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Book and Media Reviews
January 6, 2010

The Fatal Strain: On the Trail of Avian Flu and the Coming Pandemic

JAMA. 2010;303(1):77-80. doi:10.1001/jama.2009.1949

Despite all of the problems that have arisen while trying to contain and minimize the effects of the 2009 influenza A(H1N1) pandemic, the ease with which it has spread around the globe, the social disruption it has spawned, the difficulties encountered in producing and distributing an effective vaccine in a timely manner and in overcoming widespread doubts about its safety, and the emergence of strains resistant to antiviral therapy, things could have been a whole lot worse. It now appears (as of mid November 2009) that mortality from this particular strain of influenza is less than that of the “regular” seasonal flu. However, considering the 40% to 70% mortality rate among persons unfortunate enough to have been stricken with avian influenza A(H5N1), which first appeared in Southeast Asia in 1997 and which has since become endemic throughout the world's bird population, leads to an appreciation of just how bad a pandemic of a different, more virulent strain of flu could have been.

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