Are We Ready for the Next Flu Pandemic?

As flu activity continues to ramp up around the United States, public health leaders met at a recent event to discuss the lack of preparedness for the next flu pandemic.

In the Centers for Disease Control and Prevention’s (CDC) weekly FluView report for the week ending November 4, 2017, regional flu activity was up from the previous week and reported in six states—Georgia, Louisiana, Massachusetts, Oklahoma, South Carolina, and Texas—and Guam; 13 states reported local activity.

In South Carolina, the Department of Health and Environmental Control (DHEC) confirmed the state’s first flu death of the season on November 14, 2017. "Sadly, an individual from the Upstate region has become our first lab-confirmed, influenza-associated death of the season," said the DHEC’s Teresa Foo MD, MPH, in a recent press release. Dr. Foo notes that those who are at high risk of flu complications include young children, pregnant women, people 65 years and older and those with chronic health conditions such as asthma, diabetes or heart or lung disease. "Unfortunately, we see many deaths, hospitalizations, and other serious complications of flu each year in South Carolina,” she said. In fact, last season, South Carolina saw 2,455 laboratory-confirmed flu cases and 94 flu-related deaths.

In North Carolina, the Department of Health and Human services reported its third flu death of the season, following its announcement on November 2, 2017, of North Carolina’s first two flu deaths of the 2017-2018 season. All three cases involved residents who were 65 or older, though officials released no additional information about the victims to protect their privacy.

So far, this season, the CDC has reported that the majority of flu samples collected are well-matched to the components of the 2017-18 Northern Hemisphere trivalent vaccine. On November 13, 2017, a panel of thought leaders gathered at an event called The Next Pandemic, organized by Johns Hopkins School of Public Health and the Smithsonian National Museum of Natural History, to discuss the potential for the next flu pandemic and whether or not the world is ready for it. The event took place nearly a century after the flu pandemic of 1918, which infected about one-third of the world’s population at the time, and caused as many as 100 million deaths worldwide. According to John Barry, author of “The Great Influenza: The Story of the Deadliest Pandemic in History,” who spoke at the event, such a pandemic today would kill as many as 400 million individuals. He, along with other speakers at the event, argued that if a similar pandemic were to hit right now, we wouldn’t be ready.

Anthony Fauci, MD, director of the National Institutes of Allergy and Infectious Diseases, was one of the speakers at the event and discussed preparing for pandemic influenza in the future. “When you look at influenza, the preparation for seasonal influenza essentially should be the preparation for pandemic influenza in a perfect world,” said Dr. Fauci, emphasizing the need for the development of a universal influenza vaccine. He noted his concern regarding current capabilities against any strain of influenza, as current seasonal influenza vaccines are not consistently effective. Since 2004, the flu vaccine has only been 10% to 60% effective each season.

“Pandemics do occur,” and we need to do more than just respond to them once they’ve begun, said Dr. Fauci, highlighting the 2009 H1N1 “swine flu” pandemic. “We were expecting that the next pandemic would come out of China or the Far East, when, in fact, it did not. It came right in our Western Hemisphere somewhere around California and Mexico.” Despite the fact that flu surveillance efforts detected the new emerging influenza that year, the virus showed an early peak in September, while vaccine doses to prevent the virus were not ready until October. “Even though we have some warning about a pandemic, even then, with our current capabilities, it doesn’t work well.”

Other speakers and panelists at the event discussed the latest flu research and ways that public health officials, researchers, and vaccine makers are working to improve pandemic preparedness.