- The Washington Times - Sunday, December 24, 2006

PARIS (Agence France-Presse) — A global pandemic of a novel, contagious and lethal form of influenza could kill as many people in a year as died in World War II, according to an estimate published Friday by the medical journal Lancet.

In a calculation based on mortality figures from the 1918-20 “Spanish flu” pandemic, U.S. researchers think 62 million people could die within 12 months if a similar pathogen emerged today. The vast majority of deaths — 96 percent — would occur in the developing world.

The study, led by Harvard University professor Christopher Murray, is based on death registration data used to estimate the toll in 27 countries during the 1918-20 pandemic.

That data was then extrapolated to the worldwide population of 2004.

But it also takes into account gains in prosperity and access to medical care since 1918, as well as changes in the size and age of those 27 populations.

Mr. Murray’s team said 51 million to 81 million people could die, making an average of 62 million, if a similar pandemic were to occur, on the basis of the 2004 data.

Historians estimate the death toll from World War II at 50 million to 62 million.

The 27 countries included the United States, European nations, Argentina, India and the Philippines.

The safest place to be would be Denmark, where there would be excess mortality — an increase above the normal death rate — of 0.2 percent over 2004.

At the other end of the scale would be India, where the excess mortality would be more than 20 times higher, at 4.39 percent.

The study coincides with the scare surrounding the H5N1 bird flu virus, which is lethal and contagious among birds.

The fear is that this virus could acquire genes that would make it easily transmissible among humans, creating as in 1918 and on two other occasions last century a novel pathogen against which no one would have natural immunity.

Mr. Murray said the high death toll predicted and its preponderance in developing countries can be explained by differences in access to vaccination, antiviral drugs and speedy treatment with antibiotics to treat secondary infections such as pneumonia.

“The predicted mortality today for India is lower than in 1918 because there has been significant advances” in Indian prosperity since then, Mr. Murray told Agence France-Presse.

“The predicted mortality for sub-Saharan Africa, though, is probably quite similar to what it was in 1918 because there hasn’t been that big a change in per capita income.”

But, he said, “We saw a strong relationship between mortality and income in 1918-20, and it was such a strong relationship that there’s nothing to suggest that also won’t hold true if something like that happened again.”

Mr. Murray said the findings raised concerns about preparedness in poor countries, such as early provision of antivirals to slow the spread of a pandemic and swift distribution of a vaccine to deal with the new virus.

“Much of the global policy attention on early detection, surveillance, national pandemic preparedness plans is going to benefit high-income and maybe some upper middle-income countries,” he said.

“There really hasn’t been, I believe, enough attention on practical things that low-income and lower-middle income countries can do, and that is where most of the harm will come.”

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