1918 Influenza: the Mother of All Pandemics

TLDR

The “Spanish” influenza pandemic of 1918‑1919 caused roughly 50 million deaths worldwide, leaving unresolved questions about its origins, epidemiology, and pathogenicity and raising uncertainty about its public health implications for future pandemics. The study seeks to understand the 1918 pandemic and its relevance to future outbreaks through careful experimentation and in‑depth historical analysis. New data are emerging, including complete genome sequencing from archival autopsy tissues, which offers fresh insights into the 1918 virus.

Abstract

The "Spanish" influenza pandemic of 1918-1919, which caused approximately 50 million deaths worldwide, remains an ominous warning to public health. Many questions about its origins, its unusual epidemiologic features, and the basis of its pathogenicity remain unanswered. The public health implications of the pandemic therefore remain in doubt even as we now grapple with the feared emergence of a pandemic caused by H5N1 or other virus. However, new information about the 1918 virus is emerging, for example, sequencing of the entire genome from archival autopsy tissues. But, the viral genome alone is unlikely to provide answers to some critical questions. Understanding the 1918 pandemic and its implications for future pandemics requires careful experimentation and in-depth historical analysis.