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Volume 5, Number 2—April 1999


The Next Influenza Pandemic: Lessons from Hong Kong, 1997

René Snacken*Comments to Author , Alan P. Kendal†, Lars R. Haaheim‡, and John M. Wood
Author affiliations: *Scientific Institute of Public Health Louis Pasteur, Brussels, Belgium;; †The Rollins School of Public Health, Emory University, Atlanta, Georgia, USA;; ‡University of Bergen, Bergen, Norway; §National Institute for Biological Standards and Control, Potters Bar, United Kingdom

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Influenza landmarks in humans this century

Year Colloquial Name (Subtype) Source Impact
1918 (1) Spanish flu (H1N1 viruses like swine flu) Possible emergence from swine or an avian host of a mutated H1N1 virus Pandemic with >20 million deaths globally
1957 (2) Asian flu (H2N2) Possible mixed infection of an animal with human H1N1and avian H2N2 virus strains in Asia Pandemic, H1N1virus disappeared
1968 (2) Hong Kong flu (H3N2) High probability of mixed infection of an animal with human H2N2 and avian H3Nx virus strains in Asia Pandemic, H2N2 virus disappeared
1977 (3) Russian flu (H1N1) Source unknown but virus is almost identical to human epidemic strains from 1950. Reappearance detected at almost the same time in China and Siberia Benign pandemic, primarily involving persons born after the 1950s. H1N1 virus has cocirculated with H3N2 virus in humans since 1977
Incidents with limited spread
1976 (4) Swine flu (H1N1) United States/New Jersey. Virus enzootic in U.S. swine herds since at least 1930 Localized outbreak in military training camp, with one death
1986 (5) (H1N1) The Netherlands. Swine virus derived from avian source One adult with severe pneumonia
1988 (6) Swine flu (H1N1) United States/Wisconsin. Swine virus Pregnant woman died after exposure to sick pig
1993 (7) (H3N2) The Netherlands. Swine reassortant between old human H3N2 (1973/75-like) and avian H1N1 Two children with mild disease. Fathers suspected to have transmitted the virus to the children after having been infected by pigs.
1995 (8) (H7N7) United Kingdom Duck virus One adult with conjunctivitis
1997 (9) Chicken flu (H5N1) Hong Kong Poultry virus 18 confirmed human case, 6 deaths

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