The site of origin of the 1918 influenza pandemic and its public health implications

The 1918-1919 influenza pandemic killed more people than any other outbreak of disease in human history. The lowest estimate of the death toll is 21 million, while recent scholarship estimates from 50 to 100 million dead. World population was then only 28% what it is today, and most deaths occurred in a sixteen week period, from late September 1918 to early January 1919. The site of origin has never been clearly established. A new review of contemporary medical and lay literature has found previously-overlooked epidemiological evidence that suggests that the pandemic began in a sparsely populated region of southwestern Kansas. The fact that a new influenza virus could cross from animals to man in such a region demonstrates the need for WHO to get the political and diplomatic support and the resources necessary to expand its influenza surveillance system, currently limited to only about half the countries in the world.