Pandemic Influenza: Potential Contribution to Disease Burden

  • M. Nuño
Reference work entry


Records of disease outbreaks resembling influenza date to the writings of Hippocrates (fifth century BPE). Since then, influenza has afflicted humans around the globe. The most severe (“Spanish Flu”  pandemic) of three major outbreaks of the twentieth century killed approximately 20–50 million people worldwide. More recently, the global spread of highly pathogenic bird-adapted strain H5N1 is considered a significant pandemic threat. Since 2003, a total of 379 cases and 239 deaths have been reported. This chapter provides an overview of the genetic characteristics of the virus that elucidate its ability to continuously evade a host’s immune system; it describes some of the approaches used to quantify the burden of influenza and discusses their implications for the prevention and containment of future pandemics. The preliminary findings of the studies discussed here suggest that influenza-related burden is highly underestimated in tropical and subtropical regions of the world. This implicates that proper assessment of influenza-related morbidity and mortality worldwide is essential in planning and allocating resources to protect against what could be one of mankind’s most devastating challenges. A summary of learned lessons from past influenza pandemics are described and new intervention strategies aim at curtailing a future pandemic are discussed. More importantly, however, is the discussion of today’s challenges such as antiviral resistance, limited resources in a world that is globally connected and the imminent gap between the capacity (resources available) of developed and developing parts of the world to respond to a pandemic.


Influenza Virus Excess Mortality Basic Reproduction Number Pandemic Period Pandemic Outbreak 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:


Center for Disease Control and Prevention


Currency Code for France and Germany





H1N1, H2N2, H3N2, H5N1

Influenza A Virus Subtypes






Influenza B Virus Glycoprotein


Non-Pharmaceutical Interventions


Proapoptotic Influenza A Virus Protein


Pharmaceutical Interventions


Pneumonia & Influenza


Basic Reproduction Number

S-I-R Model

Susceptible-Infected-Recovered Model



Miriam Nuño was supported under the National Institutes of Health grant AI28697 (UCLA). The author is thankful to Thomas A. Reichert and James M. Bugni and for their helpful comments and suggestions.


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  • M. Nuño

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