a1 Australian Army Malaria Institute, Enoggera, QLD, Australia
a2 University of Queensland, School of Population Health, Brisbane, QLD, Australia
a3 University of Queensland, Centre for Military and Veteran's Health, Brisbane, QLD, Australia
a4 University of Nottingham, School of Geography, Nottingham, UK
This paper draws on the mortality records of the French, US and UK Royal navies to reconstruct the spatiotemporal evolution of the 1918–1919 influenza pandemic in global Allied naval forces. For a total of 7658 deaths attributed to respiratory diseases (French and US navies) and all diseases (UK Royal Navy) at 514 locations worldwide, techniques of spatial point pattern analysis were used to generate weekly maps of global mortality intensity in 1918. The map sequence for the main period of pandemic mortality, mid-August to mid-November 1918, revealed a near-simultaneous development of mutiple foci of high disease intensity in three distant locations (Europe, North America, West Africa). Given the relatively slow speed of naval ships in convoy at this time (<12 knots), our findings suggest that the pandemic influenza virus was circulating on three continents at the observed onset of the main mortality wave.
(Received September 13 2012)
(Revised November 21 2012)
(Accepted December 05 2012)