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Econometric analyses of the Spanish influenza epidemic on United States military bases.

机译：在美国军事基地进行的西班牙流感流行病的计量经济学分析。

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摘要

This dissertation consists of two essays. The first essay estimates the parameters of a Spanish influenza epidemic model using data from 19 U.S. military bases. The second essay examines mortality of the Spanish influenza epidemic on five U.S. naval bases.;Estimates of epidemic models parameters are important for identifying disease outbreaks, evaluating treatments and estimating the impacts of quarantines and vaccine provision. In the first essay, I describe and use newly developed primary data from 19 U.S. military establishments during the Spanish flu epidemic of 1918 to estimate the parameters of the widely used Susceptible-Infectious-Removed (or SIR) model. Daily data allow us to test common assumptions of the model. Empirical estimates indicate that the infectivity parameter of the SIR model is higher during the initial days of the epidemic (especially up to the peak of the epidemic) at each military base and that the Spanish flu was highly infectious relative to more recent influenza strains. Alternative model specifications suggest that the parameter estimates are sensitive to assumptions about asymptomatic cases. Results of the data analyses suggest that if a vaccine that were 100% effective had been available, approximately 69% of the population would have needed to be vaccinated to have prevented the epidemic.;While there are studies that examine the overall the mortality level of the Spanish flu epidemic of 1918-19 on U.S. military bases, there is little analysis of the time pattern of mortality following infection. Using a newly developed data set from patient registers at five U.S. Navy hospitals, I construct life tables summarizing daily patterns of mortality and examine sources of mortality variation among patients. The results indicate that mortality of Spanish flu patients reached a peak approximately ten days after their admission to a hospital, and nearly 10% of all admitted patients died within a two-week period. The case mortality rate for patients initially diagnosed with pneumonia is exceptionally high, approximately 3.5 times greater than that of non-pneumonia patients. Patients admitted in the second week of the epidemic on a base have lower survival rates compared to patients admitted at other times. The Gulfport base had a significantly lower mortality and a different pattern of mortality than the other four naval bases in our sample. There were no statistically significant differences between the distribution of survival times in our data and the distribution constructed by Mills, et al. (2004) from three sets of autopsy reports.
机译：本文由两篇论文组成。第一篇论文使用来自美国19个军事基地的数据估算了西班牙流感流行模型的参数。第二篇文章从五个美国海军基地考察了西班牙流感流行的死亡率。流行病模型参数的估计对于识别疾病暴发，评估治疗方法以及估计隔离区和疫苗供应的影响非常重要。在第一篇文章中，我描述和使用了1918年西班牙流感大流行期间美国19个军事机构的最新开发的主要数据，以估算广泛使用的易感性传染物去除（或SIR）模型的参数。每日数据使我们能够测试模型的常见假设。经验估计表明，SIR模型的传染性参数在流行病爆发的最初几天（尤其是流行病的最高峰）在每个军事基地都较高，并且相对于最新的流感病毒株，西班牙的流感具有高度传染性。替代模型规范表明，参数估计值对无症状病例的假设敏感。数据分析的结果表明，如果可获得100％有效的疫苗，则大约需要接种69％的人口才能预防该流行病;尽管有研究检查了该病的总体死亡率水平在1918-19年西班牙在美国军事基地流行的流感中，很少有人分析感染后死亡的时间模式。我使用来自美国五家海军医院患者登记表的最新开发数据集，构建了生命表，总结了每日的死亡率模式，并检查了患者之间死亡率变化的来源。结果表明，西班牙流感患者的病死率大约在入院后十天达到峰值，并且在所有入院患者中，近10％在两周内死亡。最初诊断为肺炎的患者的病死率异常高，约为非肺炎患者的3.5倍。与其他时间入院的患者相比，在流行病第二周入院的患者生存率较低。与我们样本中的其他四个海军基地相比，Gulfport基地的死亡率和死亡率模式明显不同。在我们的数据中生存时间的分布与Mills等人构建的分布之间没有统计学上的显着差异。 （2004年）来自三组尸检报告。

著录项

  • 作者

    Sohn, Kyongsei.;

  • 作者单位

    The George Washington University.;

  • 授予单位 The George Washington University.;
  • 学科 Economics General.;Military Studies.;Health Sciences Public Health.
  • 学位 Ph.D.
  • 年度 2007
  • 页码 126 p.
  • 总页数 126
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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