title: Transmissibility of the 1918 pandemic influenza in Montreal and Winnipeg of Canada.
abstract: BACKGROUND
  The threat of 2009 pandemic influenza A (H1N1) is still causing widespread public concern. A comprehensive understanding of the epidemiology of 1918 pandemic influenza commonly referred to as the Spanish flu may be helpful in offering insight into control strategies for the new pandemic.
  
  
  OBJECTIVE
  We explore how the preparedness for a pandemic at the community and individual level impacts the spread of the virus by comparing the transmissibility of the 1918 Spanish flu in two Canadian cities: Montreal and Winnipeg, bearing in mind that each pandemic is unique and the current one may not follow the pattern of the 1918 outbreak.
  
  
  METHODS
  The historical epidemiological data obtained for Montreal and Winnipeg in Canada is analyzed to estimate the basic reproduction number which is the most important summary measure of transmission potential of the pandemic.
  
  
  RESULTS
  The transmissibility of the 1918 pandemic influenza virus in Winnipeg in the fall of 1918 was found to be much lower than in Montreal based on the estimated reproduction number obtained assuming different serial intervals which are the time between onsets of symptoms in an index case and a secondary case.
  
  
  CONCLUSIONS
  The early preparedness and public health control measures could suggest an explanation for the fact that the number of secondary cases generated by a primary case was significantly reduced in Winnipeg comparing to it in Montreal.
authors.affiliation: Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON, Canada.
authors.forename: Shenghai
authors.initials: S
authors.lastname: Zhang
authors.forename: Ping
authors.initials: P
authors.lastname: Yan
authors.forename: Brian
authors.initials: B
authors.lastname: Winchester
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
mesh_terms: D002170:Canada / Q000453:epidemiology; D004196:Disease Outbreaks / Q000266:history*; D018562:Disease Transmission, Infectious / Q000266:history* / Q000517:prevention & control; D049673:History, 20th Century; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology / Q000266:history* / Q000635:transmission; D014505:Urban Population