Affiliations: National Centre for Immunisation Research and
Surveillance (NCIRS), The Children's Hospital at Westmead and The University of
Sydney, Westmead, NSW, Australia | The Sydney Institute for Emerging Infections and
Biosecurity (SEIB), Sydney Medical School, The University of Sydney, Sydney,
NSW, Australia
Note: [] Correspondence: Dr. Gulam Khandaker, National Centre for
Immunisation Research and Surveillance, The Children's Hospital at Westmead,
Cnr Hawkesbury Rd and Hainsworth St, Locked Bag 4001, Westmead, NSW 2145,
Australia. Tel.: +612 9845 0000; Fax: +612 9845 1418; E-mail:
[email protected]
Abstract: The WHO declared the first pandemic of the 21st century in June 2009
[influenza A(H1N1)pdm09]. The exact burden of the pandemic is still unknown and
data continues to emerge on the direct and indirect costs associated with this
pandemic. In this review we explore why the 2009 pandemic was so mild, what we
might have done better to control and manage it then suggest some lessons for
the future. Compared to previous influenza pandemics, the 2009 pandemic would
be considered mild. It raises questions as to whether the pandemic virus was
less virulent compared with previous pandemics and/or whether advances in
modern medicine helped to keep the mortality low. This is the first pandemic
that has been tackled with the combination of antivirals, antibiotics, vaccines
for both the virus and bacterial super-infections as well as advanced
intensive-care management. The pandemic influenza virus showed some remarkable
antigenic and genetic similarities with the 1918 pandemic H1N1 virus. Related
to this, it spared the elderly who are usually at much higher risk of influenza
morbidity and mortality during seasonal epidemics and pandemics.
