Pandemic influenza--including a risk assessment of H5N1
1Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 33 North Drive, Bethesda, MD 20892-3203, USA. taubenbergerj@niaid.nih.gov
Abstract:
Influenza pandemics and epidemics have apparently occurred since at least the Middle Ages. When pandemics appear, 50% or more of an affected population can be infected in a single year, and the number of deaths caused by influenza can dramatically exceed what is normally expected. Since 1500, there appear to have been 13 or more influenza pandemics. In the past 120 years there were undoubted pandemics in 1889, 1918, 1957, 1968, and 1977. Although most experts believe we will face another influenza pandemic, it is impossible to predict when it will appear, where it will originate, or how severe it will be. Nor is there agreement about the subtype of influenza virus most likely to cause the next pandemic. The continuing spread of H5N1 highly pathogenic avian influenza viruses has heightened interest in pandemic prediction. Despite uncertainties in the historical record of the pre-virology era, study of previous pandemics may help guide future pandemic planning and lead to a better understanding of the complex ecobiology underlying the formation of pandemic strains of influenza A viruses.
Insights
Influenza pandemics have impacted populations for centuries, causing widespread illness and death. Studying past influenza pandemics can inform future planning and understanding of pandemic strain formation.
Area of Science:
- Epidemiology
- Virology
- Public Health
Background:
- Influenza pandemics and epidemics have been recurring global health events since at least the Middle Ages.
- Historically, pandemics have infected over 50% of populations and caused significant excess mortality.
- At least 13 influenza pandemics have been recorded since 1500, with five major events in the last 120 years.
Observation:
- Predicting the timing, origin, and severity of future influenza pandemics remains challenging.
- There is no consensus on which influenza virus subtype is most likely to cause the next pandemic.
- The spread of highly pathogenic avian influenza H5N1 viruses has increased focus on pandemic prediction.
Findings:
- Historical analysis of influenza pandemics, despite pre-virology era uncertainties, offers valuable insights.
- Understanding past pandemic events is crucial for developing effective future pandemic preparedness strategies.
- Research into influenza A virus ecobiology is key to understanding pandemic strain emergence.
Implications:
- Studying historical influenza pandemics can guide public health planning and response.
- Enhanced understanding of influenza virus ecobiology may improve prediction of pandemic strains.
- Proactive research is essential for mitigating the impact of future global influenza outbreaks.
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