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. 2016 Apr;106(4):642-4.
doi: 10.2105/AJPH.2015.303018.

Overcrowding and Mortality During the Influenza Pandemic of 1918

C Andrew Aligne  1
Affiliations

Overcrowding and Mortality During the Influenza Pandemic of 1918

C Andrew Aligne. Am J Public Health. 2016 Apr.

Abstract

The influenza pandemic of 1918 killed more than 50 million people. Why was 1918 such an outlier? I. W. Brewer, a US Army physician at Camp Humphreys, Virginia, during the First World War, investigated several factors suspected of increasing the risk of severe flu: length of service in the army, race, dirty dishes, flies, dust, crowding, and weather. Overcrowding stood out, increasing the risk of flu 10-fold and the risk of flu complicated with pneumonia five-fold. Calculations made with Brewer's data show that the overall relationship between overcrowding and severe flu was highly significant (P < .001). Brewer's findings suggest that man-made conditions increased the severity of the pandemic flu illness.

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Figures

FIGURE 1—
FIGURE 1—
Flu Illness Incidence as a Function of Average Floor Space in Various Regiments During the Influenza Pandemic: Camp A. A. Humphreys, Virginia, 1918 Note. EOTS = Engineer Officers’ Training School. The sample size was n = 15 952. One square foot = 0.09 m2; 50 square feet = 4.65 m2.
FIGURE 2—
FIGURE 2—
Reproduction of Page 2 of Brewer’s Manuscript, Revealing Details About the Devastation in the Camp From the Epidemic Source. Brewer.
See this image and copyright information in PMC

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References

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