Medical Surveillance Monthly Report (MSMR). Volume 11, Number 5, December 2005
ARMED FORCES HEALTH SURVEILLANCE CENTER SILVER SPRING MD
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The influenza pandemic of 1918-1919 accounted for an estimated 40 to 100 million deaths worldwide. The concentration of deaths among previously healthy young adults in both military and general populations was an unusual and concerning characteristic of the pandemic. In September-October 1918, every major military installation in the United States was attacked by influenza. The epidemics that affected the widely dispersed camps were remarkably similar. In general, they had sudden onsets, sharp increases in case rates, nearly as rapid declines, and overall durations of 3 to 6 weeks. Secondary bacterial infections were common and had unusually fulminant clinical expressions. Epidemic curves of secondary pneumonias and deaths lagged those of influenza by 5-10 days. Overall attack rates of clinically significant influenza among soldiers was approximately 23- of these, approximately one-sixth developed pneumonias of which approximately one-third were fatal. The recent emergence and international spread of coronavirus-associated SARS, of H5N1 influenza among domestic and migratory avian species, and of highly virulent avian influenza among humans have heightened awareness of the potential effects of and stimulated plans to counter the next influenza pandemic. The timely detection and characterization of initial herald attacks of the next influenza pandemic is an important part of pandemic influenza preparedness. To detect significant perturbations from baseline rates andor clinical severities of pneumonia and influenza in military populations, it is essential to know relevant background experiences. In this report, we summarize recent experiences of U.S. service members in relation to pneumonia and influenza.
- Medicine and Medical Research