Using mortality data from the 1918-20 influenza pandemic, researchers have predicted that 62 million people – 96% from the developing world - could die in a year if a similar pandemic were to occur today. They report their findings in an Article in this week's issue of The Lancet.
The threat of an avian influenza pandemic is causing widespread public concern. Estimates of potential mortality from a major influenza pandemic have varied from 2 million to 360 million and even up to 1 billion. However, these estimates have been based on historical accounts rather than quantitative data.
In the latest study, Christopher Murray (Harvard University, Cambridge, MA, USA) and colleagues used death registration data to calculate excess mortality during the 1918-20 pandemic in 27 countries. When they extrapolated the 1918-20 mortality rates to the worldwide population of 2004, they found that 51-81 million individuals could die if a similar pandemic were to occur that year. They found that people on high-incomes were less likely to die in a pandemic than poor people. Death rates varied by 30-fold across countries and income per head could explain half this variation.
Professor Murray concludes: "Our results indicate that, irrespective of the lethality of the virus, the burden of the next influenza pandemic will be overwhelmingly focused in the developing world, as has been suggested for the 1918–20 pandemic."
In an accompanying Comment Neil Ferguson (Imperial College London, UK) states: "So what can be done to mitigate the depressingly familiar wealth-related distribution of disease burden predicted by Murray and colleagues? Access to vaccines, antivirals, and antibiotics for the most vulnerable populations is clearly part of the solution." Dr Ferguson adds that public-health measures (such as school closure, household quarantine, or mask-wearing) could offer the most hope to countries without access to medical interventions. However, he concludes that more research is needed to determine whether public health measures on their own could substantially delay or reduce the effect of a pandemic.
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Contact: Prof Christopher J L Murray, Harvard University, Cambridge, MA, USA. T) 617-495-8300 firstname.lastname@example.org
Dr Neil Ferguson, Department of Infections Disease Epidemiology, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK. T) +44 7974 921856 (mobile) email@example.com
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