Why predicting the next influenza pandemic is difficult and how scientists can best prepare

In a commentary in the May 9, 2007 issue of the Journal of the American Medical Association, scientists at the National Institutes of Health discuss why predicting the next pandemic is so difficult and outline steps that can be taken to better understand the behavior of the virus.

Drawing upon the lessons of past pandemics, the authors analyze the significance of the highly pathogenic avian influenza strain H5N1, which has spread among bird populations and infected hundreds of humans in the last decade. In preparing for the next influenza pandemic, however, the authors argue that researchers and public health officials should not focus solely on H5N1 strains, because the next pandemic might be caused by a different influenza virus.

Instead, research efforts should go beyond H5N1 and focus broadly on influenza viruses. This entails improving our knowledge of the basic biological and ecological means by which influenza A viruses infect birds; enhancing surveillance of infected animals and the circulation of influenza virus globally; understanding how the virus evolves and jumps from birds and other animals to humans; finding new approaches to vaccine design and vaccination; and developing new antivirals and diagnostics. Such broad activities can also help combat seasonal influenza, which is a major public health concern in the United States, accounting for an estimated 36,000 deaths and 200,000 hospitalizations each year.