Low but highly variable mortality among nurses and physicians during the influenza pandemic of 1918-1919

Shanks, G. Dennis, MacKenzie, Alison, Waller, Michael and Brundage, John F. (2011) Low but highly variable mortality among nurses and physicians during the influenza pandemic of 1918-1919. Influenza and Other Respiratory Viruses, 5 3: 213-219. doi:10.1111/j.1750-2659.2010.00195.x

Author Shanks, G. Dennis
MacKenzie, Alison
Waller, Michael
Brundage, John F.
Title Low but highly variable mortality among nurses and physicians during the influenza pandemic of 1918-1919
Journal name Influenza and Other Respiratory Viruses   Check publisher's open access policy
ISSN 1750-2640
Publication date 2011-05-01
Year available 2011
Sub-type Article (original research)
DOI 10.1111/j.1750-2659.2010.00195.x
Open Access Status DOI
Volume 5
Issue 3
Start page 213
End page 219
Total pages 7
Place of publication Oxford, United Kingdom
Publisher Wiley-Blackwell
Language eng
Abstract Background
Formatted abstract
Background During the 1918–1919 influenza pandemic, nurses and physicians were intensively exposed to the pandemic A ⁄ H1N1 strain. There are few published summaries of the mortality experiences of nurses and physicians during the pandemic.

Methods Mortality records from U.S. and British Armies during the First World War and obituary notices in national medical association journals were reviewed to ascertain death notices of nurses and physicians likely to have died of influenza.

Results Illness-related mortality among U.S. military nurses (1Æ05%) was one and one-half times higher than among U.S. medical officers (0Æ68%), nearly two times higher than among British medical officers (0Æ55%), and nine times higher than
among British nurses (0Æ12%). Among U.S. nursing officers, mortality was  approximately twice as high among those assigned in the United States than in Europe. Among civilian physicians, mortality during the influenza pandemic was markedly increased in Canada, New Zealand, South Africa and the United States but
not Australia.

Conclusions During the 1918 pandemic, mortality among nurses and physicians was relatively low compared to their patients and significantly varied across locations and settings. Medical-care providers (particularly U.S. nursing officers) who were new to
their assignments when pandemic-related epidemics occurred may have had higher risk of influenza-related mortality because of occupational exposures to bacterial respiratory pathogens that they had not previously encountered.
Keyword Infectious Diseases
Infectious Diseases
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Public Health Publications
Centre for Military and Veterans' Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 10 times in Thomson Reuters Web of Science Article | Citations
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Created: Thu, 20 Oct 2011, 00:39:44 EST by Mr Michael Waller on behalf of Centre for Australian Military & Veterans' Health