If humanity is lucky, the next flu virus with pandemic potential will unfold somewhere quick to catch and contain the threat—a country with a strong public health service and well-stocked hospitals.
If we’re unlucky, a novel, lethal and highly infectious flu virus will break out in a crowded, unprepared megacity that lacks public health infrastructure. A fast-moving virus could burst from a city and catch a ride with international travelers before public health officials realize what is happening.
Specifically, avian influenza viruses like H7N9 top pandemic threat lists, including the CDC’s Influenza Risk Assessment Tool. While strains are mostly low-pathogenic in chickens, they could potentially evolve into much deadlier strains.
…influenza viruses excel at the element of surprise. Few would have guessed Mexico as the origin of that 2009 H1N1 pandemic, for example, notes [doctor Keiji] Fukuda. That outbreak was recognized in San Diego—never considered a hotspot—when a little girl happened to seek treatment at a clinic participating in a study focused on diagnosis, [influenza expert Amesh] Adalja explains. That’s why he believes it is important to build up the diagnostic capacity for frontline clinicians, and not be satisfied with non-specific diagnoses—failing to pin down the specific microbial cause. With respiratory viruses, there will be mild cases—like the first index H1N1 case—and more rigorous attention to diagnostics improves the chances of identifying a dangerous strain early.
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