Pandemic influenza: confronting a re-emergent threat. The 1976 experience

The Swine Influenza Immunization Program began in January 1976 with an outbreak of swine influenza among trainees at Ft. Dix, New Jersey. The program ended in December 1976 after an increased incidence of Guillain-Barre syndrome was attributed to the vaccine. The issues and events of 1976 provide valuable lessons for the future. A thorough and objective review of the swine flu program should be a prerequisite for influenza pandemic planning. Strong consideration should be given to creating separate structures for risk assessment and risk management. Risk assessment estimates the probability of a pandemic, the options available for control, and the relative benefits of those options as situations change. Risk management is the political response to that assessment.