The 1918 influenza pandemic hastened the decline of tuberculosis in the United States: An age, period, cohort analysis

The effect of the 1918 influenza pandemic on other diseases is a neglected topic in historical epidemiology. This paper takes up the hypothesis that the influenza pandemic affected the long-term decline of tuberculosis through selective mortality, such that many people with tuberculosis were killed in 1918, depressing subsequent tuberculosis mortality and transmission. Regularly collected vital statistics data on mortality of influenza and tuberculosis in the US are presented and analyzed demographically. The available population-level data fail to contradict the selection hypothesis. More work is needed to understand fully the role of multiple morbidities in the 1918 influenza pandemic. (C) 2011 Elsevier Ltd. All rights reserved.