New England Journal of Medicine
Volume 360 — June 18, 2009 — Number 25
The Signature Features of Influenza Pandemics — Implications for Policy
M. A. Miller, C. Viboud, M. Balinska, and L. Simonsen
[Initial text per NEJM convention]
Vast amounts of time and resources are being invested in planning for the next influenza pandemic, and one may indeed have already begun. Data from past pandemics can provide useful insights for current and future planning. Having conducted archeo-epidemiologic research, we can clarify certain “signature features” of three previous influenza pandemics — A/H1N1 from 1918 through 1919, A/H2N2 from 1957 through 1963, and A/H3N2 from 1968 through 1970 — that should inform both national plans for pandemic preparedness and required international collaborations.
Past pandemics were characterized by a shift in the virus subtype, shifts of the highest death rates to…