Lessons from the past: Familial aggregation analysis of fatal pandemic influenza (Spanish flu) in Iceland in 1918.

2.50
Hdl Handle:
http://hdl.handle.net/2336/18212
Title:
Lessons from the past: Familial aggregation analysis of fatal pandemic influenza (Spanish flu) in Iceland in 1918.
Authors:
Gottfredsson, Magnus; Halldorsson, Bjarni V; Jonsson, Stefan; Kristjansson, Mar; Kristjansson, Kristleifur; Kristinsson, Karl G; Love, Arthur; Blondal, Thorsteinn; Viboud, Cécile; Thorvaldsson, Sverrir; Helgason, Agnar; Gulcher, Jeffrey R; Stefansson, Kari; Jonsdottir, Ingileif
Citation:
Proc. Natl. Acad. Sci. U.S.A. 2008, 105(4):1303-8
Issue Date:
29-Jan-2008
Abstract:
The pandemic influenza of 1918 (Spanish flu) killed 21-50 million people globally, including in Iceland, where the characteristics and spread of the epidemic were well documented. It has been postulated that genetic host factors may have contributed to this high mortality. We identified 455 individuals who died of the Spanish flu in Iceland during a 6-week period during the winter of 1918, representing >92% of all fatal domestic cases mentioned by historical accounts. The highest case fatality proportion was 2.8%, and peak excess mortality was 162/100,000/week. Fatality proportions were highest among infants, young adults, and the elderly. A genealogical database was used to study relatedness and relative risk (RR) of the fatal influenza victims and relatives of their unaffected mates. The significance of these RR computations was assessed by drawing samples randomly from the genealogical database matched for age, sex, and geographical distribution. Familial aggregation of fatalities was seen, with RRs for death ranging from 3.75 for first-degree relatives (P < 0.0001) to 1.82 (P = 0.005), 1.12 (P = 0.252), and 1.47 (P = 0.0001) for second- to fourth-degree relatives of fatal influenza victims, respectively. The RRs within the families of unaffected mates of fatal influenza victims were 2.95 (P < 0.0001), 1.27 (P = 0.267), 1.35 (P = 0.04), and 1.42 (P = 0.001), for first- to fourth-degree relatives, respectively. In conclusion, the risk of death from the Spanish flu was similar within families of patients who succumbed to the illness and within families of their mates who survived. Our data do not provide conclusive evidence for the role of genetic factors in susceptibility to the Spanish flu.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://www.pnas.org/cgi/content/full/105/4/1303

Full metadata record

DC FieldValue Language
dc.contributor.authorGottfredsson, Magnus-
dc.contributor.authorHalldorsson, Bjarni V-
dc.contributor.authorJonsson, Stefan-
dc.contributor.authorKristjansson, Mar-
dc.contributor.authorKristjansson, Kristleifur-
dc.contributor.authorKristinsson, Karl G-
dc.contributor.authorLove, Arthur-
dc.contributor.authorBlondal, Thorsteinn-
dc.contributor.authorViboud, Cécile-
dc.contributor.authorThorvaldsson, Sverrir-
dc.contributor.authorHelgason, Agnar-
dc.contributor.authorGulcher, Jeffrey R-
dc.contributor.authorStefansson, Kari-
dc.contributor.authorJonsdottir, Ingileif-
dc.date.accessioned2008-02-14T09:07:11Z-
dc.date.available2008-02-14T09:07:11Z-
dc.date.issued2008-01-29-
dc.date.submitted2008-02-14-
dc.identifier.citationProc. Natl. Acad. Sci. U.S.A. 2008, 105(4):1303-8en
dc.identifier.issn1091-6490-
dc.identifier.pmid18216264-
dc.identifier.doi10.1073/pnas.0707659105-
dc.identifier.urihttp://hdl.handle.net/2336/18212-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractThe pandemic influenza of 1918 (Spanish flu) killed 21-50 million people globally, including in Iceland, where the characteristics and spread of the epidemic were well documented. It has been postulated that genetic host factors may have contributed to this high mortality. We identified 455 individuals who died of the Spanish flu in Iceland during a 6-week period during the winter of 1918, representing >92% of all fatal domestic cases mentioned by historical accounts. The highest case fatality proportion was 2.8%, and peak excess mortality was 162/100,000/week. Fatality proportions were highest among infants, young adults, and the elderly. A genealogical database was used to study relatedness and relative risk (RR) of the fatal influenza victims and relatives of their unaffected mates. The significance of these RR computations was assessed by drawing samples randomly from the genealogical database matched for age, sex, and geographical distribution. Familial aggregation of fatalities was seen, with RRs for death ranging from 3.75 for first-degree relatives (P < 0.0001) to 1.82 (P = 0.005), 1.12 (P = 0.252), and 1.47 (P = 0.0001) for second- to fourth-degree relatives of fatal influenza victims, respectively. The RRs within the families of unaffected mates of fatal influenza victims were 2.95 (P < 0.0001), 1.27 (P = 0.267), 1.35 (P = 0.04), and 1.42 (P = 0.001), for first- to fourth-degree relatives, respectively. In conclusion, the risk of death from the Spanish flu was similar within families of patients who succumbed to the illness and within families of their mates who survived. Our data do not provide conclusive evidence for the role of genetic factors in susceptibility to the Spanish flu.en
dc.language.isoenen
dc.publisherNational Academy of Sciencesen
dc.relation.urlhttp://www.pnas.org/cgi/content/full/105/4/1303en
dc.subject.meshDisease Outbreaksen
dc.subject.meshInfluenza, Humanen
dc.subject.meshGenetic Predisposition to Diseaseen
dc.subject.meshSurvival Analysisen
dc.titleLessons from the past: Familial aggregation analysis of fatal pandemic influenza (Spanish flu) in Iceland in 1918.en
dc.typeArticleen
dc.contributor.departmentLandspitali University Hospital, 108 Reykjavik, Iceland. magnusgo@landspitali.isen
dc.identifier.journalProceedings of the National Academy of Sciences of the United States of Americaen

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