The 1919-21 influenza pandemic in Greenland

Abstract

In Alaska, the 1918-20 influenza pandemic was devastating, with mortality rates up to 90% of the population, while in other arctic regions in northern Sweden and Norway mortality was considerably lower. We investigated the timing and age-patterns in excess mortality in Greenland during the period 1918-21 and compare these to other epidemics and the 1889-92 pandemic. We accessed the Greenlandic National Archives and transcribed all deaths from 1880 to 1921 by age, geography, and cause of death. We estimated monthly excess mortality and studied the spatial-temporal patterns of the pandemics and compared them to other mortality crises in the 40-year period. The 1918-21 influenza pandemic arrived in Greenland in the summer of 1919, one year delayed due to ship traffic interruptions during the winter months. We found that 5.2% of the Greenland population died of the pandemic with substantial variability between counties (range, 0.1% to 11%). We did not see the typical pandemic age-pattern of high young-adult mortality, possibly due to high baseline mortality in this age-group or remoteness. However, despite substantial mortality, the mortality impact was not standing out relative to other mortality crises, or of similar devastation reported in Alaskan populations.

Keywords: 1889–92 pandemic; 1918–20 influenza pandemic; Greenland; Historical epidemiology; excess mortality.

Figure 1.

Geographical and temporal pattern of the first wave of the pandemic in Greenland in 1919. Colors indicate the presumed arrival of the pandemic in each parish. Size of the circles indicates the relative total excess mortality (see also Table 1).

Figure 2.

Time series of monthly burials in the parishes of Greenland 1916–1921. Vertical lines indicate the month July in each year. Red areas indicate the estimated excess mortality with the dark-red areas indicating the excess above the 0.99 quantile of Poisson distributions.

Figure 3.

Age-patterns of the 1889–92 and 1919–21 pandemics. (a) overall all-cause mortality per 1000 population; (b) excess mortality per 1000 population; (c) ratio of all-cause observed mortality and baseline. Vertical lines indicate 95% confidence intervals.