scholarly journals COVID-19 in Newborns and Infants—Low Risk of Severe Disease: Silver Lining or Dark Cloud?

2020 ◽  
Vol 37 (08) ◽  
pp. 845-849 ◽  
Author(s):  
Munmun Rawat ◽  
Praveen Chandrasekharan ◽  
Mark D. Hicar ◽  
Satyan Lakshminrusimha
Keyword(s):  
Influenza Pandemic ◽  
Severe Disease ◽  
The United States ◽  
Dark Cloud ◽  
Symptomatic Infection ◽  
Key Points ◽  
High Incidence ◽  
1918 Influenza ◽  
Novel Coronavirus ◽  
Low Prevalence

One hundred years after the 1918 influenza pandemic, we now face another pandemic with the severe acute respiratory syndrome–novel coronavirus-2 (SARS-CoV-2). There is considerable variability in the incidence of infection and severe disease following exposure to SARS-CoV-2. Data from China and the United States suggest a low prevalence of neonates, infants, and children, with those affected not suffering from severe disease. In this article, we speculate different theories why this novel agent is sparing neonates, infants, and young children. The low severity of SARS-CoV-2 infection in this population is associated with a high incidence of asymptomatic or mildly symptomatic infection making them efficient carriers. Key Points

scholarly journals Influenza Circulation in United States Army Training Camps Before and During the 1918 Influenza Pandemic: Clues to Early Detection of Pandemic Viral Emergence

2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Daniel S. Chertow ◽  
Rongman Cai ◽  
Junfeng Sun ◽  
John Grantham ◽  
Jeffery K. Taubenberger ◽  
...  
Keyword(s):  
United States ◽  
World War I ◽  
United States Army ◽  
Respiratory Diseases ◽  
National Guard ◽  
Influenza Pandemic ◽  
Case Fatality ◽  
The United States ◽  
Low Incidence ◽  
1918 Influenza

Abstract Background.  Surveillance for respiratory diseases in domestic National Army and National Guard training camps began after the United States’ entry into World War I, 17 months before the “Spanish influenza” pandemic appeared. Methods.  Morbidity, mortality, and case-fatality data from 605 625 admissions and 18 258 deaths recorded for 7 diagnostic categories of respiratory diseases, including influenza and pneumonia, were examined over prepandemic and pandemic periods. Results.  High pandemic influenza mortality was primarily due to increased incidence of, but not increased severity of, secondary bacterial pneumonias. Conclusions.  Two prepandemic incidence peaks of probable influenza, in December 1917–January 1918 and in March–April 1918, differed markedly from the September–October 1918 pandemic onset peak in their clinical-epidemiologic features, and they may have been caused by seasonal or endemic viruses. Nevertheless, rising proportions of very low incidence postinfluenza bronchopneumonia (diagnosed at the time as influenza and bronchopneumonia) in early 1918 could have reflected circulation of the pandemic virus 5 months before it emerged in pandemic form. In this study, we discuss the possibility of detecting pandemic viruses before they emerge, by surveillance of special populations.

scholarly journals Racial Disparities in Mortality During the 1918 Influenza Pandemic in United States Cities

2021 ◽  
Author(s):  
Martin Eiermann ◽  
Elizabeth Wrigley-Field ◽  
James J. Feigenbaum ◽  
Jonas Helgertz ◽  
Elaine Hernandez ◽  
...  
Keyword(s):  
United States ◽  
Racial Disparities ◽  
Early Life ◽  
Racial Inequality ◽  
Influenza Pandemic ◽  
The United States ◽  
Careful Examination ◽  
Unexpected Result ◽  
1918 Influenza ◽  
Socio Demographic Factors

The 1918 influenza pandemic stands out because of the unusual age pattern of high mortality. In the United States, another feature merits scientific scrutiny: against a historical backdrop of extreme racial health inequality, the pandemic produced strikingly small ratios of nonwhite to white influenza and pneumonia mortality. We provide the most complete account to date of these racial disparities in 1918, showing that, across U.S. cities, they were almost uniformly small. We examine four potential explanations for this unexpected result, including [1] socio-demographic factors like segregation, [2] city-level implementation of non-pharmaceutical interventions (NPIs), [3] exposure to the milder spring 1918 “herald wave,” and [4] early-life exposures to other influenza strains resulting in differential immunological vulnerability to the 1918 flu. While we find little evidence for 1-3, we offer suggestive evidence that racial variation in early-life exposure to the 1889-1892 influenza pandemic shrunk racial disparities during the 1918 pandemic. We also raise the possibility that differential behavioral responses to the herald wave may have protected nonwhite urban populations. By providing a comprehensive description and careful examination of the potential drivers of racial inequality in mortality during the 1918 pandemic, our study provides a framework to consider interactions between the natural history of particular microbial agents and the social histories of the populations they infect.

scholarly journals 1363Just a flu? Comparing COVID-19 and influenza mortality

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
David Muscatello ◽  
Peter McIntyre
Keyword(s):  
New York ◽  
Death Rate ◽  
Influenza Season ◽  
Influenza Pandemic ◽  
The United States ◽  
Epidemiological Methods ◽  
Influenza Pandemics ◽  
Specific Mortality ◽  
Standardized Mortality Ratios ◽  
1918 Influenza

Abstract Background Benchmarks are needed for assessing the severity of the COVID-19 pandemic. However, comparisons can be misleading unless marked differences in age-specific mortality and differences in population age structure are considered. Methods Using COVID-19 death rates for New York City as at 2 June 2020, we used indirect age standardization to estimate standardized mortality ratios (SMR) for the first winter waves of the 1918 and 2009 influenza pandemics and the severe 2017-2018 influenza season in the United States (US). Data were obtained from published statistics. Results After adjusting for age, New York City’s death rate during the 1918 winter influenza pandemic wave was 6.7 times higher overall compared with the first wave of COVID-19 in 2020. New York City's first wave COVID-19 death rate was an estimated 59 times higher than that of the 2009 US influenza pandemic, and 14 times higher than that of the severe 2017-2018 influenza season. In < 45 year-olds, the 1918 influenza death rate was 42 times higher than COVID-19 in 2020. In ≥ 65 year-olds, compared with the 2009 pandemic, the COVID-19 death rate was 320 times higher, while in children it was one half. Conclusions The 1918 pandemic was more deadly than COVID-19, which was, in turn, far more deadly than both the 2009 influenza pandemic and severe seasonal influenza. Age-specific mortality differences should be considered in decisions on COVID-19 vaccination strategies. Key messages Fundamental epidemiological methods remain valuable for modern epidemic risk assessment. COVID-19 is not just a ‘flu’.

scholarly journals Transmission frequency of COVID-19 through pre-symptomatic and asymptomatic patients in AJK: a report of 201 cases

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Majid Mahmood ◽  
Noor-ul-ain Ilyas ◽  
Muhammad Faraz Khan ◽  
Muhammad Naseem Hasrat ◽  
Nicholas Richwagen
Keyword(s):  
Disease Transmission ◽  
Transmission Rate ◽  
Human Life ◽  
Influenza Pandemic ◽  
Symptomatic Infection ◽  
Transmission Frequency ◽  
Asymptomatic Patients ◽  
History Of ◽  
1918 Influenza ◽  
Asymptomatic Individuals

Abstract Background The COVID-19 pandemic is a catastrophic global phenomenon, affecting human life in a way unseen since the 1918 influenza pandemic. Effective management of this threat requires halting transmission, a strategy requiring accurate knowledge of SARS-CoV-2 transmission patterns. Methods This was a retrospective contact study aiming to estimate the transmission rate of COVID-19 by tracing contacts in symptomatic, pre-symptomatic, and asymptomatic patients. History of patients’ contacts during 24 h before appearance of symptoms or infection confirmation was traced for disease transmission. Results Overall, a total of 201 COVID-19 patients had contact with 7168 people in 24 h with an average of 35.66 contacts per patient, ranging from a minimum of 4 to maximum of 87 contacts (meetings). Out of 7168 persons met, infection was detected in 64 (0.89%). For the 155 symptomatic patients, a total of 5611 contacted persons were traced before appearance of symptoms (pre-symptomatic) in last 24 h with an average of 36.20 meetings per patient. The infection was transmitted in 63 (1.12%) people with 5548 (98.88%) remaining uninfected. Out of the 63 transmissions, 62 (98.4%) were traced within 6 h before symptom onset, while only 1 was identified in the 6–12 h timeframe before symptoms. A total of 1557 persons were traced having meeting/contacts with asymptomatic cases in last 24 h before infection confirmation. Out of these 1557 persons, only 1 was found to be infected and the infection rate was calculated to be 0.06%. Statistically, the transmission rate by pre-symptomatic patients was found to be significantly higher than the transmission rate by asymptomatic individuals (P < 0.05). Conclusion In the studied population, the risk of pre-symptomatic and asymptomatic transmission of COVID-19 was low, with transmission risks of 1.12% and 0.06% respectively. Pre-symptomatic infection becomes very rare in contacts made longer than 6 h before onset of symptoms. The infection transmission is traced as long as about 9 h before the appearance of clear symptoms in the patients, but the incidence rate was as low as about 0.02% of the total contacts in that period.

scholarly journals The Fight Against Enzy: US Libraries During the Influenza Epidemic of 1918

2021 ◽  
Vol 49 (1) ◽  
pp. 12
Author(s):  
Lorri Mon
Keyword(s):  
Influenza Pandemic ◽  
Influenza Epidemic ◽  
Government Documents ◽  
Time Period ◽  
New Challenges ◽  
1918 Influenza ◽  
Novel Coronavirus

In 2020, a pandemic of the COVID-19 novel coronavirus struck worldwide, rapidly becoming the most devastating since the 1918 global influenza pandemic. As librarians confronted entirely new challenges in how to safely manage libraries during the COVID-19 crisis, a common question was, “what happened in libraries during the 1918 influenza pandemic?” This article explores that question through the lens of government documents and news articles of the 1918-1921 time period, seeking to understand what happened then in libraries nationwide, and what we might learn from it today.

Politics, Pushback, and Pandemics: Challenges to Public Health Orders in the 1918 Influenza Pandemic

2021 ◽  
Vol 111 (3) ◽  
pp. 416-422
Author(s):  
J. Alexander Navarro ◽  
Howard Markel
Keyword(s):  
Public Health ◽  
United States ◽  
Influenza Pandemic ◽  
The United States ◽  
Business Owners ◽  
Public Health Emergency ◽  
Health Measures ◽  
Legal Challenges ◽  
Local Politicians ◽  
1918 Influenza

During the first wave of the COVID-19 pandemic in the United States, many state governors faced an increasing number of acts of defiance as well as political and legal challenges to their public health emergency orders. Less well studied are the similar acts of protest that occurred during the 1918–1919 influenza pandemic, when residents, business owners, clergy, and even local politicians grew increasingly restless by the ongoing public health measures, defied public health edicts, and agitated to have them rescinded. We explore several of the themes that emerged during the late fall of 1918 and conclude that, although the nation seems to be following the same path as it did in 1918, the motivations for pushback to the 2020 pandemic are decidedly more political than they were a century ago.

scholarly journals The parallels between COVID-19 and the Spanish flu of 1918

2020 ◽  
Vol 7 (11) ◽  
pp. 4687
Author(s):  
Markordor Lyngdoh
Keyword(s):  
Vaccine Development ◽  
Influenza Pandemic ◽  
World Health ◽  
Health Crisis ◽  
The World ◽  
Spanish Flu ◽  
Avian Origin ◽  
1918 Influenza ◽  
Novel Coronavirus ◽  
Health Organization

The 1918 influenza pandemic was the most severe pandemic in recent history. It was caused by an H1N1 virus with genes of avian origin. On the other hand, the ongoing COVID-19 pandemic caused by a novel coronavirus hailed by the world health organization as a “once in a century health crisis” which has led to devastating impacts to health and livelihood the world over. The prevailing situation is reminiscent of the Spanish flu where definitive cure is unavailable and the public health measures like quarantine, social distancing, hand hygiene and isolation are the only alternatives. Both these diseases are transmitted through respiratory droplets, highly contagious and target the respiratory organs. The parallels between these two events cannot be denied. The Spanish flu thrived at a time when the knowledge and availability of antivirals and vaccine development were inadequate. This article strives to highlight a little more on these two separate pandemics and observe their similarities as well as their differences.

scholarly journals Pandemics, Public Health Interventions and Fertility: Evidence from the 1918 Influenza

2020 ◽  
Author(s):  
Sander Wagner ◽  
Felix C Tropf ◽  
Nicolo Cavalli ◽  
Melinda C. Mills
Keyword(s):  
Influenza Pandemic ◽  
Virus Transmission ◽  
The United States ◽  
Health Interventions ◽  
Strong Reduction ◽  
Policy Interventions ◽  
Vital Records ◽  
Demographic Processes ◽  
1918 Influenza ◽  
Pharmaceutical Interventions

Understanding how pandemics — and the policy interventions to counter them — interact with demographic processes is of urgent scientific importance. Leveraging vital records from 26 major cities in the United States, we assess how variation in non-pharmaceutical interventions (NPIs), during the 1918 influenza pandemic influenced fertility. We find a strong reduction in fertility 9 months after pandemic peaks, with fertility dropping 20% in cities with short NPIs. Fertility a year later returns to pre-pandemic levels only in the cities with longer implementation of NPIs. The interplay between longer NPIs and reduced virus transmission appears to be the main mechanism increasing fertility 9 months after implementation.

scholarly journals Disease burden and clinical severity of the first pandemic wave of COVID-19 in Wuhan, China

2020 ◽  
Author(s):  
Juan Yang ◽  
Xinhua Chen ◽  
Xiaowei Deng ◽  
Zhiyuan Chen ◽  
Hui Gong ◽  
...  
Keyword(s):  
Disease Burden ◽  
Influenza Pandemic ◽  
Clinical Severity ◽  
Multiple Data ◽  
Medical Consultations ◽  
Community Transmission ◽  
Data Source ◽  
1918 Influenza ◽  
Novel Coronavirus ◽  
2009 Influenza Pandemic

The pandemic of novel coronavirus disease 2019 (COVID-19) began in Wuhan, China, where a first wave of intense community transmission was cut short by interventions. Using multiple data source, we estimated the disease burden and clinical severity of COVID-19 by age in Wuhan from December 1, 2019 to March 31, 2020. We adjusted estimates for sensitivity of laboratory assays and accounted for prospective community screenings and healthcare seeking behaviors. Rates of symptomatic cases, medical consultations, hospitalizations and deaths were estimated at 796 (95%CI: 703-977), 489 (472-509), 370 (358-384), and 36.2 (35.0-37.3) per 100,000 persons, respectively. The COVID-19 outbreak in Wuhan had higher burden than the 2009 influenza pandemic or seasonal influenza, and that clinical severity was similar to that of the 1918 influenza pandemic. Our comparison puts the COVID-19 pandemic into context and could be helpful to guide intervention strategies and preparedness for the potential resurgence of COVID-19.

scholarly journals Oseltamivir Is Effective against 1918 Influenza Virus Infection of Macaques but Vulnerable to Escape

mBio ◽  
2019 ◽  
Vol 10 (5) ◽  
Author(s):  
Friederike Feldmann ◽  
Darwyn Kobasa ◽  
Carissa Embury-Hyatt ◽  
Allen Grolla ◽  
Tracy Taylor ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Treatment Effectiveness ◽  
Influenza Pandemic ◽  
Severe Disease ◽  
Disease Model ◽  
Influenza Virus Infection ◽  
Macaque Model ◽  
1918 Influenza ◽  
Oseltamivir Phosphate

ABSTRACT The 1918 influenza virus, subtype H1N1, was the causative agent of the most devastating pandemic in the history of infectious diseases. In vitro studies have confirmed that extreme virulence is an inherent property of this virus. Here, we utilized the macaque model for evaluating the efficacy of oseltamivir phosphate against the fully reconstructed 1918 influenza virus in a highly susceptible and relevant disease model. Our findings demonstrate that oseltamivir phosphate is effective in preventing severe disease in macaques but vulnerable to virus escape through emergence of resistant mutants, especially if given in a treatment regimen. Nevertheless, we conclude that oseltamivir would be highly beneficial to reduce the morbidity and mortality rates caused by a highly pathogenic influenza virus although it would be predicted that resistance would likely emerge with sustained use of the drug. IMPORTANCE Oseltamivir phosphate is used as a first line of defense in the event of an influenza pandemic prior to vaccine administration. Treatment failure through selection and replication of drug-resistant viruses is a known complication in the field and was also demonstrated in our study with spread of resistant 1918 influenza virus in multiple respiratory tissues. This emphasizes the importance of early treatment and the possibility that noncompliance may exacerbate treatment effectiveness. It also demonstrates the importance of implementing combination therapy and vaccination strategies as soon as possible in a pandemic situation.

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