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Communicable diseases
Published in Liam J. Donaldson, Paul D. Rutter, Donaldsons' Essential Public Health, 2017
Liam J. Donaldson, Paul D. Rutter
The third influenza pandemic of the twentieth century came a decade later, in 1968–69. It was caused by a H3N2 subtype of the influenza A virus and was called Hong Kong influenza. The first isolation of the new virus in Britain was in August 1968. Throughout the autumn of 1968, and into the winter and spring of 1969, there were more cases and local outbreaks, but there was no large-scale epidemic in Britain in this first year. This was in marked contrast to the situation in the United States that same year, where there was a large epidemic with high attack rates and many deaths. North America was unusual compared with other temperate parts of the world in suffering a high impact from Hong Kong influenza during the winter of 1968–69. It was the following winter of 1969–70 that the virus caused major epidemics in Britain and other European countries. This pattern of spread was very different to the Asian influenza pandemic and illustrates how unpredictably influenza viruses behave.
Recommended hospital preparations for future cases and outbreaks of novel influenza viruses
Published in Expert Review of Respiratory Medicine, 2020
Seasonal influenza, in addition to periodic pandemics, is a major health burden with a significant morbidity and mortality. Epidemics of seasonal influenza occur in all parts of the world every year and an individual may build up some degree of immunity toward certain strains of influenza virus following repeated exposure with increased protection through influenza vaccinations. The background immunity will be lost when a novel influenza virus emerges through an antigenic shift or genetic reassortment leading to a pandemic. There have been 4 influenza pandemics since the 20th century: the Spanish Influenza in 1918–19 (an estimated 20–50 million deaths globally), the Asian Influenza in 1957–58 (1–4 million deaths globally), the Hong Kong Influenza in 1968–69 (1–4 million deaths worldwide) and the 2009 pandemic due to A(H1N1) (100,000–400,000 deaths worldwide). The estimated case fatality rates were 2–3%, <0.2%, <0.2% and 0.02% for the 4 pandemics, respectively [1].