National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Crit Care Med. 2010 Apr;38(4 Suppl):e10-20. doi: 10.1097/CCM.0b013e3181ceb25b.
The 1918 to 1919 H1N1 influenza pandemic is among the most deadly events in recorded human history, having killed an estimated 50 to 100 million persons. Recent H5N1 avian influenza epizootics associated with sporadic human fatalities have heightened concern that a new influenza pandemic, one at least as lethal as that of 1918, could be developing. In early 2009, a novel pandemic H1N1 influenza virus appeared, but it has not exhibited unusually high pathogenicity. Nevertheless, because this virus spreads globally, some scientists predict that mutations will increase its lethality. Therefore, to accurately predict, plan, and respond to current and future influenza pandemics, we must first better-understand the events and experiences of 1918. Although the entire genome of the 1918 influenza virus has been sequenced, many questions about the pandemic it caused remain unanswered. In this review, we discuss the origin of the 1918 pandemic influenza virus, the pandemic's unusual epidemiologic features and the causes and demographic patterns of fatality, and how this information should impact our response to the current 2009 H1N1 pandemic and future pandemics. After 92 yrs of research, fundamental questions about influenza pandemics remain unanswered. Thus, we must remain vigilant and use the knowledge we have gained from 1918 and other influenza pandemics to direct targeted research and pandemic influenza preparedness planning, emphasizing prevention, containment, and treatment.
1918 至 1919 年的 H1N1 流感大流行是有记录以来人类历史上最致命的事件之一，估计造成 5000 万至 1 亿人死亡。最近与零星人类死亡相关的 H5N1 禽流感暴发事件使人更加担心，一种新的流感大流行，其致命性至少与 1918 年的流感大流行一样，可能正在发展之中。2009 年初，一种新型大流行 H1N1 流感病毒出现，但它并没有表现出异常高的致病性。尽管如此，由于这种病毒在全球范围内传播，一些科学家预测其突变会增加其致命性。因此，为了准确预测、规划和应对当前和未来的流感大流行，我们必须首先更好地了解 1918 年的事件和经验。虽然已经对 1918 年流感病毒的整个基因组进行了测序，但关于它引起的大流行仍有许多问题没有答案。在这篇综述中，我们讨论了 1918 年大流行流感病毒的起源、大流行的异常流行病学特征以及死亡的原因和人口统计学模式，以及这些信息应该如何影响我们对当前 2009 年 H1N1 大流行和未来大流行的应对。经过 92 年的研究，流感大流行的基本问题仍未得到解答。因此，我们必须保持警惕，利用从 1918 年和其他流感大流行中获得的知识，指导有针对性的研究和流感大流行防范规划，强调预防、遏制和治疗。
