Preparing for Pandemic Influenza: The Global 1918 Influenza Pandemic and the Role of World Historical Information

The 1918 “Spanish Influenza” was one of the three most devastating epidemics known to humankind. Today it is taken as a model of possible future pandemics by health authorities in many countries. This study reviews and assesses the qualitative and quantitative studies of the 1918 pandemic. It shows that the qualitative studies, while wide-ranging, are neither consistent nor comprehensive at the global level. The quantitative studies, in turn, are limited to the national level and have yet to be combined into a picture of the global dynamics of the pandemic. Existing studies have considered such issues as mortality waves (from one to three waves for each region of the epidemic), patterns of global diffusion, and the age profile of mortality (often noting high mortality among young adults). Nevertheless, studies of these factors need to be pursued in greater depth. Additional questions, identified by the authors as worthy of analysis, include lingering effects (such as impact on fertility), the relationship between population and mortality, and the relationship between climate and mortality. It is argued that preparation for pandemic influenza is now a security issue, and that historical studies need to be organized on a more systematic and global level in order to prepare a thorough picture of the 1918 pandemic, in order to anticipate the possible character of any future infections. The study concludes with practical suggestions for creating a global picture of the pandemic from its unfolding in 1918 to its expiration in 1921.