Abstract At first glance, there appear to be significant differences between mass death from disasters and catastrophes and mass death from pandemics. In a disaster or catastrophe the major problem is identifying the dead and, sometimes, determining cause of death. This can be very frustrating for next of kin. In a pandemic, the identity of the dead is usually known as is the cause of their death. There is an immediate certainty in pandemic death. Despite these major differences there are many similarities. Because it takes time to identify the dead after a disaster or catastrophe, there is a steady release of bodies for cremation or burial, just as in a pandemic. In both types of incidents, there tends to be a shortage of supplies and personnel and, therefore, a need for use of volunteers. There are also massive amounts of paper work. This would suggest a need in both cases for stockpiling and for training of volunteers. And, although this does not always happen, both types of incidents tend to strike harder among the poorer elements in cities yet both create serious economic problems. Despite these many similarities, planning for the first tends to be done by emergency agencies, especially the police; planning for the second by health agencies. Given the many similarities this separation makes no sense. Since both types of mass death incidents lead to similar problems, it would make sense to take an all-hazards approach to planning for dealing with mass death.

Abstract With the recent outbreaks of avian influenza A (H5N1), the risk for the next influenza pandemic has increased. For effective countermeasures against the next pandemic, investigation of past pandemics is necessary. We selected cases diagnosed as influenza from medical records and hospitalization registries of Japanese army hospitals during 1918–1920, the Spanish influenza era, and investigated clinical features and circumstances of outbreaks. Admission lists showed a sudden increase in the number of inpatients with influenza in November 1918 and showed the effect of the first wave of this pandemic in Tokyo. The death rate was high (6%–8%) even though patients were otherwise healthy male adults.