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Non-Pharmaceutical Measures May Help with Flu Pandemic

School closures, isolation were effective during 1918-1919 outbreak

TUESDAY, Aug. 7 (HealthDay News) -- Non-pharmaceutical interventions such as school closures, prohibition of mass gatherings, isolation and quarantine helped to reduced the excess death rate during the 1918-1919 influenza pandemic and could help contain a future flu pandemic, according to study findings published in the Aug. 8 issue of the Journal of the American Medical Association.

Howard Markel, M.D., Ph.D., of the University of Michigan Medical School in Ann Arbor, and colleagues analyzed data from 43 cities during the period between September 1918 and February 1919 to see if non-pharmaceutical interventions had an impact on excess death rates.

During the six-month period studied, there were 115,340 deaths from pneumonia and influenza, yielding an excess death rate of 500 per 100,000 population. In all the cities, non-pharmaceutical measures were adopted to some extent. Thirty-four cities (79 percent) introduced school closures and bans on public gatherings for a median four weeks, which led to a significant reduction in the weekly excess death rate. Peak mortality was delayed the longest in cities that implemented non-pharmaceutical controls earliest. These cities also had lower peak mortality and total mortality rates.

"Although these urban communities had neither effective vaccines nor antivirals, cities that were able to organize and execute a suite of classic public health interventions before the pandemic swept fully through the city appeared to have an associated mitigated epidemic experience," the authors conclude.

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