Testing the Influenza-Tuberculosis Selective Mortality Hypothesis in Australia

Andrew Noymer, University of California, Berkeley

I have postulated that there was selective mortality in the USA during the great 1918 influenza pandemic (Noymer & Garenne, PDR 2000). Tuberculosis morbidity enhances influenza mortality; this selection hypothesis is potentially important for the way we think about mortality change. Influenza pandemics are also a timely public health topic, and since TB remains very prevalent in developing countries, this work is highly relevant. Confirmation in another country is a next step. Australia is ideal, because (unlike many countries) there are good historical vital statistics and, like the USA, the 1914-18 war was far-removed, at least physically. Using mortality sex differentials and an external event as a natural experiment was the previous methodological innovation. Early analysis has already shown that the flu year (1919 in Australia) was a pivot point in TB mortality sex differentials; this is confirmatory. This paper will provide a valuable comparison to the American results.