Inferring the causes of the three waves of the 1918 influenza pandemic in England and Wales

Daihai He, Jonathan Dushoff, Troy Day, Junling Ma, David J.D. Earn

Research output: Journal article publicationJournal articleAcademic researchpeer-review

77 Citations (Scopus)


Past influenza pandemics appear to be characterized by multiple waves of incidence, but the mechanisms that account for this phenomenon remain unclear. We propose a simple epidemic model, which incorporates three factors that might contribute to the generation of multiple waves: (i) schools opening and closing, (ii) temperature changes during the outbreak, and (iii) changes in human behaviour in response to the outbreak. We fit this model to the reported influenza mortality during the 1918 pandemic in 334 UK administrative units and estimate the epidemiological parameters. We then use information criteria to evaluate how well these three factors explain the observed patterns of mortality. Our results indicate that all three factors are important but that behavioural responses had the largest effect. The parameter values that produce the best fit are biologically reasonable and yield epidemiological dynamics that match the observed data well.
Original languageEnglish
JournalProceedings of the Royal Society B: Biological Sciences
Issue number1766
Publication statusPublished - 7 Aug 2013


  • Behavioural response
  • Iterated filtering
  • Pandemic influenza
  • School closure
  • Spanish flu
  • Weather

ASJC Scopus subject areas

  • Medicine(all)
  • Immunology and Microbiology(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Environmental Science(all)
  • Agricultural and Biological Sciences(all)

Cite this