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May 15, 1987

Pandemic Influenza 1700-1900: A Study in Historical Epidemiology

JAMA. 1987;257(19):2656. doi:10.1001/jama.1987.03390190134045

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Influenza remains one of the most important infectious diseases in the wealthier countries of the world. It is a major cause of sickness and, especially among the elderly, a significant cause of death; it is the only infectious disease among the ten top killers in the United States.

In the Great Pandemic that swept the world near the end of World War I, an estimated 559 000 people died in the United States, about ten times the number of Americans who died in the war. Worldwide, two to three times more people died in a six-month period when influenza raged than from military action during the four years of a devastating war. Can such a dreadful catastrophe occur again?

Type A influenza virus, the type associated with pandemics, has a genome made up of eight segments, which can separate, mix with the fragments of other strains of A influenza that