Transmissibility of 1918 pandemic influenza

By Christina E. Mills, James M. Robins, Marc Lipsitch. Nature, 2004

855 citations recorded by the source corpus.

The 1918 influenza pandemic killed 20–40 million people worldwide, and is seen as a worst-case scenario for pandemic planning. Like other pandemic influenza strains, the 1918 A/H1N1 strain spread extremely rapidly. A measure of transmissibility and of the stringency of control measures required to stop an epidemic is the reproductive number, which is the number of secondary cases produced by each primary case. Here we obtained an estimate of the reproductive number for 1918 influenza by fitting a deterministic SEIR (susceptible-exposed-infectious-recovered) model to pneumonia and influenza death epidemic curves from 45 US cities: the median value is less than three. The estimated proportion of the population with A/H1N1 immunity before September 1918 implies a median basic reproductive number of less than four. These results strongly suggest that the reproductive number for 1918 pandemic influenza is not large relative to many other infectious diseases. In theory, a similar novel influenza subtype could be controlled. But because influenza is frequently transmitted before a specific diagnosis is possible and there is a dearth of global antiviral and vaccine stores, aggressive transmission reducing measures will probably be required.

Subfields: Epidemiology, Infectious Diseases, Modeling and Simulation

View Paper: https://www.semanticscholar.org/paper/d9161467cecc03d632452117a8f4e0a7fc9155bb

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Epidemiology

In Infectious Diseases

In Modeling and Simulation

Citations in the corpus

Comparing large-scale computational approaches to epidemic modeling: Agent-based versus structured metapopulation models (2010, background): “[6-8], taking on three values for the reproductive number, R 0 = 1.5, 1.9, and 2.3, in the range of expected values for a newly-emerging influenza pandemic as based on estimates for previous pandemics [15,46].”
Strategies for containing an emerging influenza pandemic in Southeast Asia (2005, background): “In summary, points (4) and (5) are the most critical, as one might expect.”
Mining social mixing patterns for infectious disease models based on a two-day population survey in Belgium (2009, positive): “the basic reproduction number R0, equaled 2 (thus mimicking the emergence of pandemic influenza [23,24]).”
How generation intervals shape the relationship between growth rates and reproductive numbers (2007, background): “Such a difference might explain the discrepancies between the various reported values for the mean generation interval of influenza A (Longini et al. 2004; Mills et al. 2004; Ferguson et al. 2005, 2006).”
The structure of online diffusion networks (2012, background): “Referring again to the 1918 influenza epidemic, although it infected more than 500 million people, individuals typically infected no more than a handful of others [Mills et al. 2002], and hence its scale was determined almost entirely by the large number of generations over which it spread.”
Absolute Humidity and the Seasonal Onset of Influenza in the Continental United States (2010, background): “Estimates of D range from 2 to 7 d [16,25], and estimates of L range from 2 to 10 y.”
Mathematical models of infectious disease transmission (2008, background): “Estimates from other historical data vary on either the higher or lower side of this number depending on the data and assumptions that are made 44, 45 .”
Dynamics and Control of Diseases in Networks with Community Structure (2010, background): “flu-like infectious diseases that are transmitted directly from person to person by the respiratory or close-contact route [8,9,48,49,50]).”