Global Mortality Impact of the 1957–1959 Influenza Pandemic
Open accessAbstract
BACKGROUND: Quantitative estimates of the global burden of the 1957 influenza pandemic are lacking. Here we fill this gap by modeling historical mortality statistics. METHODS: We used annual rates of age- and cause-specific deaths to estimate pandemic-related mortality in excess of background levels in 39 countries in Europe, the Asia-Pacific region, and the Americas. We modeled the relationship between excess mortality and development indicators to extrapolate the global burden of the pandemic. RESULTS: The pandemic-associated excess respiratory mortality rate was 1.9/10,000 population (95% confidence interval [CI], 1.2-2.6 cases/10,000 population) on average during 1957-1959. Excess mortality rates varied 70-fold across countries; Europe and Latin America experienced the lowest and highest rates, respectively. Excess mortality was delayed by 1-2 years in 18 countries (46%). Increases in the mortality rate relative to baseline were greatest in school-aged children and young adults, with no evidence that elderly population was spared from excess mortality. Development indicators were moderate predictors of excess mortality, explaining 35%-77% of the variance. Overall, we attribute 1.1 million excess deaths (95% CI, .7 million-1.5 million excess deaths) globally to the 1957-1959 pandemic. CONCLUSIONS: The global mortality rate of the 1957-1959 influenza pandemic was moderate relative to that of the 1918 pandemic but was approximately 10-fold greater than that of the 2009 pandemic. The impact of the pandemic on mortality was delayed in several countries, pointing to a window of opportunity for vaccination in a future pandemic.
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In contrast with previous influenza pandemics such as the 1918-1920 Spanish influenza and the 1957 pandemic, the mortality impact of the COVID-19 pandemic has primarily affected older age groups.
“In contrast with previous influenza pandemics such as the 1918–1920 Spanish influenza that primarily affected the young,37 or the 1957 pandemic that affected both the young and old,38 the mortality impact of the COVID-19 pandemic has primarily affected older age groups.”
From Estimating the burden of the COVID-19 pandemic on mortality, life expectancy and lifespan inequality in England and Wales: a population-level analysis (2021) · cites this paper as [38]
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- Authors
- Viboud, C., Simonsen, L., Fuentes, R., Flores, J., Miller, M. A., & Chowell, G.
- Affiliations
- University of Copenhagen (DK)
- Ministerio de Salud (AR)
- National Institutes of Health (US)
- Venue
- Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-02-04
- Volume
- 213
- Issue
- 5
- Pages
- 738-745
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- PMC
- PMC4747626
- OpenAlex
- W2282909188
- Cited by
- 228
- References
- 22
- Citations by year
- 2026: 12 · 2025: 13 · 2024: 19 · 2023: 30 · 2022: 31 · 2021: 45 · 2020: 42 · 2019: 14 · 2018: 7 · 2017: 10 · 2016: 5
- FWCI
- 11.55
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- public-domain
- Locations
- The Journal of Infectious Diseases (publishedVersion, public-domain)
- Europe PMC (PubMed Central) (publishedVersion, public-domain)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion, public-domain)
- Universidad de Chile (submittedVersion, cc-by-nc-nd)
- Funders
- Fogarty International Center
- National Institutes of Health
- Marie Sklodowska-Curie Senior Fellowship
- award (H2020-MSCA-IF-2014 to L. S.)
- Topics
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Social Sciences › Demography › Insurance, Mortality, Demography, Risk Management
- Keywords
- pandemic mortality, excess mortality, global burden of disease, respiratory mortality, influenza vaccination, pandemic preparedness
- MeSH terms
- Adolescent, Adult, Child, Child, Preschool, Humans, Infant, Influenza, Human, Middle Aged, Global Health, History, 20th Century, Influenza A Virus, H2N2 Subtype, Young Adult, Pandemics
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