The article "Pandemic influenza in Korea with special references to its etiology," published in JAMA in April, 1919 by Dr. Frank William Schofield, is a valuable material reflecting the influenza pandemic situation in 1918 in Korea. It contains the case reports of influenza infected patients and the results of the bacteriological experiments. Dr. Schofield worked as a bacteriology professor in Severance Union Medical College in Seoul from 1916 to 1920. His academic activities are lesser-known than the role of contributor of Korean independent movement. However, he was a remarkable veterinarian and scientist. According to Dr. Schofield, the number of Influenza infected population in Korea in 1918 was supposed to be 4,000,000 to 8,000,000, which corresponds with other resources(6.7 per 1,000 in Gangwon province). Considering the cases which were not registered as influenza infection by misdiagnosis of pneumonia complication the sum should be higher. However, the estimated crude influenza death rate from the reports by the Japanese colonial government was only 2.38(per 1,000). Dr. Schofield and his colleague tried to culture "Pfeiffer Bacillus" from the sputum and blood specimens of patients showing typical influenza symptoms. The bacterium was mistakenly considered as the influenza agent till the virological nature of influenza was discovered in the 1930s. From the results of his study he seemed to agree that "filterable virus" was the influenza agent and the secondary infection of the bacillus caused respiratory symptoms. He also reported on the influenza vaccination during the epidemics. Dr. Schofield's article confirms that the damage caused by the influenza outbreak in Korea was as great as in other Asian countries or even worse. It also gives information about the researches and education on the etiology and vaccination of influenza based on the germ theory in the medical colleges in Korea, which adopted the western medical educational system in the early 20th century.
Disease Outbreaks/*history ; History, 20th Century ; Humans ; Influenza Vaccines/history ; Influenza, Human/epidemiology/*history/mortality ; Korea/epidemiology ; Vaccination/history

Five influenza pandemics had occurred during the past century (1918 "Spanish flu" , 1957 "Asian flu" , 1968 "Hong Kong flu" , 1977 "Russian flu" and 2009 H1N1 Pandemic), accounting for hundreds of millions of people infected and tens of millions dead. China was influenced by all the five pandemics, and three of them (1957 "Asian flu" , 1968 "Hong Kong flu" and 1977 "Russian flu" ) were originated from China. The pandemics triggered the establishment of public health agencies and influenza surveillance capacities. In addition, more resources were allocated to influenza-related research, prevention and control. As a leader in the field of influenza, China should further strengthen its pandemic preparedness and response to contribute to global health.
Asian People ; China/epidemiology* ; Disease Outbreaks/history* ; History, 20th Century ; History, 21st Century ; Hong Kong ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human/history* ; Pandemics/history* ; Public Health

Pandemic influenza has posed an increasing threat to public health worldwide in the last decade. In the 20th century, three human pandemic influenza outbreaks occurred in 1918, 1957 and 1968, causing significant mortality. A number of hypotheses have been proposed for the emergence and development of pandemic viruses, including direct introduction into humans from an avian origin and reassortment between avian and previously circulating human viruses, either directly in humans or via an intermediate mammalian host. However, the evolutionary history of the pandemic viruses has been controversial, largely due to the lack of background genetic information and rigorous phylogenetic analyses. The pandemic that emerged in early April 2009 in North America provides a unique opportunity to investigate its emergence and development both in human and animal aspects. Recent genetic analyses of data accumulated through long-term influenza surveillance provided insights into the emergence of this novel pandemic virus. In this review, we summarise the recent literature that describes the evolutionary pathway of the pandemic viruses. We also discuss the implications of these findings on the early detection and control of future pandemics.
Animals ; Birds ; virology ; Communicable Diseases, Emerging ; epidemiology ; history ; virology ; Evolution, Molecular ; History, 20th Century ; History, 21st Century ; Humans ; Influenza A Virus, H1N1 Subtype ; genetics ; Influenza A Virus, H3N2 Subtype ; genetics ; Influenza in Birds ; epidemiology ; history ; virology ; Influenza, Human ; epidemiology ; history ; virology ; Pandemics ; history

INTRODUCTIONSingapore was substantially affected by three 20th Century pandemics. This study describes the course of the pandemics, and the preventive measures adopted.

MATERIALS AND METHODSWe reviewed and researched a wide range of material including peer-reviewed journal articles, Ministry of Health reports, Straits Settlements reports and newspaper articles. Monthly mortality data were obtained from various official sources in Singapore.

RESULTSThe 1918 epidemic in Singapore occurred in 2 waves--June to July, and October to November--resulting in up to 3500 deaths. The 1957 epidemic occurred in May, and resulted in widespread morbidity, with 77,000 outpatient attendances in government clinics alone. The 1968 epidemic occurred in August and lasted a few weeks, with outpatient attendances increasing by more than 65%. The preventive measures instituted by the Singapore government during the pandemics included the closure of schools, promulgation of public health messages, setting up of influenza treatment centres, and screening at ports. Students, businessmen and healthcare workers were all severely affected by the pandemics.

CONCLUSIONSTropical cities should be prepared in case of a future pandemic. Some of the preventive measures used in previous pandemics may be applicable during the next pandemic.

Disease Outbreaks ; history ; statistics & numerical data ; History, 20th Century ; Humans ; Influenza, Human ; epidemiology ; history ; mortality ; Public Health ; history ; Singapore ; epidemiology

Global Health ; History, 20th Century ; Humans ; Influenza A Virus, H2N2 Subtype ; genetics ; isolation & purification ; Influenza, Human ; epidemiology ; history ; transmission ; virology

Global Health ; History, 20th Century ; Humans ; Influenza A Virus, H1N1 Subtype ; genetics ; isolation & purification ; Influenza A Virus, H3N2 Subtype ; genetics ; isolation & purification ; Influenza, Human ; epidemiology ; history ; therapy ; virology ; Russia ; epidemiology

Global Health ; History, 20th Century ; Humans ; Influenza A Virus, H2N2 Subtype ; genetics ; isolation & purification ; Influenza A Virus, H3N2 Subtype ; genetics ; isolation & purification ; Influenza, Human ; epidemiology ; history ; mortality ; virology

Animals ; History, 20th Century ; History, 21st Century ; Humans ; Influenza A Virus, H1N1 Subtype ; genetics ; isolation & purification ; Influenza, Human ; epidemiology ; history ; virology ; Swine ; virology

Fears of a potential pandemic due to A(H5N1) viruses have focussed new attention on our current vaccines, their shortcomings, and concerns regarding global vaccine supply in a pandemic. The bulk of current vaccines are inactivated split virus vaccines produced from egg-grown virus and have only modest improvements compared with those first introduced over 60 years ago. Splitting, which was introduced some years ago to reduce reactogenicity, also reduces the immunogenicity of vaccines in immunologically naïve recipients. The A(H5N1) viruses have been found poorly immunogenic and present other challenges for vaccine producers which further exacerbate an already limited global production capacity. There have been some recent improvements in vaccine production methods and improvements to immunogenicity by the development of new adjuvants, however, these still fall short of providing timely supplies of vaccine for all in the face of a pandemic. New approaches to influenza vaccines which might fulfil the demands of a pandemic situation are under evaluation, however, these remain some distance from clinical reality and face significant regulatory hurdles.
Animals ; Birds ; Disease Outbreaks ; prevention & control ; statistics & numerical data ; Global Health ; History, 20th Century ; History, 21st Century ; Humans ; Influenza A Virus, H5N1 Subtype ; isolation & purification ; Influenza Vaccines ; history ; Influenza in Birds ; epidemiology ; prevention & control ; Influenza, Human ; epidemiology ; prevention & control ; World Health Organization

Avian influenza viruses (AIV) have been isolated from a wide range of domestic and wild birds. Wild birds, predominantly ducks, geese and gulls form the reservoir of AIV in nature. The viruses in wild bird populations are a potential source of widespread infections in poultry. Active surveillance for AIV infection provides information regarding AIV distribution, and global AIV surveillance can play a key role in the early recognition of highly pathogenic avian influenza (HPAI). Since 2003 in Korea, there have been four H5N1 HPAI outbreaks caused by clade 2.5, 2.2 and 2.3.2. Therefore, improvement of AIV surveillance strategy is required to detect HPAI viruses effectively. This article deals with the major events establishing the role of wild birds in the natural history of influenza in Korea. We highlighted the need for continuous surveillance in wild birds and characterization of these viruses to understand AIV epidemiology and host ecology in Korea.
Animals ; Birds* ; Charadriiformes ; Disease Outbreaks ; Ducks ; Ecology ; Epidemiology ; Geese ; Influenza in Birds* ; Influenza, Human ; Korea* ; Natural History ; Poultry ; Viruses*