Please start here: None of what is written below is conjecture. I am simply relaying the information provided by the worlds foremost experts on Influenza A, virology, epidemiology and what a pandemic may mean for us all. Lets start with a set of interviews conducted late in 2005 with many of the world leaders in the relevant fields, so if you are in any doubt about the chances of a Pandemic occurring you'd best read this 11JAN06 set of interviews by the worlds experts
So what is a pandemic? It is a world wide epidemic. To become a pandemic strain a pathogen (in this case Influenza A) must meet three criteria:
1. It must be an emergent virus - that is it has not been seen before. Each virus has a host species in which it is endemic but which usually remains asymptomatic. Typically birds (H5N1), Pigs (H1N1) etc. The host species just acts as a reservoir. Occasional a virus will change such that it can jump the species barrier. A virus can change (some same say mutate) in one of two ways. Antigenic drift - this is a result of the sloppy way copies of the virus are reproduced in the host cell, primarily because a virus is so simple it is like building a house with only roughed out plans.. the end result is often different to the original. Reassortment is when two different virus infect the same cell there may be some swapping of genetic info between the virus' so that a new one emerges containing properties of both precursors. The guts of it is that Viruses change and fast!
2. The new virus must be able to infect humans and cause disease therein {otherwise who cares?} This is generally a property of being a novel virus to us, that is we have no pre-existing immunity through exposure to previous strains of the particular virus. The current H1N1/2009 strain seems to be affecting mostly people born after the mid1960s. This is possibly due to the exposure of older people to the 1967 pandemic strain of Influenza A. This is theory only at this stage. Pandemic strains kill an additional demographic to seasonal influenza (normally the young and the old) in addition to it's usual victims - those with depressed or inadequate immune function. Another cause of mortality is called a 'cytokine storm'. In effect it is a healthy bodies extreme reaction to a pathogen that is so over the top it attacks healthy cells as well. This is why many victims in 1918 were healthy people between age 18-45.
3. It must be easily transmissible and able to reproduce successfully within humans. Virus is transmitted in two ways. Aerosolisation - someone coughs or sneezes and you inhale their nasal secretions, mucus etc .. pretty yucky eh? :D Contact transmission - they contaminate a surface, you then touch it and then touch your face (nose/mouth/eyes) and self infect. BTW a virus can remain inert on a surface for days! The best way to avoid infection is get no closer than about 6 feet to someone and the main one is to practice good hygiene and stop touching your face!
The Centre for Disease Control in the USA. H1N1 Info page.
For my professional colleagues who CDC identify as a serious risk they offer the following:
Guidance for Air Crew
Planning advice for the Travel Industry from the the US Government:
Travel Industry Planning
Effect Measure is a blog run by public health officials in the USA.
What would a post pandemic world look like?
This is an article from from APR06. Its' focus is the threat of H5N1 Pandemic. Dr Michael Osterholm is an epidemiologist and heads CIDRAP. He is a world leader in his field, has advised two USA Administrations and is well qualified in his opinions. In this interview his focus is on the shape of a post-pandemic world. Click Here.
On this page I have previously laid out a rough chronology of Influenza A, it's evolution and spread around the world. I believe the threat of a pandemic is no longer in question. This is on the strength of the advice of the worlds leading lights in the field and as of MAR06 I will start adding links and information on pandemic preparedness and what we can do for ourselves and our families before one starts. Most of this is in the form of links to other websites. Here is one I use. But keep your Bullshit Filter firmly in place. Current Events Forum, not just for its up to the moment news on developments but especially for its enormous database on preparedness (colloquially known as 'prepping'), home nursing and treatment. There is also a large body of 'MUST READ' info lower down this page as well as links to several sites that monitor the worlds news wires/services for reports of outbreaks. There is also a section of links to many of the leading Influenza A research institutes and the information they are providing.
A pandemic is imminent if not already underway. I am sure most governments are already well aware of this threat but at this time there is no vaccine for Influenza A H1N1. There is only one recognized antiviral - Tamiflu (from Roche) that is thought to help with recovery once you are infected but personally I'd rather not let it get that far. Oseltamivir simply slows down the rate at which the virus is able to replicate in your body thereby giving ity time to develop the appropriate response. Once a pandemic is underway there will be very little chance of stopping it unless something is done now - this is what the worlds health officials are shouting about and yet nothing is being done. If or when it happens the consequences for the world may well be catastrophic - worst case is a complete halt to all international trade and travel, factories and offices closed, police, fire and other essential services crippled (I certainly won't be going to work!) and health care systems overrun. Worst case predictions are 10s to 100s of millions of people will die (one prediction mentioned 20% of the worlds population - this means about 1 billion). Think about what that would mean. Hopefully the articles below will help your understanding. And I really do hope that I am completely wrong. This is an article from the H5N1 scare a couple of years back. I hope this fellow is too: Dr Albert Osterhaus