Heat wave of 1915-1916

[Snowy Owl]

New thread for compilation of the heat wave of 1915-1916

[Snowy Owl]

Re: Heat wave of 1915-1916

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<CENTER><TABLE width=596 align=center border=0><TBODY><TR><TD><CENTER>Compiled by Ellen O'Brien and Lyle Benedict, Reference Librarians in CPL's Municipal Reference Collection.</CENTER></TD></TR></TBODY></TABLE></CENTER>

http://www.chipublib.org/004chicago/...eat_waves.html

<CENTER>1915, 1916, 1955, 1995: Heat Waves

</CENTER><CENTER><TABLE width=596 align=center border=0><TBODY><TR><TD></TD><TD vAlign=center align=middle><CENTER>Image from:U.S. National Weather Service. Natural Disaster Survey Report:
July 1995 Heat Wave. 1995. </CENTER>(Click image for larger view)</TD></TR></TBODY></TABLE></CENTER>

Hot late July weather in each of these years caused high mortality. The 1915 heat wave was credited with 535 deaths from "heatstroke" as well as high general mortality for the summer. 1955 had the hottest July on record and accounted for a large number of deaths. In 1995, hot weather again claimed over 500 lives and was a contributing cause in more than 200 additional deaths. The 1995 deaths received dramatic media coverage because of the current requirement that deaths outside of hospitals be autopsied by the Cook County Medical Examiner.
Below is a short exceprt from the Cook County Hospital Annual Report for 1916 p.15 showing the serious consequences of the weather that year:

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"Heat Prostrations Cared for</CENTER>

Another test which strained the service of the institution to the utmost came during the extreme heat of last summer when our empoyes worked day and night almost without sleep trying to save the lives of over two hundred persons who were overcome by heat. The patients were not merely given a bath and put to bed. The had to be put in large bath tubs filled with ice water and rubbed for half an hour or more until their temperature were brought somewhere near normal. When they were broutht into the hospital their tempertures could not be registered, for they were highter thatn the thermometer would record, 110 depgrees. The clothes of practically all these pattients had to be destroyed. The employes had to work in obnoxious odors with the patients delirious and having convulsions, and it is surprising that they themselves were not overcome with heat while working so hard."

Death statistics for other years also show a relationship between heat and mortality statistics.
<HR align=center width=596>
Sources: (Underlined sources available on line)
Chicago (Ill.). Dept. of Health. Chicago (Ill.). Dept. of Health. General and Chronological Summary of Vital Statistics.(Annual Report 1911-1918. Reprint Series-No.16) Chicago: The Dept. 1919. see especially page 1454a Chicago (Ill.). Mayor's Commission on Extreme Weather Conditions. Final Report. 1995 (MRC Cc E965 1995a) Chicago Public Library. Weather Records on CPL's Timeline--A Chronological History of Chicago: 1673-.</PRE>
Interfaith Memorial Service for Indigent Persons. (MRC series) Spielman, Fran. "Daley Readies Response in Case of New Heat Wave." Chicago Sun Times. May 24, 1996. p.10. United States. National Weather Service.July 1995 Heat Wave. 1995. (MRC Cz Y.9 U58 1995xa) United States. Weather Bureau. Climatic Guide for Chicago, Illinois Area. Washington, D.C.: GPO 1962. (Cz Y .9 U58 1962) MRC clipping file: Climatology--Chicago--Heat Wave of 1995Links to outside sources:</PRE>
U.S. Center for Disease Control. "Heat-related mortality -- Chicago, July 1995" MMWR v.44 no.31, Aug.11,1995, pp.577-579. </PRE>
Released 1996, Last Updated: 03/2005
</PRE>

[Snowy Owl]

Re: Heat wave of 1915-1916

We obtained annual P&I mortality rates by age group for<SUP> </SUP>1915-1917 to look for the typical "U-shaped" mortality curve<SUP> </SUP>(increased rates at the extremes of age) and for 1918 to look<SUP> </SUP>for the "W-shaped" curve characteristic of the pandemic (highest<SUP> </SUP>annual mortality rates among young children, young adults, and<SUP> </SUP>the elderly). To provide an alternative measure of the age-specific<SUP> </SUP>impact on interpandemic and pandemic influenza-related deaths,<SUP> </SUP>excess mortality rates were plotted by age and compared for<SUP> </SUP>the severe 1915/1916 influenza season, the March and April 1918<SUP> </SUP>epidemic months, and the 1918/1919 pandemic season. As done<SUP> </SUP>recently to characterize mortality age patterns for the 1968<SUP> </SUP>pandemic (31), we calculated the age-specific ratio of pandemic<SUP> </SUP>to interpandemic excess rates to estimate age-specific relative<SUP> </SUP>risk by using 45 years of age as the cutoff.<SUP> </SUP>
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<TABLE cellSpacing=0 cellPadding=0 width="100%" bgColor=#e1e1e1><TBODY><TR><TD vAlign=center align=left width="5%" bgColor=#ffffff></TD><TH vAlign=center align=left width="95%"> Results </TH></TR></TBODY></TABLE><TABLE cellPadding=5 align=right border=1><TBODY><TR><TH align=left>Top
Abstract
Materials and Methods
Results
Discussion
References
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Excess Mortality. Severe epidemic mortality occurred in 5 of<SUP> </SUP>the 10 influenza seasons during 1911-1921. The 1911/1912 influenza<SUP> </SUP>season was reported by the health department as distinctly free<SUP> </SUP>of epidemic influenza, and the 1915/1916 influenza epidemic<SUP> </SUP>was noted at the time as the worst to date that century (4).<SUP> </SUP>During the 1915-1920 epidemic seasons, the temporal pattern<SUP> </SUP>and peaks in all-cause and P&I deaths coincided (Fig. 1 A and B).<SUP> </SUP>Epidemic period estimates for all ages in the 1915/1916<SUP> </SUP>and 1916/1917 seasons were 2,100 and 2,800 excess all-cause<SUP> </SUP>deaths, respectively (Table 1). Excess all-cause deaths in the<SUP> </SUP>1918/1919 pandemic and 1919/1920 recrudescence were 29,200 and<SUP> </SUP>8,200, respectively (Table 1). An estimated 4,600 excess all-cause<SUP> </SUP>deaths occurred during the 1917/1918 influenza season (Table 1);<SUP> </SUP>epidemic mortality in this season occurred in two peaks,<SUP> </SUP>in January and March 1918 (Fig. 1 A and B, arrowheads).<SUP> </SUP>
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</NOBR> </TD><TD vAlign=top align=left>Fig. 1. All-cause and P&I monthly mortality rates for all ages (A and B) and all-cause mortality rates by age group (C-H) are calculated per 10,000 population. Observed rates are days-per-month adjusted. Expected model baselines (solid lines) are derived from each series of nonepidemic months. Epidemic thresholds (dashed lines) are the upper 95% confidence limit above each baseline. The major epidemic influenza season months are indicated (shaded). Two 1917/1918 influenza season peaks (arrowheads) show excess mortality primarily confined to the 65-years age group in January (C), and to the groups <45 years old in March 1918 (E-H). Other severe mortality events are evident: summer diarrheal disease epidemics were confined to young children (H), the 1916 polio epidemic to all children (G and H), and the summer 1917 heat wave and diarrheal disease epidemic among the youngest and oldest age groups (C and H).
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<CENTER><TABLE cellSpacing=0 cellPadding=0 width="95%"><TBODY><TR bgColor=#e1e1e1><TD><TABLE cellSpacing=2 cellPadding=2><TBODY><TR bgColor=#e1e1e1><TD vAlign=top align=middle bgColor=#ffffff>View this table:
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</NOBR> </TD><TD vAlign=top align=left>Table 1. Influenza season excess deaths
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Age-Specific Analyses. The age pattern of mortality shifted<SUP> </SUP>profoundly during the 1917/1918 season. In the 1915/1916 and<SUP> </SUP>1916/1917 influenza seasons and in January 1918, excess mortality<SUP> </SUP>incidence was greatest in those 65 years old (Fig. 1 C). During<SUP> </SUP>February-April 1918 and the 1918/1919 season, those 65 years<SUP> </SUP>old experienced little or no excess mortality (Fig. 1C), whereas<SUP> </SUP>those aged 15-24 and 25-44 years experienced sharply elevated<SUP> </SUP>death rates (Fig. 1 E and F). Mortality data for children <5<SUP> </SUP>and 5-14 years old did not exhibit winter peaks before the 1917/1918<SUP> </SUP>season (Fig. 1 G and H). Before 1918, children experienced mortality<SUP> </SUP>peaks from summer diarrheal disease epidemics, a severe polio<SUP> </SUP>epidemic in the summer of 1916 (Fig. 1 G and H), and a coincident<SUP> </SUP>diarrheal epidemic and heat wave in the summer of 1917 (Fig.<SUP> </SUP>1H).<SUP> </SUP>

Because of the striking contrast in mortality impact by age<SUP> </SUP>during the 1918/1919 pandemic season, we calculated the ratio<SUP> </SUP>of <45 to 45 years epidemic period excess death rates (Table 1).<SUP> </SUP>The ratio of age-specific epidemic deaths shifted abruptly<SUP> </SUP>in February 1918 and reached values >20-fold higher in March<SUP> </SUP>and April 1918 and in the 1918/1919 season than in the 1915/1916<SUP> </SUP>and 1916/1917 epidemic seasons (Table 1). The age-specific ratio<SUP> </SUP>in the 1919/1920 season was closer to prepandemic levels (Table 1);<SUP> </SUP>however, the total burden of excess deaths among people<SUP> </SUP><45 years old remained extremely high, compared with the<SUP> </SUP>interpandemic period (Fig. 1 E-H).<SUP> </SUP>
The W-Shaped Curve. Average annual P&I death rates by age<SUP> </SUP>for 1915-1917 showed the classic U-shaped mortality pattern<SUP> </SUP>characteristic of influenza epidemic years (Fig. 2A). For calendar<SUP> </SUP>year 1918, the age-specific mortality pattern showed the classic<SUP> </SUP>W-shaped distribution of the pandemic (Fig. 2 A). In contrast,<SUP> </SUP>when we plotted seasonal age-specific excess mortality rates<SUP> </SUP>(specifically representing influenza-related mortality), a strikingly<SUP> </SUP>different pattern emerged. For the 1915/1916 interpandemic season,<SUP> </SUP>the U pattern is flattened on one end because children <5<SUP> </SUP>years had little excess epidemic-period impact, whereas the<SUP> </SUP>U pattern was elevated on the other, because the greatest increase<SUP> </SUP>in epidemic period mortality was among the elderly (Fig. 2B).<SUP> </SUP>For the 1918/1919 pandemic season, mortality rates in young<SUP> </SUP>children and young adults were sharply higher than for the 1915/1916<SUP> </SUP>epidemic, whereas mortality rates were lowest among the oldest<SUP> </SUP>age group, presenting an age pattern resembling an attenuated<SUP> </SUP>W shape (Fig. 2B).<SUP> </SUP>
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<CENTER><TABLE cellSpacing=0 cellPadding=0 width="95%"><TBODY><TR bgColor=#e1e1e1><TD><TABLE cellSpacing=2 cellPadding=2><TBODY><TR bgColor=#e1e1e1><TD vAlign=top align=middle bgColor=#ffffff>
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</NOBR> </TD><TD vAlign=top align=left>Fig. 2. Annual and epidemic period mortality rates by age group. (A) Average age-specific calendar year P&I death rates are plotted in a U-shaped age distribution for 1915-1917 (), and in the characteristic W-shaped distribution for the pandemic year 1918 (). (B) Influenza-season-attributable excess deaths are plotted for the 1915/1916 epidemic influenza season (), the epidemic months March and April 1918 (), and the pandemic season from September 1918 through April 1919 (). (C) The excess rates are plotted on a log<SUB>10</SUB> scale. (D) Relative risk of death is plotted by age group on a log<SUB>10</SUB> scale for the March and April 1918 epidemic period () and the pandemic from September 1918 through April 1919 () relative to the severe 1915/1916 epidemic season.</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></CENTER>http://www.pnas.org/cgi/content/full/pnas;102/31/11059

[Snowy Owl]

Re: Heat wave of 1915-1916

Historically, a corresponding condition especially in Armed Forces, called 'Exertional Heat Hyperpyrexia', was described in the past as 'Classic Fatigue Syndrome' by the British troops from the days of the Crimean War and Indian Mutiny3. Sir Victor Horsely an eminent neurosurgeon and pathologist is perhaps the most celebrated victim, who died on duty in the desert in 1916(4). The exhaustive report5 on 125 cases of heat stroke is an oft-quoted and authoritative treatise on clinical and pathological aspects. A recent report6 of death due to EHI of a young British Officer Cadet was followed by a vigorous debate on several aspects of exercise schedules in the Royal Army Medical Corps (RAMC), therapy and possible legal implications7. From time to time, such studies have paved the way for development of more rational management and treatment of cases of heat hyperpyrexia.

Sporadic cases of classical heat hyperpyrexia were known for long throughout the Indian sub-continent, by different names such as, sun- stroke, heat exhaustion, and fatal heat hyperpyrexia.

http://findarticles.com/p/articles/mi_qa3867/is_200406/ai_n9445846

[AlaskaDenise]

Re: Heat wave of 1915-1916

from #3 above, figure 1 test -

.....and the summer 1917 heat wave and diarrheal disease epidemic among the youngest and oldest age groups.....

Wonder if that was the early H1N1 - GI version of AI???

.