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Australia was the last continent involved with about 12\u2009000 influenza deaths in 1919. Most cases were clinically unremarkable and recovered quickly, but a small minority developed severe tracheobronchitis compromising oxygenation and immune defences usually dying in the second week of illness. Histopathology showed massive destruction of the respiratory epithelium with evidence of secondary bacterial invasion. No simple explanation (e.g. hypervirulent virus) is consistent with these observations.<\/jats:p>","DOI":"10.1111\/imj.14344","type":"journal-article","created":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T23:36:42Z","timestamp":1562888202000},"page":"919-923","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Anomalies of the 1919 influenza pandemic remain unexplained after 100 years"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5763-8660","authenticated-orcid":false,"given":"G. Dennis","family":"Shanks","sequence":"first","affiliation":[{"name":"Australian Defence Force Malaria and Infectious Diseases Institute  Brisbane Queensland Australia"},{"name":"School of Public Health University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,7,11]]},"reference":[{"key":"e_1_2_2_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30178-6"},{"key":"e_1_2_2_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp0904819"},{"key":"e_1_2_2_4_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1802.102042"},{"key":"e_1_2_2_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/591708"},{"volume-title":"Report on the Influenza Epidemic in New South Wales in 1919","year":"1920","author":"Paton RT","key":"e_1_2_2_6_1"},{"volume-title":"Health and Disease in Australia: A History","year":"1989","author":"JHL C","key":"e_1_2_2_7_1"},{"key":"e_1_2_2_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1750-2659.2010.00195.x"},{"volume-title":"Deadly Encounters: How Infectious Disease Helped Shape Australia","year":"2015","author":"Curson P","key":"e_1_2_2_9_1"},{"key":"e_1_2_2_10_1","doi-asserted-by":"publisher","DOI":"10.1071\/NB06025"},{"key":"e_1_2_2_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwy148"},{"key":"e_1_2_2_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0069586"},{"key":"e_1_2_2_13_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aag1322"},{"key":"e_1_2_2_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/652868"},{"key":"e_1_2_2_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268816000479"},{"key":"e_1_2_2_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/emph\/eoz001"},{"key":"e_1_2_2_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)52169-8"},{"key":"e_1_2_2_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(02)00185-8"},{"key":"e_1_2_2_19_1","unstructured":"MacPhersonW LeishmanW CumminsSL. 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