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The 1918 Influenza Epidemic

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What would later become one of the deadliest plagues the world had ever seen started innocuously enough in the spring of 1918 spreading through populations on both sides of the Atlantic. Remarkable for its highly infectious nature, the spring strain was relatively non-lethal, rarely killing infected individuals (Kolata, 1999). Thus little more than average attention was paid to the precursor of a virus that would eventually kill between twenty-one and one-hundred million individuals worldwide (Barry, 2004). Only after the fall wave of the 1918 influenza did it become a requirement to report cases of influenza thus information on this first wave is sporadic at best (Kolata, 1999). I will argue that the nature of this missing data combined with the biology of the virus itself could explain a fascinating phenomenon that cropped up in the infection rate data for the 1918 influenza, that despite significantly poorer living conditions, African-Americans were significantly less likely to contract the virus or die from it.

The Spanish Influenza pandemic that ravaged the world came in two waves; the first during the spring of 1918 was relatively mild. The second wave began in the fall of 1918 and is the better remembered and far more virulent strain that killed millions (Figure 2). Although the virus returned for an encore in 1920 the new strain was attenuated and the population had a high level of resistance so relatively few individuals died (Crosby, 1989).

Figure 1. Combined weekly influenza and pneumonia mortality, United Kingdom, 1918-1919. Reprinted from “1918 Influenza: the Mother of All Pandemics,” by Jeffery K. Taubenberger and David M. Morens, 2006, Emerging Infectious Diseases

The origin of the H1N1 influenza of 1918 is...

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...enza pandemic of 1918 and the search for the virus that caused it. New York: Farrar, Straus, and Giroux.

Maloney, T. N. (2010, February). African Americans in the Twentieth Century. Retrieved 2011, from EH.net: http://eh.net/encyclopedia/article/maloney.african.american

Metropolitan Life Insurance Company. (1937). Influenza and Pneumonia. In L. I. Dublin, & A. J. Lotka, Twenty-Five Years of Health Progress (p. 124). New York.

Taubenberger, J. K., & Morens, D. M. (2006). 1918 Influenza: the Mother of All Pandemics. Emerging Infectious Diseases.

Whatley, W. C., & Sedo, S. (1998, May). Quit Behavior as a Measure of Worker Opportunity: Black Workers in the Interwar Industrial North. The American Economic Review, 88(2), 363-367.

Williams, D. (1999). Race, socioeconomic status, and health. The added effects of racism and discrimination. Ann. N. Y. Acad. Sci, 173-188.
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