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Book and Media Reviews
May 23/30, 2007

Influenza and Its Global Public Health Significance

Author Affiliations

Book and Media Reviews Section Editor: John L. Zeller, MD, PhD, Fishbein Fellow.

JAMA. 2007;297(20):2287-2291. doi:10.1001/jama.297.20.2289

Influenza and Its Global Public Health Significance is a primer on influenza. The monograph contains 13 chapters contributed by 9 authors; the chapters vary considerably in quality, timeliness, and completeness. The first chapter provides adequate references for the history of influenza and influenza pandemics. Chapter 2 is a reasonable summary of the classification and structure of influenza viruses but notes only 15 hemagglutinin subtypes—an error corrected in the chapter on avian influenza that correctly recognizes 16 subtypes. Most lacking is a thorough description of the epidemiology of influenza in human populations and the burden of disease for both seasonal and pandemic influenza. The global perspective promised by the monograph title is not evident. The 2 distinct lineages of influenza B currently circulating in the world are not mentioned. The mode of spread of influenza among human populations is barely described and limits airborne spread to susceptible persons within “3 feet” of the infectious person. Observations of closed populations have demonstrated that the risk may extend well beyond this arbitrary distance. The table on page 25 does not list those “at higher risk for contracting influenza,” but those who, if infected, are more likely to have complications. The chapter on influenza C has no reference more recent than 1976; it places heavy emphasis on the problems of isolation and identification of the virus but does not describe or even propose the use of new technologies.

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