Top 10 General Medical Stories in 2005

Medscape Editorial staff

January 12, 2006

In This Article

1. The 1918 Spanish Flu Pandemic Redux?

During the 1918 pandemic, worldwide, 21-50 million people died of the Spanish flu, with approximately 678,000 of them in the United States, including 43,000 US soldiers. Fortunately, pathogenic blocks from some of those who died were conserved by the Armed Forces Institute of Pathology (AFIP). Using these old lung tissue samples, the complete sequence of the hemagglutinin gene has now been identified and suggests an avian origin of that virus.[1,2]

Pandemics occur when a pathogen rapidly changes (antigenic shift) or continuously evolves (antigenic drift) and develops the ability to: (1) cause human infections; (2) result in severe disease; and (3) spread by sustained human-to-human transmission. The avian influenza A H5N1 virus has already achieved the first 2 characteristics: Although, the threat of another pandemic is of great concern, the experience gained from the SARS outbreak can hopefully serve as a template for a global collaborative medical response.[2] The US Food and Drug Administration (FDA) has also formed a rapid-response team to facilitate safe and rapid manufacture, testing, and approval of Tamiflu and of other antiviral drugs and vaccines.[3,4]


  1. 1918 Flu Deaths Give Insight to Avian Virus

  2. Epidemics -- SARS, H5N1, and Beyond (Conference Coverage)

  3. FDA Rapid Response Team to Combat Avian Flu: A Newsmaker Interview

  4. Response Plans Prepare for Avian Influenza Outbreak: Progress Made on Vaccine for Flu Strain


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