Disease and Demography in British
India: The Influenza Pandemic of
1918-19
Siddharth Chandra, Eva Kassens-Noor, Goran Kuljanin,
Joshua Vertalka, Jennifer Wray
Michigan State University
Presentation prepared for “A Workshop on World-Historical
Dataverse Vision and Research”
The Influenza Pandemic of 1918-19:
Background
• Single most deadly short-term epidemic of the
20th century
– Duration – 6-9 months
– Worldwide mortality (25-50 million)
• Some estimates as high as 100 million
• Exceeded combined death toll from World War I and World
War II
• Johnson and Mueller (1992)
• India was the single worst hit country
• “The mother of all pandemics”
• Taubenberger and Morens (2006)
Prior work on the 1918-19 Influenza in
India
• Primary source: sanitary and public health
reports of India and the provinces
– Government of India, various years, for example
– Usual “flu-like” symptoms
– A common complication is pneumonia
– Excess mortality is largest for people in the prime
of life
• Not infants and elderly people as is usually the case
Major research questions
• How many people died in India?
– Presented at World-Historical Dataverse workshop,
February 2011
– Chandra, Kuljanin and Wray (2012)
• How is this related to population growth before
and after the pandemic?
– Presented at World-Historical Dataverse workshop,
February 2011
• What geographic patterns do we see?
– Focus of this presentation
Geographic patterns of the pandemic
• Data source
– Sanitary and public health reports
– Nine major provinces
– 199 districts
• Six “chief diseases” of India
–
–
–
–
Monthly mortality data by district
Mortality data are highly unreliable
Underreporting
Problematic categories
• Diarrhea & dysentery, respiratory diseases, fevers, cholera,
plague, smallpox
Obtaining Information about Influenza
from Colonial Data
• Most deaths from influenza reported under “fevers”
category
– But fever deaths include other major causes, especially malaria
– Cannot be used as-is to investigate influenza mortality itself
• However, the data still reveal patterns about timing
• Peak monthly fever mortality over the period 1916-1920
always
– occurs between September 1918 and January 1919 and
– is much higher than “background” fever mortality
– see over for example
Methodology
• Use monthly fever mortality data for five-year
period 1916-1920
– 60 monthly observations for 199 districts
• Estimate weekly mortality using monthly time
series
– 60*52=3120 weekly observations per district
• Rank weeks on the basis of fever mortality
– Top four weeks vs. all other weeks
Estimated Spread of Influenza Across
India
www.youtube.com/watch?v=9s9LUzkFjp8
(Password protected, please refer to following slides)
Findings
• Pandemic peaks between September 22, 1918
and January 19, 1919
• Rapid spread
• Three sub-waves
• Monthly spacing between sub-waves
Findings
• First sub-wave
– Entry through Bombay (west)
– Madras (south) and Puri (east)
– Peak: week of October 13
• Second sub-wave
– Punjab (northwest), Central Province (central), subGangetic region (north central)
– Peak: weeks of November 10/November 17
• Third sub-wave
– North of the Ganges (north)
– Peak: weeks of December 6/December 15
Future Research
• How rapidly did the disease spread?
• What are the correlates of spread?
– Enablers and inhibitors
– Human and non-human
• Possible adaptations of epidemiologic models for
aggregate data as well
• Colonial data are rich
– Data inventory for project
– Excel spreadsheet showing variables collected to date
Conclusions
• Historical data such as those collected by the
sanitary authorities in British India can provide
valuable insights into important questions in
public health and demography
• While the raw data may not be presented in
the most desirable form, they can still be
leveraged for valuable insights
• Modern methodologies need to be deployed
to analyze these data to obtain these insights
References
• Chandra, Siddharth, Goran Kuljanin, and Jennifer Wray. 2012.
“Mortality from the Influenza Pandemic of 1918-19: The Case of
India.” Demography, in press.
• Government of India. Various years. Annual Report of the Sanitary
Commissioner with the Government of India. Calcutta:
Superintendent, Government Printing.
• Johnson, Niall P. A. S. and Juergen Mueller. 2002. “Updating the
Accounts: Global Mortality of the 1918-1920 “Spanish” Influenza
Pandemic.” Bulletin of the History of Medicine 76(1): 105-115.
• Patterson, K. David, and Gerald Pyle. 1991. “The Geography and
Mortality of the 1918 Influenza Pandemic .” Bulletin of the History
of Medicine 65(1): 4-21.
• Taubenberger, J.K. and D.M. Morens. 2006. “1918 Influenza: the
mother of all pandemics.” Emerging Infectious Diseases 12(1):
15-22.
Acknowledgements
This project was conceived as part of the World-Historical
Dataverse project at the University of Pittsburgh
This research was funded in part by a grant
(1R21DA025917, PI: Chandra) from the National Institute
on Drug Abuse (NIDA) of the National Institutes of
Health. Its contents are solely the responsibility of the
authors and do not necessarily represent the official
views of NIDA.