Influenza Re visited…..
"Today, nearly a century after the 1918 influenza pandemic, its mysteries remain largely unexplained…….."a large amount work remains to be done, by scientists as well as by historians and other scholars, with regard to the many unanswered questions surrounding this historic pandemic. These studies must be part of our preparedness efforts as we face the scene of a outlook influenza pandemic."
Although science may yet offer little in the way of pandemic prediction, understanding the size of the influenza trouble and the mechanisms by which influenza viruses cause severe and mortal disease, i.e., pathogenesis, is still important... Although influenza is a foremost cause of death worldwide, measuring the whole effect of deaths from influenza is impossible, in part because diagnostic records for a key risk group, the elderly, are incomplete and inexact.
Influenza also kills by different mechanisms such as primary viral pneumonia, secondary bacterial pneumonia in virus-damaged lungs, and an acute respiratory distress like syndrome possibly associated with overly brisk immune responses, as well as by cardiac and other pathways
The problems of understanding influenza rate and pathogenesis are consequently complicated by the many different pathways that lead to severe disease and death and by the difficulty in determining the frequency with which these events occur.