Influenza: the next pandemic?: a review

Objectives: To examine existing information on the recent influenza outbreaks in order to create awareness of a possible influenza pandemic and to suggest future research areas in developing control strategies in Kenya.Data sources: Review of literature via Internet, articles, journals and un-refereed features from the media and personal communications. Data selection: Most published data from 1979 to March 2005 found to reveal cases of influenza outbreaks were included in the review. Also, selected articles on the recent outbreaks and professional guidance on influenza infections were critically examined and analyzed.Data extraction: Abstracts and articles identified were accessed, read to establish relevance to this review.Data synthesis: Important points were prioritised and then included as subtitles; below each subtitle, published works were included. Finally, a table of influenza outbreaks and the strains of the viruses involved were drawn as summary.Conclusion: Influenza is a highly contagious, acute respiratory disease that may spread rapidly and pervasively through a population. Due to the diversity of susceptible reservoirs of influenza viruses and the interspecies transmission recently reported, a mutated strain of the virus to which people have no immunity could cause an influenza pandemic once the virus gains efficient and sustained human-to-human transmission. The fear that avian influenza could be a precursor to the next pandemic is real and inevitable, given the extremely high case-fatality ratio among confirmed cases and that genetic sequencing of influenza A (H5N1) viruses from human cases in Thailand and Vietnam show resistance to the antiviral medication amantadine and rimantadine. This calls for a high level of preparedness to avoid a public health emergency. Nowhere is this paradigm more real than in Africa. East African Medical Journal Vol. 82(9) 2005: 477-48