Haven't been able to go through your stuff. Maybe will have time later. Did give this question to Grok to see what I would get. Looks like type of flu (seasonal or the exotic sort) plays a big role in the rate.
The result:
In the US, before 1960, which disease had the higher fatality rate, measles or influenza
To determine which disease—measles or influenza—had a higher fatality rate in the United States before 1960, we need to consider historical data from that period. This was an era before the measles vaccine (introduced in 1963) and when influenza vaccines were either not widely available or less effective than today’s versions. Let’s break it down based on available historical evidence.
Measles Fatality Rate Before 1960
Measles was a common childhood disease in the U.S. prior to vaccination. According to data from the Centers for Disease Control and Prevention (CDC) and historical studies, in the early 20th century and up to the 1950s, the U.S. saw about 500,000 reported measles cases annually, though the actual number was likely higher (estimated at 3-4 million) due to underreporting. Annual deaths from measles typically ranged from 400 to 500 in the decades leading up to 1960, though earlier in the century (e.g., 1920s), deaths could exceed 6,000 per year.
Using reported cases, the case fatality rate (CFR) for measles in the U.S. during the 1940s and 1950s is estimated at around 0.1% to 0.3% (1-3 deaths per 1,000 cases). For example:
- In 1950, approximately 319,124 cases were reported with 468 deaths, yielding a CFR of about 0.15%.
- Earlier, in the 1920s and 1930s, the CFR was higher (closer to 1% or more) due to poorer medical care and nutrition, but by the 1940s and 1950s, improvements in supportive care (e.g., antibiotics for secondary infections) had lowered it.
Influenza Fatality Rate Before 1960
Influenza’s fatality rate in the U.S. before 1960 varied significantly depending on whether it was a typical seasonal outbreak or a pandemic year. Seasonal influenza in the mid-20th century typically had a lower CFR than measles, often estimated at 0.05% to 0.1% (fewer than 1 death per 1,000 cases). For example:
- In non-pandemic years during the 1940s and 1950s, influenza and pneumonia (often combined in mortality statistics) caused 20,000–40,000 deaths annually, but cases numbered in the millions, keeping the CFR low.
- However, the 1918-1919 Spanish Flu pandemic was an exception, with a CFR estimated at 2-3% in the U.S., killing over 500,000 people out of roughly 25-30 million infected. Another notable pandemic, the 1957-1958 Asian Flu, caused about 70,000 deaths in the U.S., with a CFR closer to 0.1%-0.5%, still lower than the 1918 strain.
Since the question covers "before 1960," we must consider both pandemic and non-pandemic years. Excluding the outlier of 1918, typical influenza seasons in the 1940s and 1950s had a CFR below that of measles.
Comparison
- Measles: CFR consistently around 0.1%–0.3% in the 1940s-1950s, occasionally higher in earlier decades (up to 1%).
- Influenza: CFR typically <0.1% in non-pandemic years, though pandemics like 1918 (2-3%) and 1957 (0.1%-0.5%) spiked it significantly.
In non-pandemic years, which represent the majority of the pre-1960 period, measles generally had a higher fatality rate than influenza. For instance, in a typical year like 1955, measles might kill 1-3 per 1,000 cases, while seasonal influenza killed fewer than 1 per 1,000. The 1918 pandemic is a dramatic exception, but it’s not representative of the broader timeframe.
Conclusion
Before 1960 in the U.S.,
measles had a higher fatality rate than influenza in most years, outside of rare pandemic events like 1918. By the 1940s and 1950s, measles’ CFR (0.1%–0.3%) typically exceeded that of seasonal influenza (<0.1%).
www.cdc.gov
