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Recurrence of a flu pandemic similar to infamous 1918 flu could kill 62 million

distributed fairly equally. A simple population count from that period would lead to the conclusion that about 20 percent of all fatalities occurred in the developed world. "But when you look at the data," said Murray, "that number shrinks to about three or four percent."

The disparities between the developed and developing worlds during this period are striking. For example, in Denmark 0.2 percent of the population succumbed to the flu. In the United States, that figure is 0.3 percent (based on data from 24 states). In the Philippines, the mortality rate was 2.8 percent, in the Bombay region of India, 6.2 percent, and in central India, 7.8 percent, which was the highest rate of the countries and regions analyzed. According to this data then, from Denmark to central India, death rates from the 1918-1920 flu pandemic varied more than 39-fold.

The researchers then took the relationship observed in 1918 between per capita income and mortality and extrapolated it to 2004 population data. After adjusting for global income and population changes, as well as changes in age structures within different populations, the research team estimated that if a similarly virulent strain of flu virus were to strike today, about 62 million people worldwide would die.

This could represent a devastating impact on global mortality, more than doubling deaths from all causes in a single year. However, only four percent of these fatalities would occur in the developed world. The developing world would absorb the remaining 96 percent of deaths--an estimate that the researchers believe is actually conservative.

"We all know that the poor tend to have higher mortality," said Murray, "but we never expected that so much of the cross-country and cross-community variation would be related to economic status."

The researchers caution that per capita income only explains about half of the wide mortality range seen among--and in many cases within--pa
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Source:Harvard School of Public Health


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