Alfredo Morabia is the Editor-in-Chief of AJPH. He is with the Barry Commoner Center for Health and the Environment, Queens College, City University of New York, Flushing, NY, and the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
Am J Public Health. 2021 Mar;111(3):438-445. doi: 10.2105/AJPH.2020.306025. Epub 2020 Dec 8.
Between November 20, 1918, and March 12, 1919, the US Public Health Service carried out a vast population-based survey to assess the incidence rate and mortality of the influenza pandemic among 146 203 persons in 18 localities across the United States. The survey attempted to retrospectively assess all self-reported or diagnosed cases of influenza since August 1, 1918. It indicated that the cumulative incidence of symptomatic influenza over 6 months had been 29.4% (range = 15% in Louisville, KY, to 53.3% in San Antonio, TX). The overall case fatality rate (CFR) was 1.70%, and it ranged from 0.78% in San Antonio to 3.14% in New London, Connecticut. Localities with high cumulative incidence were not necessarily those with high CFR. Overall, assuming the survey missed asymptomatic cases, between August 1, 1918, and February 21, 1919, maybe more than 50% of the population was infected, and about 1% of the infected died. Eight months into the COVID-19 pandemic, the United States has not yet launched a survey that would provide population-based estimates of incidence and CFRs analogous to those generated by the 1918 US Public Health Service house-to-house canvass survey of influenza.
1918 年 11 月 20 日至 1919 年 3 月 12 日期间，美国公共卫生署（US Public Health Service）在美国各地 18 个地点开展了一项大规模的基于人群的调查，以评估流感大流行期间美国 146203 人的发病率和死亡率。该调查试图回顾性评估自 1918 年 8 月 1 日以来所有自我报告或诊断的流感病例。调查结果表明，6 个月内有症状流感的累计发病率为 29.4%（范围为肯塔基州路易斯维尔的 15%至得克萨斯州圣安东尼奥的 53.3%）。总体病死率（CFR）为 1.70%，范围从圣安东尼奥的 0.78%到康涅狄格州新伦敦的 3.14%。累计发病率高的地区不一定病死率也高。总体而言，假设该调查漏报了无症状病例，从 1918 年 8 月 1 日至 1919 年 2 月 21 日期间，可能有超过 50%的人口被感染，而约 1%的感染者死亡。在 COVID-19 大流行的 8 个月后，美国尚未开展一项调查，该调查将提供类似于 1918 年美国公共卫生署对流感进行的逐户上门调查所产生的基于人群的发病率和病死率估计值。
