What Will the Next Influenza Pandemic Look Like?

Predicting pandemics might still be impossible, but with millions of lives at stake, researchers are using the latest science and lessons from history to best prepare for the next big one















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But researchers are not simply watching and waiting. Scientists are continually developing new proto, so-called seed vaccines, to test against newly emerging strains of the flu.

And there is plenty to do on the logistics side. The H1N1 pandemic hit Europe later than it did South and North America. And even though the outbreak was milder, thanks to the arrival of the vaccine during the pandemic peak, as I.C.L.'s Openshaw pointed out, many places were still running out of respirators, hospital beds and nursing staff.

"We know that it takes at least four to six months to have a vaccine," noted Sylvie Briand, of the World Health Organization (WHO). And for countries that receive the early waves of a pandemic, a vaccine will likely not come in time to protect people against the virus. "So it's very important to improve clinical response," by having ample medication and facilities to treat those at risk and reduce overall mortality.

Advancing preparedness in one fell swoop, however—even within the comparatively well-equipped European Union—has proved difficult, as Cambridge's Smith pointed out, because countries that are less prepared are so for different reasons—making a one-size-fits-all approach to improving preparedness impractical. And when countries the world-over are thrown into the mix—many of which have far fewer scientific, medical and infrastructural resources—the task is even more of a challenge.

At the end of the day, much of the preparation lays in the hands of policymakers—within "the realpolitik of the department of health," Openshaw noted, adding that he realized that science was only part of the equation that politicians and governmental officials must consider.

In addition to battling the mercurial virus and any political roadblocks, those trying to mitigate a future pandemic face another unpredictable force: public behavior.

In the first days of a pandemic, scientists and policymakers are forced to make consequential decisions—about containment, treatment, prophylaxis—with relatively limited information, "based on a perception," Briand said. And communicating the appropriate message to the public, which might not be well versed in risk and uncertainty, is a difficult task. Cry wolf, and it is likely to cause panic as well as subsequent criticism of overreacting. But fail to instill adequate caution, and the reaction—and mortality rate—will be even worse.

Ill-advised
In 2009, for example, the WHO eventually declared the H1N1 pandemic a level 6—the highest designation possible. But that, Briand pointed out, was not indicative of the disease's severity, but rather the extent of its spread. This distinction, which is great in the eyes of epidemiologists, was typically unaddressed in the media and thus in public perception, leading to later claims that officials had oversold the virus's danger.

So, in addition to lab work on the viruses, some scientists are hard at work "thinking about how best to communicate the uncertainty" that is undoubtedly going to arrive with the first wave of the next outbreak, I.C.L.'s Van Kerkhove said. "We learned that from the last pandemic, and we can expect that from the next one."

Unlike other human plagues, such as polio or smallpox, however, "eradication of the flu is impossible," Osterhaus said. The latest scientific and social research has pointed to three important steps to best meet the next pandemic head on, Briand said. Officials must make a variety of plans based on different scenarios; they must remain flexible to respond to rapidly changing situations; and they must keep plans up to date—refreshing stockpiles and reevaluating plans based on the latest science.



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  1. 1. Torchlake 12:58 PM 9/19/11

    Wouldn't it be prudent to keep the pressure on the public to be repaired as best we can. Example..Does a hepa-filter in a confined area be effective in creating a somewhat safe area? Should the public have face masks? The CDC has a nice web-page on these matters? Try reading "The Great Influenza" This is a real eye opener as to what will occur....! not IF...WHEN!






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  2. 2. ASHIK 01:14 PM 9/19/11

    It is a never ending fight with mutating viruses for sure.Preparation to fight against next flu attack could only be possible if scientists can predict it accurately and in advance.Lets hope we win every single time virus attacks in the future.

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  3. 3. mr2sheds 01:46 PM 9/19/11

    I think you are missing the real story here...FERRETS?

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  4. 4. biomedical 06:04 PM 9/19/11

    Health experts and CDC scientists seem to all agree that "it is not if, but when a real, large scale pandemic will occur," and Public Health officials are realizing that front-line respiratory protection is critical. I keep hearing people as … "will we be prepared?" Bio-Medical, http://www.maxair-systems.com

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  5. 5. rumyan 10:17 AM 9/20/11


    The 2009 pandemic of influenza A H1N1 has been relatively mild. It killed about one in 10,000 people who came down with it. The pandemic claimed near14,000 lives across the globe i.e. less than 0.0002% of world population. The most basic question that arises immediately - why 0.0002% of healthy people died of the flu and others 99, 999% did not. This question is most basic and it must be answered first of al. Unfortunately, the experts cited in the discussed letter don’t focus their attention on relevant traits of most susceptible human individuals. They continue to exploit infertile idea of prevalent value of virus mutations. What is more, they ignore the observations and technologies evidenced genetic nature of individual differences in human susceptibility to influenza has been published in the article “Genetic immunity and influenza pandemics” (FEMS immunology and medical microbiology 2006;48:1-10) and in the book “Hereditary Immunity: Fundamental Principles and Exploitation in Life Study and Health Care” (New York: Nova Biomedical Books, 2008).
    .

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  6. 6. bucketofsquid 04:17 PM 9/23/11

    So out of curiosity this guy weaponized H5N1 virus and he only had to do a handful of variety combinations and then spread it through 10 hosts before it became airborn and thus weapon suitable. An airborn virus with a 60% fatality rate of infected persons is pretty impressive. I wonder how much he is selling it for.

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  7. 7. rumyan 05:07 PM 9/23/11

    Dear "bucketofsquid”, the answer to your questions you can find inside of the book entitled "Is Bioterrorism Idea a Delusion or Skillful Swindling?" Puurs, Belgium: UniBook, 2010.


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  8. 8. Wayne Williamson in reply to bucketofsquid 08:25 PM 9/29/11

    reminds me of the movie 12 monkeys....

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  9. 9. JamesRoday in reply to mr2sheds 11:14 PM 1/23/12

    Would you rather... HUMANS?

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