The age pattern of mortality in the 1918-19 influenza pandemic: an attempted explanation based on data for England and Wales.

was "Quite a godsend! Everybody ill, nobody dying"') the 1918-19 variety showed a dreadful propensity to lead on to pneumonic complications and death. The bodies of the deceased, it might be added, were prone to a distressing darkening or even blackening.2 Mortality among pregnant women seemed to be particularly high.3 Edwin Jordan, writing in the 1920s, put the global toll of the pandemic at, minimally, 21.6 million deaths; Kingsley Davis later estimated that there were about 20 million deaths in India alone; F Macfarlane Burnet suggested that influenza may have been responsible for 50-100 million deaths worldwide at this time.4 A recent textbook on influenza refers to an estimated 40-50 million deaths in the pandemic.5 Thus the 1918-19 influenza outbreak has tended to invite comparison with such other great historical pestilences as the Black Death of the fourteenth century and the plague of Justinian in the sixth century, many accounts ranking it third in mortality terms after these two but some even putting it in second place.6 Coming as it did towards the end of the First World War (and just afterwards), inevitably comparisons have