Age-Specific Mortality During the 1918 Influenza Pandemic: Unravelling the Mystery of High Young Adult Mortality
Identifieur interne : 000637 ( Pmc/Checkpoint ); précédent : 000636; suivant : 000638Age-Specific Mortality During the 1918 Influenza Pandemic: Unravelling the Mystery of High Young Adult Mortality
Auteurs : Alain Gagnon [Canada] ; Matthew S. Miller [États-Unis] ; Stacey A. Hallman [Canada] ; Robert Bourbeau [Canada] ; D. Ann Herring [Canada] ; David Jd. Earn [Canada] ; Joaquín Madrenas [Canada]Source :
- PLoS ONE [ 1932-6203 ] ; 2013.
Abstract
The worldwide spread of a novel influenza A (H1N1) virus in 2009 showed that influenza remains a significant health threat, even for individuals in the prime of life. This paper focuses on the unusually high young adult mortality observed during the Spanish flu pandemic of 1918. Using historical records from Canada and the U.S., we report a peak of mortality at the exact age of 28 during the pandemic and argue that this increased mortality resulted from an early life exposure to influenza during the previous Russian flu pandemic of 1889–90. We posit that in specific instances, development of immunological memory to an influenza virus strain in early life may lead to a dysregulated immune response to antigenically novel strains encountered in later life, thereby increasing the risk of death. Exposure during critical periods of development could also create holes in the T cell repertoire and impair fetal maturation in general, thereby increasing mortality from infectious diseases later in life. Knowledge of the age-pattern of susceptibility to mortality from influenza could improve crisis management during future influenza pandemics.
Url:
DOI: 10.1371/journal.pone.0069586
PubMed: 23940526
PubMed Central: 3734171
Affiliations:
- Canada, États-Unis
- Ontario, Québec, État de New York
- Hamilton (Ontario), Montréal
- Université McGill, Université McMaster
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DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario</wicri:regionArea><orgName type="university">Université McMaster</orgName><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Madrenas, Joaquin" sort="Madrenas, Joaquin" uniqKey="Madrenas J" first="Joaquín" last="Madrenas">Joaquín Madrenas</name><affiliation wicri:level="4"><nlm:aff id="aff7"><addr-line>Department of Microbiology and Immunology, McGill University, Montreal, Quebec, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Microbiology and Immunology, McGill University, Montreal, Quebec</wicri:regionArea><orgName type="university">Université McGill</orgName><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The worldwide spread of a novel influenza A (H1N1) virus in 2009 showed that influenza remains a significant health threat, even for individuals in the prime of life. This paper focuses on the unusually high young adult mortality observed during the Spanish flu pandemic of 1918. Using historical records from Canada and the U.S., we report a peak of mortality at the exact age of 28 during the pandemic and argue that this increased mortality resulted from an early life exposure to influenza during the previous Russian flu pandemic of 1889–90. We posit that in specific instances, development of immunological memory to an influenza virus strain in early life may lead to a dysregulated immune response to antigenically novel strains encountered in later life, thereby increasing the risk of death. Exposure during critical periods of development could also create holes in the T cell repertoire and impair fetal maturation in general, thereby increasing mortality from infectious diseases later in life. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23940526</article-id><article-id pub-id-type="pmc">3734171</article-id><article-id pub-id-type="publisher-id">PONE-D-13-09397</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0069586</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Biology</subject><subj-group><subject>Immunology</subject><subj-group><subject>Immunity</subject><subj-group><subject>Humoral Immunity</subject><subject>Immunity to Infections</subject></subj-group></subj-group></subj-group><subj-group><subject>Microbiology</subject><subj-group><subject>Immunity</subject><subj-group><subject>Adaptive Immunity</subject></subj-group></subj-group><subj-group><subject>Virology</subject><subj-group><subject>Mechanisms of Resistance and Susceptibility</subject></subj-group></subj-group><subj-group><subject>Emerging Infectious Diseases</subject></subj-group></subj-group><subj-group><subject>Population Biology</subject><subj-group><subject>Epidemiology</subject></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Medicine</subject><subj-group><subject>Infectious Diseases</subject><subj-group><subject>Viral Diseases</subject><subj-group><subject>Influenza</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Social and Behavioral Sciences</subject><subj-group><subject>Anthropology</subject><subj-group><subject>Biological Anthropology</subject></subj-group></subj-group><subj-group><subject>Economics</subject><subj-group><subject>Economic History</subject></subj-group></subj-group><subj-group><subject>Sociology</subject><subj-group><subject>Demography</subject><subj-group><subject>Death Rate</subject></subj-group></subj-group></subj-group></subj-group></article-categories><title-group><article-title>Age-Specific Mortality During the 1918 Influenza Pandemic: Unravelling the Mystery of High Young Adult Mortality</article-title><alt-title alt-title-type="running-head">Young Adult Mortality During the 1918 Flu Pandemic</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Gagnon</surname><given-names>Alain</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Miller</surname><given-names>Matthew S.</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Hallman</surname><given-names>Stacey A.</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bourbeau</surname><given-names>Robert</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Herring</surname><given-names>D. Ann</given-names></name><xref ref-type="aff" rid="aff4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Earn</surname><given-names>David JD.</given-names></name><xref ref-type="aff" rid="aff5"><sup>5</sup></xref><xref ref-type="aff" rid="aff6"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Madrenas</surname><given-names>Joaquín</given-names></name><xref ref-type="aff" rid="aff7"><sup>7</sup></xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>Département de Démographie, Université de Montréal, Montreal, Quebec, Canada</addr-line></aff><aff id="aff2"><label>2</label><addr-line>Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, United States of America</addr-line></aff><aff id="aff3"><label>3</label><addr-line>Deparment of Sociology, Western University, London, Ontario, Canada</addr-line></aff><aff id="aff4"><label>4</label><addr-line>Department of Anthropology, McMaster University, Hamilton, Ontario, Canada</addr-line></aff><aff id="aff5"><label>5</label><addr-line>Department of Mathematics and Statistics, McMaster University, Hamilton, Ontario, Canada</addr-line></aff><aff id="aff6"><label>6</label><addr-line>M.G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada</addr-line></aff><aff id="aff7"><label>7</label><addr-line>Department of Microbiology and Immunology, McGill University, Montreal, Quebec, Canada</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Digard</surname><given-names>Paul</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>University of Edinburgh, United Kingdom</addr-line></aff><author-notes><corresp id="cor1">* E-mail: <email>alain.gagnon.4@umontreal.ca</email></corresp><fn fn-type="COI-statement"><p><bold>Competing Interests: </bold>The authors have declared that no competing interests exist.</p></fn><fn fn-type="con"><p>Analyzed the data: AG MSM SAH RB. Wrote the paper: AG MSM SAH RB DAH DJDE JM. Provided cues regarding immunological mechanisms: MSM JM.</p></fn></author-notes><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub"><day>5</day><month>8</month><year>2013</year></pub-date><volume>8</volume><issue>8</issue><elocation-id>e69586</elocation-id><history><date date-type="received"><day>6</day><month>3</month><year>2013</year></date><date date-type="accepted"><day>9</day><month>6</month><year>2013</year></date></history><permissions><copyright-statement>© 2013 Gagnon et al</copyright-statement><copyright-year>2013</copyright-year><copyright-holder>Gagnon et al</copyright-holder><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.</license-p></license></permissions><abstract><p>The worldwide spread of a novel influenza A (H1N1) virus in 2009 showed that influenza remains a significant health threat, even for individuals in the prime of life. This paper focuses on the unusually high young adult mortality observed during the Spanish flu pandemic of 1918. Using historical records from Canada and the U.S., we report a peak of mortality at the exact age of 28 during the pandemic and argue that this increased mortality resulted from an early life exposure to influenza during the previous Russian flu pandemic of 1889–90. We posit that in specific instances, development of immunological memory to an influenza virus strain in early life may lead to a dysregulated immune response to antigenically novel strains encountered in later life, thereby increasing the risk of death. Exposure during critical periods of development could also create holes in the T cell repertoire and impair fetal maturation in general, thereby increasing mortality from infectious diseases later in life. Knowledge of the age-pattern of susceptibility to mortality from influenza could improve crisis management during future influenza pandemics.</p></abstract><funding-group><funding-statement>This work was supported by the Social Science and Humanity and Research council of Canada <ext-link ext-link-type="uri" xlink:href="http://www.sshrc-crsh.gc.ca/home-accueil-eng.aspx">http://www.sshrc-crsh.gc.ca/home-accueil-eng.aspx</ext-link> (AG, SAH, DAH, and RB), the Canadian Institutes of Health Research <ext-link ext-link-type="uri" xlink:href="http://www.cihr-irsc.gc.ca/e/193.html">http://www.cihr-irsc.gc.ca/e/193.html</ext-link> (AG, MSM, DJDE, and JM) and the Natural Sciences and Engineering Research Council of Canada <ext-link ext-link-type="uri" xlink:href="http://www.nserc-crsng.gc.ca/index_eng.asp">http://www.nserc-crsng.gc.ca/index_eng.asp</ext-link> (DJDE). JM holds a Tier I Canada Research Chair in Human Immunology. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement></funding-group><counts><page-count count="9"></page-count></counts></article-meta></front></pmc><affiliations><list><country><li>Canada</li><li>États-Unis</li></country><region><li>Ontario</li><li>Québec</li><li>État de New York</li></region><settlement><li>Hamilton (Ontario)</li><li>Montréal</li></settlement><orgName><li>Université McGill</li><li>Université McMaster</li></orgName></list><tree><country name="Canada"><noRegion><name sortKey="Gagnon, Alain" sort="Gagnon, Alain" uniqKey="Gagnon A" first="Alain" last="Gagnon">Alain Gagnon</name></noRegion><name sortKey="Bourbeau, Robert" sort="Bourbeau, Robert" uniqKey="Bourbeau R" first="Robert" last="Bourbeau">Robert Bourbeau</name><name sortKey="Earn, David Jd" sort="Earn, David Jd" uniqKey="Earn D" first="David Jd." last="Earn">David Jd. Earn</name><name sortKey="Earn, David Jd" sort="Earn, David Jd" uniqKey="Earn D" first="David Jd." last="Earn">David Jd. Earn</name><name sortKey="Hallman, Stacey A" sort="Hallman, Stacey A" uniqKey="Hallman S" first="Stacey A." last="Hallman">Stacey A. Hallman</name><name sortKey="Herring, D Ann" sort="Herring, D Ann" uniqKey="Herring D" first="D. Ann" last="Herring">D. Ann Herring</name><name sortKey="Madrenas, Joaquin" sort="Madrenas, Joaquin" uniqKey="Madrenas J" first="Joaquín" last="Madrenas">Joaquín Madrenas</name></country><country name="États-Unis"><region name="État de New York"><name sortKey="Miller, Matthew S" sort="Miller, Matthew S" uniqKey="Miller M" first="Matthew S." last="Miller">Matthew S. Miller</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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