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Introduction

Figure 1 Negative-stain electron micrograph of influenza A virus. source: Courtesy of Drs Takeshi Noda and Yoshihiro Kawaoka.

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  • Figure 1 presents an electron micrograph of the influenza A virus.
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Figure 2 Emergency hospital during the Spanish flu pandemic in 1918, Camp Funston, Kansas, USA. source: Courtesy of the National Museum of Health and Medicine, Armed Forces Institute of Pathology, Washington, DC, USA (NCP1603).

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  • Since everyone will be immunologically naive to that new virus subtype, the infection may spread rapidly and cause high morbidity and mortality among the entire population, including young healthy people.3,14 Three major influenza pandemics struck the globe in the 20th century.3,4 The Spanish flu (caused by an H1N1 influenza A virus) occurred in 1918–19, after the First World War, and resulted in the death of an estimated 50 million people,14 more than the death toll of the war itself (Figure 2).
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Figure 3 Influenza vaccination in the 1950s. source: Photograph courtesy of Solvay Pharmaceuticals, Weesp, the Netherlands.

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  • Inactivated influenza vaccines have been in use for the past 60 years (Figure 3).
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Figure 4 Culling of chickens during the 1997 outbreak of H5N1 avian flu in Hong Kong. source: Copyright © Reuters/CORBIS.

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  • While the mass culling of poultry in Hong Kong in 1997 (Figure 4) may have averted a pandemic, in the meantime not only has the H5N1 virus reappeared, but it has now spread throughout many countries in Asia and parts of Europe, Africa and the Middle East, probably carried by infected migratory water fowl.
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