Enhanced risk of illness during the 1918 influenza pandemic after previous influenza-like illnesses in three military populations

Enhanced risk of illness during the 1918 influenza pandemic after previous influenza-like illnesses in three military populations

The reasons for the unprecedented mortality during the 1918 influenza pandemic remain poorly understood. We examined morbidity records from three military cohorts from years prior to and during the 1918 pandemic period to assess the effects of previous respiratory illnesses on experiences during the...

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Bibliographic Details
Published in:Epidemiology and infection Vol. 144; no. 10; pp. 2043 - 2048
Main Authors: SHANKS, G. D., BURROUGHS, S. A., SOHN, J. D., WATERS, N. C., SMITH, V. F., WALLER, M., BRUNDAGE, J. F.
Format: Journal Article
Language:English
Published: Cambridge, UK Cambridge University Press 01-07-2016
Subjects:
Adolescent
Armed forces
Australia - epidemiology
Epidemics
Europe - epidemiology
History, 20th Century
Humans
Illnesses
Immunization
Influenza
Influenza, Human - epidemiology
Influenza, Human - history
Influenza, Human - virology
Male
Maryland - epidemiology
Military Personnel - statistics & numerical data
Military training
Mortality
New York - epidemiology
Pandemics
Pandemics - history
Respiratory diseases
Risk
SHORT REPORT
Young Adult
New York
United States > US
Maryland
Europe
influenza
mortality
military
1918 pandemic
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Summary:The reasons for the unprecedented mortality during the 1918 influenza pandemic remain poorly understood. We examined morbidity records from three military cohorts from years prior to and during the 1918 pandemic period to assess the effects of previous respiratory illnesses on experiences during the pandemic. Clinical registers and morbidity lists were examined to identify all medical encounters for acute respiratory illnesses in students at two U.S. military officer training academies and Australian soldiers deployed in Europe. Influenza-like illness prior to the major pandemic wave of 1918 predisposed Australian soldiers [relative risk (RR) 1·37, 95% confidence interval (CI) 1·18–1·60, P < 0·0001] and US officer trainees at West Point (RR 3·10, 95% CI 2·13–4·52, P < 0·0001) and Annapolis (RR 2·03, 95% CI 1·65–2·50, P < 0·0001) to increased risks of medically treated illnesses in late 1918. The findings suggest that susceptibility to and/or clinical expressions of the 1918 pandemic influenza virus depended on previous experiences with respiratory infectious agents. The findings are consistent with observations during the 2009 pandemic in Canada and may reflect antibody-dependent enhancement of influenza infection.
Bibliography:ObjectType-Article-1
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ISSN:0950-2688
1469-4409
DOI:10.1017/S0950268816000479