1918 Influenza Pandemic - Africa: Fatalities

The 1918 flu pandemic (January 1918 – December 1920) was an unusually deadly influenza pandemic, the first of the two pandemics involving H1N1 influenza virus. It infected 500 million people across the world, including remote Pacific islands and the Arctic, and killed 50 to 100 million of them—three to five percent of the world's population—making it one of the deadliest natural disasters in human history.

Historical and epidemiological data are inadequate to identify the pandemic's geographic origin.It was implicated in the outbreak of encephalitis lethargica in the 1920s.

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The "Spanish Flu" in Africa

In South Africa, case-fatality rates were >2× higher for “Blacks, Indians, and Coloureds” (influenza cases 2,162,152, deaths 127,745, case-fatality rate 5.9%) than for “Whites” (influenza cases 454,653, deaths 11,726, case-fatality rate 2.6%) (26); and the influenza-associated mortality rate was >30× higher for Kimberley diamond miners (influenza deaths 2,564, overall mortality rate 22.4%) (26) than for Rand gold miners (influenza cases 61,000, deaths 1,147, case-fatality rate 1.9%, overall mortality rate 0.6%) (26). In Rhodesia, influenza-related mortality rate was ≈4× higher in mining compounds (9.2%) than in villages (2.3%) (among mine workers, overall influenza cases 19,471, deaths 2,851, case-fatality rate 14.6%) (27).