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Looking back for the future

A University of Otago, Wellington study of the 1918-19 influenza pandemic could help future pandemic planning.

The New Zealand military did not escape the 1918-19 influenza pandemic, with an estimated 930 pandemic-attributable deaths among military personnel, representing 5.1 per cent of all New Zealand military deaths from World War I.

To help understand the risk factors for death from pandemic influenza, Otago researchers conducted a case-control study using individuals situated in the northern hemisphere during the pandemic period (218 cases and 221 controls). They found some of the risk factors that had been identified in other studies such as young age (specifically 25-29 years) and having a chronic health problem such as tuberculosis.

But more novel findings for the risk of pandemic death included a relatively early year of military deployment (e.g. 1914 and 1915) and having a larger chest size.

Lead researcher Dr Jennifer Summers says the finding around larger chest size fits with anecdotal observations at the time relating to larger individual size and increased risk of complication or death during 1918.

“There has also been evidence from the more recent 2009 influenza pandemic in terms of large body size and increased risk of hospitalisation,” Summers says.
One of the study co-authors, Associate Professor Nick Wilson, notes that this type of information can inform pandemic planning.

“This is because an overwhelmed health system might need to prioritise limited resources to those groups who are most at risk of hospitalisation and death.”

The study was published in the international journal Influenza and Other Respiratory Viruses.

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