Pandemic influenza--including a risk assessment of H5N1.
Rev Sci Tech. 2009 Apr;28(1):187-202
Authors: Taubenberger JK, Morens DM
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.
PMID: 19618626 [PubMed - indexed for MEDLINE]
It appears that the authors have overlooked the current Swine Flu pandemic that began in April in Mexico and has spread to over 65 countries to date. While the Swine Flu appears mild, it could yet mutate to a more severe form as we approach the seasonal flu period in the northern hemisphere.
Additionally, the economic effect of a global pandemic should be considered as its impact may be far greater in the long term.