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August 2, 1919


JAMA. 1919;73(5):313-318. doi:10.1001/jama.1919.02610310007003

The history of influenza so far as it is known, that is, for several centuries, comprises a series of long cycles in which great pandemics alternate with periods of relative quiescence, the length of cycles as measured by the intervals between pandemics being usually a matter of decades. The special characteristics of influenza pandemics are their wide and rapid extension, their high attack rates, and great effect on general mortality rates. Since these cycles are undoubtedly of fundamental significance in the natural history of influenza any proper discussion of the epidemiology of the disease should cover at least one full cycle, preferably the last, from 1889 to the present. The material for such a discussion must, however, be collected from many and diverse sources and laboriously fitted together, since there is no concrete specific and continuous record of the prevalence or mortality of influenza during such a period of years.

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