Influenza pandemic deaths in Germany from 1918 to 2009. Estimates based on literature and own calculations
Influenza pandemic deaths in Germany from 1918 to 2009. Estimates based on literature and own calculations
复制标题
DOI：
10.1007/s00103-016-2324-9
复制
发表时间：
2016-04-01
影响因子：
1.7
通讯作者：
Uphoff, Helmut
中科院分区：
文献类型：
--
作者：
Buchholz, Udo;Buda, Silke;Uphoff, Helmut
估计二十世纪和二十一世纪(即1918-1919、1957-1958年、1968-1970年和2009年)流感大流行造成的死亡人数是一项世界性的挑战，在德国也是如此。在进行了系统的文献搜索并辅之以我们自己的计算后，对所有四种流行病的数值和估计值进行了整理和评估。系统的文献搜索包括死亡、死亡、大流行、流行病、德国，1918、1957、1968、2009。根据标题和摘要对命中数据进行审查，并根据可能的相关性进行选择。我们使用超额死亡率计算得出了我们自己的估计，这些计算估计了超过预期的死亡率。所有确定的价值都通过数据库的方法和质量进行了评估。大流行死亡人数被用来计算病死率，并与世界卫生组织提供的全球值进行比较。对于1918-1919年的大流行，我们确定了5篇相关出版物，3篇关于1957-1958年和1968-1970年的大流行，3篇关于2009年的大流行。对于所有四种流行病，最可信的估计是基于时间序列分析，这些分析要么来自文献，要么来自我们自己基于每月或每周所有原因死亡统计数据的计算。四次大流行的估计数字按时间顺序依次为426,600人(1918-1919年)、29,100人(1957-1958年)、46,900人(1968-1970年)和350人(2009年)。这意味着超额死亡率在每100,000人中有691人(1918年至1919年为0.69%)到每100,000人中有0.43人(2009年为0.00043%)。病死率显示出与全球估计的良好一致性。我们对过去四次大流行与大流行相关的超额死亡人数以及德国的超额死亡率提出了可信的估计。疫情之间的异质性很大，变异系数在1000以上。可能的解释包括病毒或宿主的特征(免疫)、社会条件、医疗系统的状况和医学进步。
Estimation of the number of deaths as a consequence of the influenza pandemics in the twentieth and twenty-first centuries (i.e. 1918-1919, 1957-1958, 1968-1970 and 2009) is a challenge worldwide and also in Germany. After conducting a systematic literature search complemented by our own calculations, values and estimates for all four pandemics were collated and evaluated.A systematic literature search including the terms death, mortality, pandemic, epidemic, Germany, 1918, 1957, 1968, 2009 was performed. Hits were reviewed by title and abstract and selected for possible relevance. We derived our own estimates using excess mortality calculations, which estimate the mortality exceeding that to be expected. All identified values were evaluated by methodology and quality of the database. Numbers of pandemic deaths were used to calculate case fatality rates and were compared with global values provided by the World Health Organization.For the pandemic 1918-1919 we identified 5 relevant publications, 3 for the pandemics 1957-1958 and 1968-1970 and 3 for 2009. For all four pandemics the most plausible estimations were based on time series analyses, taken either from the literature or from our own calculations based on monthly or weekly all cause death statistics. For the four pandemics these estimates were in chronological order 426,600 (1918-1919), 29,100 (1957-1958), 46,900 (1968-1970) and 350 (2009) excess pandemic-related deaths. This translates to an excess mortality ranging between 691 per 100,000 (0.69 % in 1918-1919) and 0.43 per 100,000 (0.00043 % in 2009). Case fatality rates showed good agreement with global estimates.We have proposed plausible estimates of pandemic-related excess number of deaths for the last four pandemics as well as excess mortality in Germany. The heterogeneity among pandemics is large with a variation factor of more than 1000. Possible explanations include characteristics of the virus or host (immunity), social conditions, status of the healthcare system and medical advances.