Risk factors for death from pandemic influenza in 1918–1919: a case–control study
Article first published online: 3 FEB 2014
© 2014 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Influenza and Other Respiratory Viruses
Volume 8, Issue 3, pages 329–338, May 2014
How to Cite
2014) Risk factors for death from pandemic influenza in 1918–1919: a case–control study. Influenza and Other Respiratory Viruses 8(3), 329–338.et al. (
- Issue published online: 10 APR 2014
- Article first published online: 3 FEB 2014
- Manuscript Accepted: 24 NOV 2013
- University of Otago Postgraduate Publishing Bursary
- 1918–1919 Influenza pandemic;
- infectious disease;
Despite the persisting threat from future influenza pandemics, much is still unknown about the risk factors for death from such events, and especially for the 1918–1919 influenza pandemic.
A case–control study was performed to explore possible risk factors for death from pandemic influenza among New Zealand military personnel in the Northern Hemisphere in 1918–1919 (n = 218 cases, n = 221 controls). Data were compiled from a Roll-of-Honour dataset, a dataset of nearly all military personnel involved in the war and archived individual records.
In the fully adjusted multivariable model, the following were significantly associated with increased risk of death from pandemic influenza: age (25–29 years), pre-pandemic hospitalisations for a chronic condition (e.g. tuberculosis), relatively early year of military deployment, a relatively short time from enlistment to foreign service, and having a larger chest size (e.g. adjusted odds ratio for 90–99 cm versus <90 cm was 2·45; 95% CI=1·47–4·10). There were no significant associations in the fully adjusted model with military rank, occupational class at enlistment, and rurality at enlistment.
This is one of the first published case–control studies of mortality risk factors for the 1918–1919 influenza pandemic. Some of the findings are consistent with previous research on risk factors (such as chronic conditions and age groups), but others appear more novel (e.g., larger chest size). As all such historical analyses have limitations, there is a need for additional studies in other settings as archival World War One records become digitalised.