id author title date pages extension mime words sentences flesch summary cache txt cord-003466-599x0euj Nickol, Michaela E. A year of terror and a century of reflection: perspectives on the great influenza pandemic of 1918–1919 2019-02-06 .txt text/plain 5772 283 45 MAIN TEXT: The 1918 H1N1 pandemic virus spread across Europe, North America, and Asia over a 12-month period resulting in an estimated 500 million infections and 50–100 million deaths worldwide, of which ~ 50% of these occurred within the fall of 1918 (Emerg Infect Dis 12:15-22, 2006, Bull Hist Med 76:105-115, 2002). Influenza viruses have posed a continual threat to global public health since at least as early as the Middle Ages, resulting in an estimated 3-5 million cases of severe illness and 291,243-645,832 deaths annually worldwide, according to a recent estimate [1] . To be considered a pandemic, an influenza virus must: i) spread globally from a distinct location with high rates of infectivity resulting in increased mortality; and ii) the hemagglutinin (HA) cannot be related to influenza strains circulating prior to the outbreak nor have resulted from mutation [14, 15] . ./cache/cord-003466-599x0euj.txt ./txt/cord-003466-599x0euj.txt