JDR Vol.7 No.3 pp. 274-280
doi: 10.20965/jdr.2012.p0274


Pandemic Influenza

Maria Eugenia Vasquez Manriquez*, Kentaro Iwata**,
Motoko Tanaka***, and Kyoko Shinya***

*National Institute of Respiratory Diseases, Calzada De Tlalpan 4502, Colonia Seccion XVI, Mexico C.P. 14080, Mexico

**Division of Infectious Disease Therapeutics, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan

***Division of Zoonosis, Graduate School of Medicine, Kobe University, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan

June 27, 2011
October 31, 2011
April 1, 2012
pandemic, influenza, future perspective

On 11 June 2009, a new influenza pandemic was declared by the World Health Organization. One of the most important lessons learned from this pandemic was the difficulty of estimating the pathogenicity of newly emergent pathogens, especially in the initial phase of the outbreak. Clinicopathological analysis of the first patients in Mexico revealed that this virus infection had accelerated the death of patients suffering from underlying diseases, although a small percentage of otherwise healthy people also suffered from rapidlyprogressing lethal pneumonia. Even under medical observation, the prognostication of the disease for individual patients remains difficult. Gathering a patient’s basic background information and making a proper physical examination likely remain the most important and effectivemethods by which severe cases can be diagnosed at an early stage. An increased incidence in cases of severe pneumonia has been repeatedly observed in the early phases of both past and recent pandemics. By the time an outbreak has been identified, it is almost certainly impossible to prevent the transmission of the airborne pathogen worldwide. In planning for future pandemics, a compromise between attempts to contain the spread of the pathogen and reliance upon the standard clinical medical procedures will be needed.

Cite this article as:
Maria Eugenia Vasquez Manriquez, Kentaro Iwata,
Motoko Tanaka, and Kyoko Shinya, “Pandemic Influenza,” J. Disaster Res., Vol.7, No.3, pp. 274-280, 2012.
Data files:
  1. [1] O. Sekkides, “Pandemic influenza – a timeline,” The Lancet Infectious Diseases, Vol.10, No.663, 2010.
  2. [2] ProMED-mail, “Swine influenza A (H1N1) infection in 2 children – southern California,”March/April 2009, ProMED-mail 2009; 21 April: 20090422, [accessed at May 24, 2011]
  3. [3] ProMED-mail, “Influenza A(H1N1) virus, swine, human-USA (02); California, Texas),” ProMED-mail 2009; 24 April: 20090424,, [accessed at May 24, 2011]
  4. [4] ProMED-mail, “Acute Respiratory Disease-Mexico, Swine Virus Suspected,” ProMED-mail 2009; 24 April: 20090424, [accessed at May 24, 2011]
  5. [5] Ministry of Health, Labour and Welfare, Japan, “Document #2 for the First Review Meeting on Measures against Pandemic Influenza (A/H1N1)” March 31, 2010 (in Japanese),
  6. [6] ProMED-mail, “Mexico Raises Swine Flu Death Toll to 149 [suspected],” ProMED-mail 2009; 27 April: 20090427, [accessed at May 24, 2011]
  7. [7] ProMED-mail, “USA confirmed cases,” ProMED-mail 2009; 29 April: 20090429, [accessed at May 24, 2011]
  8. [8] T. Shimada, Y. Gu, H. Kamiya et al., “Epidemiology of influenza A(H1N1)v virus infection in Japan,” May-June 2009, Euro Surveill, 2009, Vol.14, No.24,
    Available at: [accessed at May 24, 2011]
  9. [9] C. Franco-Paredes, I. Hernandez-Ramos, C. Del Rio et al., “H1N1 Influenza Pandemics: Comparing the Events of 2009 in Mexico with those of 1976 and 1918-1919,” Archives of Medical Research, Vol.40, No.8, pp. 669-672, 2009.
  10. [10] “CDC estimates of 2009 H1N1 influenza cases, hospitalizations and deaths in the United States,” April 2009-March 13, 2010, March 13.htm [accessed at May 24, 2011]
  11. [11] G. Nikolopoulos, P. Bagos, T. Lytras, and S. Bonovas, “An Ecological Study of the Determinants of Differences in 2009 Pandemic Influenza Mortality Rates between Countries in Europe,” PLoS ONE, Vol.6, No.5, e19432, 2011.
  12. [12] Ministry of Health, Labour and Welfare, Japan, “Document #1 for the First Review Meeting on Measures against Pandemic Influenza (A/H1N1),” March 31, 2010 (in Japanese),
  13. [13] R. Perez-Padilla, D. de la Rosa-Zamboni, S. Ponce de Leon, M. Hernandez, F. Quiñones-Falconi, E. Bautista, A. Ramirez-Venegas, J. Rojas-Serrano, C. E. Ormsby, A. Corrales, A. Higuera, E. Mondragon, and J. A. Cordova-Villalobos, “INER Working Group on Influenza. Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico,” N Engl J Med, Vol.361, No.7, pp. 680-689, Aug. 13, 2009.
  14. [14] A. Gómez-Gómez, M. Magaña-Aquino, C. Garcia-Sepúlveda, U. R. Ochoa-Pérez, R. Falcón-Escobedo, A. Comas-García, S. Aranda-Romo, H. I. Contreras-Treviño, P. V. Jimenéz-Rico, M. A. Banda-Barbosa, F. Dominguez-Paulin, J. M. Bernal-Blanco, L. F. Peréz-González, and D. E. Noyola, “Severe pneumonia associated with pandemic (H1N1) 2009 outbreak,” San Luis Potosí, Mexico. Emerg Infect Dis., Vol.16, No.1, pp. 27-34, Jan., 2010.
  15. [15] R. J. Garten, C. T. Davis, C. A. Russell, B. Shu, S. Lindstrom, A. Balish, W. M. Sessions, X. Xu, E. Skepner, V. Deyde, M. Okomo-Adhiambo, L. Gubareva, J. Barnes, C. B. Smith, S. L. Emery, M. J. Hillman, P. Rivailler, J. Smagala, M. de Graaf, D. F. Burke, R. A. Fouchier, C. Pappas, C. M. Alpuche-Aranda, H. López-Gatell, H. Olivera, I. López, C. A. Myers, D. Faix, P. J. Blair, C. Yu, K. M. Keene, P. D. Dotson Jr, D. Boxrud, A. R. Sambol, S. H. Abid, K. St George, T. Bannerman, A. L. Moore, D. J. Stringer, P. Blevins, G. J. Demmler-Harrison, M. Ginsberg, P. Kriner, S. Waterman, S. Smole, H. F. Guevara, E. A. Belongia, P. A. Clark, S. T. Beatrice, R. Donis, J. Katz, L. Finelli, C. B. Bridges, M. Shaw, D. B. Jernigan, T. M. Uyeki, D. J. Smith, A. I. Klimov, and N. J. Cox, “Antigenic and genetic characteristics of swine-origin 2009 A(H1N1) influenza viruses circulating in humans,” Science, Vol.325, No.5937, pp. 197-201, Jul. 10, 2009 (Epub May 22, 2009).
  16. [16] Y. Itoh, K. Shinya, M. Kiso, T. Watanabe, Y. Sakoda, M. Hatta, Y. Muramoto, D. Tamura, Y. Sakai-Tagawa, T. Noda, S. Sakabe, M. Imai, Y. Hatta, S. Watanabe, C. Li, S. Yamada, K. Fujii, S. Murakami, H. Imai, S. Kakugawa, M. Ito, R. Takano, K. Iwatsuki-Horimoto, M. Shimojima, T. Horimoto, H. Goto, K. Takahashi, A. Makino, H. Ishigaki, M. Nakayama, M. Okamatsu, K. Takahashi, D. Warshauer, P. A. Shult, R. Saito, H. Suzuki, Y. Furuta, M. Yamashita, K. Mitamura, K. Nakano, M. Nakamura, R. Brockman-Schneider, H. Mitamura, M. Yamazaki, N. Sugaya, M. Suresh, M. Ozawa, G. Neumann, J. Gern, H. Kida, K. Ogasawara, and Y. Kawaoka, “In vitro and in vivo characterization of new swine-origin H1N1 influenza viruses,” Nature, Vol.460, No.7258, pp. 1021-1025, Aug. 20, 2009.
  17. [17] R. G. Webster, K. F. Shortridge, and Y. Kawaoka, “Influenza: interspecies transmission and emergence of new pandemics,” WFEMS Immunol Med Microbiol., Vol.18, No.4, pp. 275-9, Review, Aug. 1997.
  18. [18] J. F. Hers, N. Masurel, and J. Mulder, “Bacteriology and histopathology of the respiratory tract and lungs in fatal Asian influenza,” Lancet., Vol.2, pp. 1141-3, 1958.
  19. [19] F. M. Burnet and E. Clark “Influenza; A survey of the last 50 years in the light of modern work on the virus of epidemic influenza,” Chapter VII, Special aspects of the 1918-1919, pp. 79-89, Macmillan and company limited, Melbourne, 1942.
  20. [20] K. Shinya, M. Ebina, S. Yamada, M. Ono, N. Kasai, and Y. Kawaoka, “Avian flu: influenza virus receptors in the human airway,” Nature, Vol.440, No.7083, pp. 435-436, Mar. 23, 2006.
  21. [21] T. Watanabe, S. Watanabe, K. Shinya, J. H. Kim, M. Hatta, and Y. Kawaoka, “Viral RNA polymerase complex promotes optimal growth of 1918 virus in the lower respiratory tract of ferrets,” Proc Natl Acad Sci U S A., Vol.106, No.2, pp. 588-592, Jan 13, 2009.
  22. [22] “Seven cases of swine influenza in the USA. Possible human-to-human transmission,” Yomiuri Shinbun Evening Paper, April 24, 2011 (in Japanese).
  23. [23] K. Iwata, C. Shirai, K. Kimura et al., “How were the High-Fever Consultation Center Perceived by the Officers Who Provided it in Kobe City, During Swine-Origin Influenza A (H1N1) Outbreak? A Qualitative Study Utilizing SCQRM,” Kobe J. Med. Sci. Vol.56, E195-203, 2010.
  24. [24] E. Bautista, T. Chotpitayasunondh, Z. Gao et al., “Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection,” N. Engl. J. Med., Vol.362, pp. 1708-1719, 2010.
  25. [25] D. J. Faix, S. S. Sherman, and S. H. Waterman, “Rapid-test sensitivity for novel swine-origin influenza A (H1N1) virus in humans,” N Engl J Med., Vol.361, No.7, pp. 728-729, Aug. 13, 2009.
  26. [26] Y. Sakai-Tagawa, M. Ozawa, D. Tamura, M. Q. Le, C. A. Nidom, N. Sugaya, and Y. Kawaoka, “Sensitivity of influenza rapid diagnostic tests to H5N1 and 2009 pandemic H1N1 viruses. J Clin Microbiol,” Vol.48, No.8, pp. 2872-2877, Aug., 2010.

*This site is desgined based on HTML5 and CSS3 for modern browsers, e.g. Chrome, Firefox, Safari, Edge, Opera.

Last updated on Mar. 05, 2021