Influenza in India 1918: epicenter of an epidemic

Kenneth Hill, Harvard University

Routine demographic data from censuses and civil registration for India for the period 1911 to 1921 are used to assess the size and regional distribution of the impact of the 1918 influenza epidemic. Modern methods of data evaluation are used to adjust for possible under- (or over-) reporting of deaths relative to census counts; given the nature of the age groups used these methods are given some modification. The analysis presents estimates for the country, provinces (now called states) and districts. Associations between excess death rates and other characteristics for sub-national areas are explored. Initial analysis of unadjusted data suggests that the “excess” crude death rate between August 1918 and January 1919 may have averaged over 30 per 1,000, and in Central Provinces may have exceed 60 per 1,000, but the severity of the impact appears unrelated to initial mortality level.