Global flu pandemic would probably kill 62m, study says

Around 62 million people in the world are likely to die if there is a flu pandemic and more than 70,000 of those deaths will be in the UK, according to a statistical analysis published today.

Previous estimates of the likely death toll have ranged from two million to one billion.

But the authors of the latest study in the Lancet medical journal argue that those estimates were largely based on historical documents and witness accounts of the devastation caused by the 1918-20 Spanish flu pandemic, which had by far the highest mortality, rather than high-quality data from death registries.

Christopher Murray, from Harvard University, and colleagues looked at death registrations between 1915 and 1923 in places around the world where the data was believed to be at least 80% complete. By looking at deaths before and after the pandemic and comparing them with the rate during the pandemic, they were able to calculate the increased mortality caused by the disease.

Extrapolating that death rate to 2004, the authors calculate that between 51 million and 81 million individuals will die around the world if a similar virus causes a flu pandemic now. They say the deaths would be concentrated in the 0 to 14, 15 to 19, and 30- to 44-year-old age groups. They add that there is no logical or biological reason why mortality should not be higher than in the Spanish flu pandemic, severe though that was.

Death rates varied as much as 30% across countries, which could be explained by income variation, they say. The poorest are far more likely to die than the richest. They predict that 96% of deaths in a pandemic today would be in the developing world.

In wealthier parts of the world, where people are generally healthier and better nourished, such as the UK, rapid treatment of those with flu symptoms, use of antiviral drugs such as Tamiflu, which is being stockpiled by many governments, vaccination, and antibiotics for bacterial pneumonia, which those with severe flu can develop, would be likely to reduce the effects of a pandemic.

“By contrast, the countries and regions that can least afford to prepare for a pandemic will be affected the most,” they write.

“The potential risk to populations of sub-Saharan Africa, south Asia and other developing regions presents a policy dilemma.

“When resources to tackle the health problems already present in the community – including HIV, tuberculosis, malaria, cardiovascular diseases and road accidents – are already scarce, how much can these populations afford to spend on preparing for a potentially very harmful but also very uncertain threat?”