The 1918 influenza pandemic hastened the decline of tuberculosis in the United States: An age, period, cohort analysis

Noymer, Andrew

doi:10.1016/j.vaccine.2011.02.053

Cited by 60 publications

(75 citation statements)

References 11 publications

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“…A harvesting effect was described by Noymer [14] using historical data from the United States, demonstrating that many of those who died during the 1918 influenza pandemic had underlying tuberculosis. This led to decreased TB mortality and transmission in the years that followed the influenza pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…Review of data from the 1918 influenza pandemic suggests that many individuals who died had active tuberculosis [14, 15] and that underlying tuberculosis infection may have contributed to the elevated mortality observed in young adults [15, 16]. However, limited data are available on excess mortality associated with seasonal influenza infection among patients with tuberculosis.…”

Section: Introductionmentioning

confidence: 99%

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Excess Mortality Associated with Influenza among Tuberculosis Deaths in South Africa, 1999–2009

et al. 2015

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BackgroundPublished data on the interaction between influenza and pulmonary tuberculosis (PTB) are limited. We aimed to estimate the influenza-associated mortality among individuals with PTB in South Africa from 1999–2009.MethodsWe modelled the excess influenza-associated mortality by applying Poisson regression models to monthly PTB and non-tuberculosis respiratory deaths, using laboratory-confirmed influenza as a covariate.ResultsPTB deaths increased each winter, coinciding with influenza virus circulation. Among individuals of any age, mean annual influenza-associated PTB mortality rate was 164/100,000 person-years (n = 439). The rate of non-tuberculosis respiratory deaths was 27/100,000 (n = 1125) for HIV-infected and 5/100,000 (n = 2367) for HIV-uninfected individuals of all ages. Among individuals aged <65 years, influenza-associated PTB mortality risk was elevated compared to influenza-associated non-tuberculosis respiratory deaths in HIV-infected (relative risk (RR): 5.2; 95% CI: 4.6–5.9) and HIV-uninfected individuals (RR: 61.0; CI: 41.4–91.0). Among individuals aged ≥65 years, influenza-associated PTB mortality risk was elevated compared to influenza-associated non-tuberculosis respiratory deaths in HIV-uninfected individuals (RR: 13.0; 95% CI: 12.0–14.0).ConclusionWe observed an increased risk of influenza-associated mortality in persons with PTB compared to non-tuberculosis respiratory deaths. If confirmed in other settings, our findings may support recommendations for active inclusion of patients with TB for influenza vaccination and empiric influenza anti-viral treatment of patients with TB during influenza epidemics.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Excess Mortality Associated with Influenza among Tuberculosis Deaths in South Africa, 1999–2009

et al. 2015

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“…Many early twentieth-century indigenous populations worldwide had high prevalence levels of the disease (Waldram et al 2006), and the negative effects of the disease on the respiratory system of sufferers are well-known. Furthermore, underlying infection with tuberculosis has been associated with excess mortality during the 1918-19 pandemic (Noymer 2009(Noymer , 2011. Disease prevalence remained high in Newfoundland and Labrador long after it declined in other locations (Dutt 2006;Thomas 1955), and tuberculosis is also noted in studies of the 1918-19 pandemic in Alaska (e.g., Fortuine 1989;Turner 1989;Wolfe 1982).…”

Section: Biological and Cultural Factorsmentioning

confidence: 99%

Influenza-Associated Mortality during the 1918-1919 Influenza Pandemic in Alaska and Labrador: A Comparison

Mamelund¹,

Sattenspiel²,

Dimka³

2013

Social Science History

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Influenza-Associated Mortality during the 1918-1919 Influenza Pandémie in Alaska and Labrador A ComparisonSome of the most severely affected communities in the world during the 1918-19 influenza pandemic were in Labrador and Alaska. Although these two regions are on the opposite ends of North America, a cultural continuum in the Inuit populations extends throughout the North American Arctic. Both regions contain other population groups, however, and because of these similarities and differences, a comparison of their experiences during the pandemic provides new insights into how culture and environment may influence patterns of spread of infectious disease. We describe here analyses of the patterns of influenza mortality in 97 Alaska communities and 37 Labrador communities. The Alaska communities are divided intoflve geographic regions corresponding to recognized cultural groups in the region; the Labrador communities are separated into three regions that vary in the degree of admixture between European and indigenous (primarily Inuit) groups. In both Alaska and Labrador mortality was substantially higher than the worldwide average of 2.5-5 percent. Average mortality ranged from less than 1 percent to 38 percent at the regional level in Alaska and from 1 percent to 75 percent at the regional level in Labrador with up to 90 percent mortality in some local communities in both Alaska and Labrador. A number of factors influencing this heterogeneous experience are discussed, including the impact of weather and geography ; attempts to protect communities by implementing quarantine policies; accessibility of health care; nutritional deflciencies; cultural factors, such as settlement patterns, seaSocial Science History

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“…In countries where pneumococcal conjugate vaccine (PCV) was not routinely given to children, pneumococcal bacteremia was highest in children <4 years of age [32]. An increase in the number of TB-related deaths was also noted during the 1918/19 pandemic [4], [33]. In South Africa, where the burden of TB continues to remain high, 10% of fatalities associated with the 2009 H1N1 influenza virus pandemic had concurrent TB [17].…”

Section: Discussionmentioning

confidence: 99%

Temporal Association in Hospitalizations for Tuberculosis, Invasive Pneumococcal Disease and Influenza Virus Illness in South African Children

et al. 2014

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IntroductionThe seasonal variability in hospitalization for tuberculosis may in part relate to super-imposed bacterial or predisposing respiratory viral infections. We aimed to study the temporal association between hospitalization for culture-confirmed pulmonary tuberculosis (PTB), invasive pneumococcal disease (IPD) and influenza virus epidemics in South African children.MethodsWe undertook a retrospective analysis which examined seasonal trends, from 2005 to 2008, for hospitalization for culture-confirmed PTB and IPD among children in relation to the influenza epidemics in Soweto, South Africa. Original time-series of the influenza virus epidemics and hospitalization rates for PTB and IPD were decomposed into three components: a trend cycle component, a seasonal component and an irregular component using the X-11 seasonal adjustment method. To compare the seasonality amongst the three series, the trend and irregular components were removed and only seasonal components examined.ResultsAcross the study period, the influenza virus epidemics peaked during May to July (winter) months, which was closely followed by an increase in the incidence of hospitalization for IPD (August to October) and PTB (August to November).DiscussionWithin- and between-year temporal changes associated with childhood TB hospitalization may in part be driven by factors which influence temporal changes in pneumococcal disease, including potential variability in the severity of influenza virus epidemics in temperate climates. The dynamics of the interplay between the host and these infectious agents appears to be complex and multifactorial.

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The 1918 influenza pandemic hastened the decline of tuberculosis in the United States: An age, period, cohort analysis

Cited by 60 publications

References 11 publications

Excess Mortality Associated with Influenza among Tuberculosis Deaths in South Africa, 1999–2009

Excess Mortality Associated with Influenza among Tuberculosis Deaths in South Africa, 1999–2009

Influenza-Associated Mortality during the 1918-1919 Influenza Pandemic in Alaska and Labrador: A Comparison

Temporal Association in Hospitalizations for Tuberculosis, Invasive Pneumococcal Disease and Influenza Virus Illness in South African Children

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