Prior immunity helps to explain wave-like behaviour of pandemic influenza in 1918-9
John D Mathews, Emma S McBryde, Jodie McVernon, Paul K Pallaghy, James M McCaw
BMC INFECTIOUS DISEASES | BMC | Published : 2010
BACKGROUND: The ecology of influenza may be more complex than is usually assumed. For example, despite multiple waves in the influenza pandemic of 1918-19, many people in urban locations were apparently unaffected. Were they unexposed, or protected by pre-existing cross-immunity in the first wave, by acquired immunity in later waves, or were their infections asymptomatic? METHODS: We modelled all these possibilities to estimate parameters to best explain patterns of repeat attacks in 24,706 individuals potentially exposed to summer, autumn and winter waves in 12 English populations during the 1918-9 pandemic. RESULTS: Before the summer wave, we estimated that only 52% of persons (95% credibi..View full abstract
We thank the Australian NHMRC, the University of Melbourne and the Menzies Foundation for supporting this work; Terry Nolan, Anne Kelso and Alan Hampson commented on earlier manuscript drafts; Chris McCaw wrote earlier MCMC code and Joanne Chesson assisted with references and figures.