Influenza Pandemic: Plan or Panic

I have been keeping half an eye on the current situation with the H7N9 avian influenza strain currently infecting humans in Eastern China. For more details on this click here.


The current Outbreak made me ask myself two questions:

  •  If the 1919-20 pandemic Influenza strain (Spanish Flu) emerged in today’s world, would it have the same devastating impact that it had back in 1919?
  •  Is there a chance we could have in the future a pandemic of equal (or greater) severity as the Spanish Flu?

My personal answers to these questions are No and Yes respectively.

The world has changed a lot since 1919. In 1919 there was massive displacement of population following WW1, there was great poverty and there were no antibiotics to deal with post influenza bacterial pneumonia. Nor was there any Influenza vaccines. For these reasons I don’t think the 1919 pandemic strain would have had nearly the same impact today.

But yes, I do think we could potentially have another pandemic as severe as 1919. It would just take a more pathogenic Influenza virus to do this, and we know that antigenic shift and mixing of Influenza strains from different species certainly have the potential of creating very pathogenic viruses. Fortunately most of these strains turn out to have low transmissability between humans.

We have had at least four recognised Influenza pandemics in the past century (Spanish Flu 1919-20, Asian Flu 1957-58, Hong Kong Flu 1968-69, Swine Flu 2009-10). The next one will not be a matter of “If”, but “When”. Fortunately the 2009 H1N1 Influenza pandemic, although very transmissable, was no more pathogenic than the usual seasonal strains.

None of us particularly enjoy putting in a lot of work to plan for something which may or may not happen during our working lifetimes. But this is what needs to happen. I am not saying it is easy either. To try and draft a policy to prepare for an Influenza pandemic of totally unpredictable size and severity is one of the hardest things I have had to do as a microbiologist. Some might say that drafting such a policy is close to impossible. But we need to try, in an attempt to at least reduce the inevitable panic that ensues….

Even though the “Swine Flu” pandemic was relatively mild in pandemic terms, hopefully we will use this recent experience to hone our policies for when the next pandemic strikes.


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