Manuscript Title

The Threat of Pandemic Influenza: Why Today is Not 1918


The specter of the 1918-1919 influenza pandemic, which killed an estimated 40-100 million people worldwide, hangs over analyses of and responses to the current pandemic of swine-origin novel influenza A (H1N1). There are four major differences between today and 1918 that reduce the likelihood that the current pandemic--or the next one--will be as deadly as the one in 1918. Today we have advance warning of the threat of a highly lethal influenza pandemic, we have a global human health surveillance and response system, we have new medical countermeasures, and there is no global conflict like World War I to act as an incubator and vector for a highly lethal influenza virus and an impediment to medical and public health responses to the pandemic.