Pandemic influenza--including a risk assessment of H5N1

Rev Sci Tech. 2009 Apr;28(1):187-202. doi: 10.20506/rst.28.1.1879.

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.

Publication types

  • Historical Article
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Disease Outbreaks / history*
  • History, 15th Century
  • History, 16th Century
  • History, 17th Century
  • History, 18th Century
  • History, 19th Century
  • History, 20th Century
  • History, Medieval
  • Humans
  • Influenza A Virus, H1N1 Subtype
  • Influenza A Virus, H2N2 Subtype
  • Influenza A Virus, H3N2 Subtype
  • Influenza A Virus, H5N1 Subtype* / pathogenicity
  • Influenza A Virus, H9N2 Subtype
  • Influenza A virus / classification*
  • Influenza A virus / pathogenicity
  • Influenza, Human / epidemiology
  • Influenza, Human / history*
  • Risk Assessment