The 1918-1920 influenza pandemic in Peru.
The 1918-1920 influenza pandemic in Peru.
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DOI：
10.1016/j.vaccine.2011.02.048
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发表时间：
2011-07-22
期刊：
影响因子：
5.5
通讯作者：
Munayco, C V
中科院分区：
文献类型：
--
作者：
Chowell, G;Viboud, C;Munayco, C V
背景：增加我们对世界不同地区过去流感大流行模式的了解对于指导未来流感大流行的准备计划至关重要。在这里，我们对秘鲁三个代表性城市——中部海岸的利马、亚马逊东北部地区的伊基托斯、南部海岸的伊卡进行了广泛的档案收集工作，以描绘该国 1918-1920 年流感大流行的时间、年龄和地理模式。 材料和方法：我们分析了描述秘鲁 1918-1920 年流感大流行的历史文献，并从当地省级档案中检索了个人死亡记录进行定量分析。我们将季节性超额死亡率模型应用于 1917-1920 年每日和每月呼吸道死亡率，并根据呼吸道死亡的每日增长率量化传播率估计。结果：从当地省级档案中检查了总共 52,739 份个人死亡记录。我们发现了 1918 年 7 月至 9 月在利马发生最初的轻度大流行浪潮的证据，确定了 1918 年 11 月至 1919 年 2 月期间所有三个地点同步发生的严重呼吸道疾病大流行浪潮，以及 1920 年 1 月至 1920 年 3 月利马和 1920 年 7 月至 10 月在伊卡的严重大流行浪潮。 1920 年伊基托斯没有再次出现大流行浪潮。值得注意的是，利马在 1920 年复发浪潮中首当其冲地受到了 1918-1920 年超额死亡率的影响，从 1918-1919 年到 1920 年，所有年龄组的全因超额死亡率均有所增加。在 1918-1919 年和 1920 年大流行浪潮中，相对于基线水平，中年群体经历了最高的超额死亡率影响。 1918-1920 年大流行期间，伊基托斯的累积超额死亡率 (2.9%) 高于利马 (1.6%)。利马的平均再生数估计在 1.3-1.5 范围内。结论：我们在 1918 年 11 月至 1919 年 2 月期间在利马、伊基托斯、伊卡确定了同步的严重过量呼吸道死亡率的大流行波，随后在 1920 年出现了异步复发波。对拉丁美洲地区 1918 年流感大流行的定量研究的累积数据证实了与这次大流行相关的高死亡率影响。为了充分了解 1918 年大流行病毒的全球影响，有必要在拉丁美洲、非洲和亚洲研究较少的地区进行进一步的历史研究。
BACKGROUND: Increasing our knowledge of past influenza pandemic patterns in different regions of the world is crucial to guide preparedness plans against future influenza pandemics. Here, we undertook extensive archival collection efforts from three representative cities of Peru-Lima in the central coast, Iquitos in the northeastern Amazon region, Ica in the southern coast-to characterize the temporal, age and geographic patterns of the 1918-1920 influenza pandemic in this country.MATERIALS AND METHODS: We analyzed historical documents describing the 1918-1920 influenza pandemic in Peru and retrieved individual mortality records from local provincial archives for quantitative analysis. We applied seasonal excess mortality models to daily and monthly respiratory mortality rates for 1917-1920 and quantified transmissibility estimates based on the daily growth rate in respiratory deaths.RESULTS: A total of 52,739 individual mortality records were inspected from local provincial archives. We found evidence for an initial mild pandemic wave during July-September 1918 in Lima, identified a synchronized severe pandemic wave of respiratory mortality in all three locations during November 1918-February 1919, and a severe pandemic wave during January 1920-March 1920 in Lima and July-October 1920 in Ica. There was no recrudescent pandemic wave in 1920 in Iquitos. Remarkably, Lima experienced the brunt of the 1918-1920 excess mortality impact during the 1920 recrudescent wave, with all age groups experiencing an increase in all cause excess mortality from 1918-1919 to 1920. Middle age groups experienced the highest excess mortality impact, relative to baseline levels, in the 1918-1919 and 1920 pandemic waves. Cumulative excess mortality rates for the 1918-1920 pandemic period were higher in Iquitos (2.9%) than Lima (1.6%). The mean reproduction number for Lima was estimated in the range 1.3-1.5.CONCLUSIONS: We identified synchronized pandemic waves of intense excess respiratory mortality during November 1918-February 1919 in Lima, Iquitos, Ica, followed by asynchronous recrudescent waves in 1920. Cumulative data from quantitative studies of the 1918 influenza pandemic in Latin American settings have confirmed the high mortality impact associated with this pandemic. Further historical studies in lesser studied regions of Latin America, Africa, and Asia are warranted for a full understanding of the global impact of the 1918 pandemic virus.