Global Mortality Impact of the 1957-1959 Influenza Pandemic
Global Mortality Impact of the 1957-1959 Influenza Pandemic
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DOI：
10.1093/infdis/jiv534
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发表时间：
2016-03-01
影响因子：
6.4
通讯作者：
Chowell, Gerardo
中科院分区：
文献类型：
--
作者：
Viboud, Cecile;Simonsen, Lone;Chowell, Gerardo
背景对1957年流感大流行的全球负担缺乏定量估计。在这里，我们填补了这一空白，通过建模的历史死亡率martics. Methods。我们使用年龄和原因特异性死亡的年比率来估计欧洲，亚太地区和美洲39个国家超过背景水平的流行病相关死亡率。我们建立了超额死亡率和发展指标之间的关系模型，以推断该流行病的全球负担。1957-1959年期间，与大流行相关的过度呼吸道死亡率平均为1.9/10 000人口（95%置信区间[CI]，1.2-2.6例/10 000人口）。各国的超额死亡率相差70倍;欧洲和拉丁美洲的超额死亡率分别最低和最高。18个国家（46%）的超额死亡率推迟了1-2年。死亡率相对于基线的增加在学龄儿童和年轻人中最大，没有证据表明老年人口免于死亡率过高。发育指标是超额死亡率的中度预测因子，解释了35%-77%的方差。总的来说，我们将全球110万例额外死亡（95%CI，0.7 - 150万例额外死亡）归因于1957-1959年的大流行。与1918年流感大流行相比，1957-1959年流感大流行的全球死亡率适中，但比2009年流感大流行高出约10倍。在几个国家，大流行对死亡率的影响被推迟，这表明在未来大流行中接种疫苗的机会之窗。
Background. Quantitative estimates of the global burden of the 1957 influenza pandemic are lacking. Here we fill this gap by modeling historical mortality statistics.Methods. We used annual rates of age-and cause-specific deaths to estimate pandemic-related mortality in excess of background levels in 39 countries in Europe, the Asia-Pacific region, and the Americas. We modeled the relationship between excess mortality and development indicators to extrapolate the global burden of the pandemic.Results. The pandemic-associated excess respiratory mortality rate was 1.9/10 000 population (95% confidence interval [CI], 1.2-2.6 cases/10 000 population) on average during 1957-1959. Excess mortality rates varied 70-fold across countries; Europe and Latin America experienced the lowest and highest rates, respectively. Excess mortality was delayed by 1-2 years in 18 countries (46%). Increases in the mortality rate relative to baseline were greatest in school-aged children and young adults, with no evidence that elderly population was spared from excess mortality. Development indicators were moderate predictors of excess mortality, explaining 35%-77% of the variance. Overall, we attribute 1.1 million excess deaths (95% CI, .7 million-1.5 million excess deaths) globally to the 1957-1959 pandemic.Conclusions. The global mortality rate of the 1957-1959 influenza pandemic was moderate relative to that of the 1918 pandemic but was approximately 10-fold greater than that of the 2009 pandemic. The impact of the pandemic on mortality was delayed in several countries, pointing to a window of opportunity for vaccination in a future pandemic.