Please use this identifier to cite or link to this item: http://hdl.handle.net/10397/20447
Title: Inferring the causes of the three waves of the 1918 influenza pandemic in England and Wales
Authors: He, D
Dushoff, J
Day, T
Ma, J
Earn, DJD
Keywords: Behavioural response
Iterated filtering
Pandemic influenza
School closure
Spanish flu
Weather
Issue Date: 2013
Publisher: Royal Soc
Source: Proceedings of the Royal Society B: Biological Sciences, 2013, v. 280, no. 1766 How to cite?
Journal: Proceedings of the Royal Society B: Biological Sciences 
Abstract: Past influenza pandemics appear to be characterized by multiple waves of incidence, but the mechanisms that account for this phenomenon remain unclear. We propose a simple epidemic model, which incorporates three factors that might contribute to the generation of multiple waves: (i) schools opening and closing, (ii) temperature changes during the outbreak, and (iii) changes in human behaviour in response to the outbreak. We fit this model to the reported influenza mortality during the 1918 pandemic in 334 UK administrative units and estimate the epidemiological parameters. We then use information criteria to evaluate how well these three factors explain the observed patterns of mortality. Our results indicate that all three factors are important but that behavioural responses had the largest effect. The parameter values that produce the best fit are biologically reasonable and yield epidemiological dynamics that match the observed data well.
URI: http://hdl.handle.net/10397/20447
ISSN: 0962-8452
DOI: 10.1098/rspb.2013.1345
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