-9262 ] ; 2018.
Abstract
Although much progress has been made to uncover age-specific mortality patterns of the 1918 influenza pandemic in populations around the world, more studies in different populations are needed to make sense of the heterogeneous death impact of this pandemic. We assessed the absolute and relative magnitudes of 3 pandemic waves in the city of Madrid, Spain, between 1918 and 1920, on the basis of age-specific all-cause and respiratory excess death rates. Excess death rates were estimated using a Serfling model with a parametric bootstrapping approach to calibrate baseline death levels with quantified uncertainty. Excess all-cause and pneumonia and influenza mortality rates were estimated for different pandemic waves and age groups. The youngest and oldest persons experienced the highest excess mortality rates, and young adults faced the highest standardized mortality risk. Waves differed in strength; the peak standardized mortality risk occurred during the herald wave in spring 1918, but the highest excess rates occurred during the fall and winter of 1918/1919. Little evidence was found to support a “W”-shaped, age-specific excess mortality curve. Acquired immunity may have tempered a protracted fall wave, but recrudescent waves following the initial 2 outbreaks heightened the total pandemic mortality impact.
Url:
DOI: 10.1093/aje/kwy171
PubMed: 30124746
PubMed Central: 6454514
Affiliations:
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<p>Although much progress has been made to uncover age-specific mortality patterns of the 1918 influenza pandemic in populations around the world, more studies in different populations are needed to make sense of the heterogeneous death impact of this pandemic. We assessed the absolute and relative magnitudes of 3 pandemic waves in the city of Madrid, Spain, between 1918 and 1920, on the basis of age-specific all-cause and respiratory excess death rates. Excess death rates were estimated using a Serfling model with a parametric bootstrapping approach to calibrate baseline death levels with quantified uncertainty. Excess all-cause and pneumonia and influenza mortality rates were estimated for different pandemic waves and age groups. The youngest and oldest persons experienced the highest excess mortality rates, and young adults faced the highest standardized mortality risk. Waves differed in strength; the peak standardized mortality risk occurred during the herald wave in spring 1918, but the highest excess rates occurred during the fall and winter of 1918/1919. Little evidence was found to support a “W”-shaped, age-specific excess mortality curve. Acquired immunity may have tempered a protracted fall wave, but recrudescent waves following the initial 2 outbreaks heightened the total pandemic mortality impact.</p>
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<contrib contrib-type="author"><name><surname>Chowell</surname>
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Institute of Economy, Geography and Demography, Center for Humanities and Social Sciences Spanish National Research Council, Madrid, Spain</aff>
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School of Public Health, Division of Epidemiology & Biostatistics, Georgia State University, Atlanta, Georgia</aff>
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Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland</aff>
<author-notes><corresp id="kwy171cor1">Correspondence to Laura Cilek, IEGD-CCHS-CSIC, Spanish National Research Council, Calle Albasanz, 26-28, Madrid, Spain, 28037 (e-mail: <email>laura.cilek@cchs.csic.es</email>
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<abstract><title>Abstract</title>
<p>Although much progress has been made to uncover age-specific mortality patterns of the 1918 influenza pandemic in populations around the world, more studies in different populations are needed to make sense of the heterogeneous death impact of this pandemic. We assessed the absolute and relative magnitudes of 3 pandemic waves in the city of Madrid, Spain, between 1918 and 1920, on the basis of age-specific all-cause and respiratory excess death rates. Excess death rates were estimated using a Serfling model with a parametric bootstrapping approach to calibrate baseline death levels with quantified uncertainty. Excess all-cause and pneumonia and influenza mortality rates were estimated for different pandemic waves and age groups. The youngest and oldest persons experienced the highest excess mortality rates, and young adults faced the highest standardized mortality risk. Waves differed in strength; the peak standardized mortality risk occurred during the herald wave in spring 1918, but the highest excess rates occurred during the fall and winter of 1918/1919. Little evidence was found to support a “W”-shaped, age-specific excess mortality curve. Acquired immunity may have tempered a protracted fall wave, but recrudescent waves following the initial 2 outbreaks heightened the total pandemic mortality impact.</p>
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