2009 H1N1 Pandemic: What Went Right and What Went Wrong?

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In this week's PLoS Medicine, Gabriel Leung from the government of the Hong Kong SAR and Angus Nicoll from the European Centre for Disease Prevention and Control offer their reflections on the international response to the 2009 H1N1 influenza pandemic, including what went well and what changes need to be made on the part of global and national authorities in anticipation of future flu pandemics.

As Leung and Nicoll note, "There is general consensus that the only predictable characteristic of influenza viruses and pandemics is their unpredictability." They add, "Indeed many of the initial responses to the 2009 pandemic went well. Once isolated, the pandemic virus strain was shared immediately, specific diagnostic assays were produced and distributed worldwide, antivirals were available in many countries, vaccine development started promptly, and clinical trials demonstrating vaccine safety and immunogenicity were conducted rapidly."

Leung and Nicoll summarize their findings:


- Many of the initial responses to the 2009 H1N1 pandemic went well but there are many lessons to learn for future pandemic planning.

- Clear communication of public health messages is crucial, and should not confuse what could happen (and should be prepared for) with what is most likely to happen.

- Decisions regarding pandemic response during the exigencies of a public health emergency must be judged according to the best evidence available at the time.

- Revising pandemic plansto be more flexible and more detailedshould wait for WHO leadership if national plans are not to diverge. Surveillance beyond influenza should be stepped up, and contingencies drawn up for the emergence or re-emergence of other novel and known pathogens.

- Data collection and sharing are paramount, and include epidemiological and immunological data. Clinical management of severe influenza disease should not be limited to the current antiviral regimen, and include the development of other therapeutics (e.g., novel antivirals and immunotherapy).

- Greater and more timely access to antivirals and influenza vaccines worldwide remains an ongoing challenge.

To access the study, CLICK HERE.

Reference: Leung GM, Nicoll A (2010) Reflections on Pandemic (H1N1) 2009 and the International Response. PLoS Med 7(10): e1000346. doi:10.1371/journal.pmed.1000346