Influenza: A Century of Science and Public Health Response

In 1976, the outbreak of a new strain of swine flu at the Fort Dix, New Jersey, army base prompted an unprecedented inoculation campaign. Some forty-two million Americans were vaccinated as the National Influenza Immunisation Program hastened to prevent a pandemic, while the World Health Organisation (WHO) took a wait-and-see approach. Fortunately, the virus did not spread, and only one death occurred. But instead of being lauded, American actions were subsequently denounced as a “fiasco” and instigator of mass panic.

In Influenza, George Dehner examines the wide disparity in national and international responses to influenza pandemics, from the Russian flu of 1889 to the swine flu outbreak in 2009. He chronicles the technological and institutional progress made along the way and shows how these developments can shape an effective future policy.

Early pandemic response relied on methods of quarantine and individual scientific research. In the aftermath of World War II, a consensus for co-operation and shared resources led to the creation of the WHO, under the auspices of the United Nations. Today, the WHO maintains a large and proactive role in responding to influenza outbreaks. International pandemic response, however, is only as strong as its weakest national link—most recently evidenced in the failed early detection of the 2009 swine flu in Mexico and the delayed reporting of the 2002 SARS outbreak in China.

As Dehner’s study contends, the hard lessons of the past highlight the need for a co-ordinated early warning system with full disclosure, shared technologies, and robust manufacturing capabilities. Until the “national” aspect can be removed from the international equation, responses will be hampered, and a threat to an individual remains a threat to all.