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May 5, 1993

The Transmission of Epidemic Influenza

JAMA. 1993;269(17):2273. doi:10.1001/jama.1993.03500170103045

In October 1918, ten years old and at school, Edgar Hope-Simpson caught influenza. Of his 90 fellow pupils only one escaped infection, and one died. Worldwide a billion plus were affected, and an estimated 20 million died. In 1932, a year before the discovery of the influenza virus, Hope-Simpson had just begun his career as a general practitioner in Dorset. That winter saw a devastating influenza A epidemic, "the behaviour of which in a rural population... seemed inexplicable in terms of a virus that was spreading directly from the sick in the manner of measles virus. The attempt to find a rational explanation of its behaviour has preoccupied me ever since...." In 1946 he moved to Cirencester in Gloucestershire, and a year later the Cirencester Epidemiological Research Unit (of which Hope-Simpson is still a director) was created. A microbiological laboratory was added in 1961, and in 1979, some 47 years