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Gottfreðsson M
The Spanish flu in lceland 1918. Lessons in medicine and history
Pandemic influenza has emerged 1-3 times each century.
The pandemic in 1918, or the „Spanish flu“ was caused by
a novel influenza strain which caused the death of 21-50
million people worid wide. Descriptions of the epidemic
in lceland give a detaiied account on how and when the
virus was introduced to the population of Reykjavik, the
capital of lceland, by the crew of two ships, „Botnía“-
and „Willemoes“ on October 19th 1918. The spread of
the illness was extremely rapid and peaked 3 weeks
later. It caused significant morbidity and mortality among
inhabitants of the southern and western part of lceland.
Within 6 weeks, close to 500 individuals had died, thereof
more than 50% in Reykjavik. The attack rate in Reykjavik
Key words: Spanish fíu, infiuenza, epidemiology, mortality, infection control
Correspondence: Magnús Gottfreðsson magnusgo@landspitali.is
was at least 63% and the case fatality proportion was
close to 2.6%. The age-specific mortality was highest
among young children, people 20-40 years of age and the
elderly. In addition, pregnant women had extremely poor
prognosis (37% case fatality). Attempts to halt the spread
of the epidemic to the northern and eastern parts of the
island were successful. By indentifying the individuals
who died from the Spanish flu using historical data, it has
recently been shown that genetic factors probably did
not play a major role in the pathogenesis of fatal cases.
These historical data can be used to assist in planning
for new pandemics of influenza, which are believed to be
inevitable.
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Barst: 3. september 2008, - samþykkt til birtingar: 21. október 2008.
LÆKNAblaðið 2008/94 745