Preparing for the Next #Influenza #Pandemic: The #Development of a #Universal Influenza #Vaccine (J Infect Dis., summary)

[Source: The Journal of Infectious Diseases, full page: (LINK). Summary, edited.]

Preparing for the Next Influenza Pandemic: The Development of a Universal Influenza Vaccine

Michelle C. Crank, John R. Mascola, Barney S. Graham*

Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD

*Correspondence: Barney S. Graham, MD, PhD; 40 Convent Dr. Bethesda, MD, 20892, Phone: 301 594-8468, Fax: 301-480-2771, Email:

Funding Statement: This work was supported by intramural funding from the National Institute of Allergy and Infectious Diseases.

Conflict of Interest Statement: JRM and BSG are listed as inventors on patents related to influenza vaccines including E-094-2014 & E-060-2015 (BSG), E-061-2016 (JRM), and E-066-2014 & E-228-2016 (both).

Keywords: Influenza, Vaccine, Pandemic

Word count: 1723 (including references) / Accepted Manuscript

Published by Oxford University Press for the Infectious Diseases Society of America 2019. This work is written by (a) US Government employee(s) and is in the public domain in the US.




At the centenary of the 1918 influenza pandemic that took upwards of 100 million lives within one year[1], the world remains unprepared to prevent a similar catastrophic event from occurring. In addition, seasonal epidemic influenza continues to cause worldwide morbidity and mortality on a yearly basis, and current vaccines offer suboptimal protective immunity. In this collection of articlesb, we review the scientific opportunities for developing influenza vaccines with broad coverage, commonly referred to as “universal” influenza vaccines, that would better protect us against the global burden of seasonal epidemics and offer the potential to protect us from a 1918-like pandemic event.


Keywords: Influenza A; Pandemic Influenza; Spanish Flu; Vaccines.



Making #Universal #Influenza #Vaccines: #Lessons from the 1918 #Pandemic (J Infect Dis., summary)

[Source: Journal of Infectious Diseases, full page: (LINK). Summary, edited.]

Making Universal Influenza Vaccines: Lessons from the 1918 Pandemic

David M. Morens 1 and Jeffery K. Taubenberger 2

1 Office of the Director, and 2 Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD USA

Contact information: DMM ( and JKT (

Published by Oxford University Press for the Infectious Diseases Society of America 2019. This work iswritten by (a) US Government employee(s) and is in the public domain in the US.



In 1918, the world experienced the deadliest single event in recorded human
history [1, 2], the sudden emergence of an influenza virus of extraordinary
lethality, unprecedented in over a millennium of influenza pandemic observation
(Figure 1). In considering the rationale for, and the desired characteristics of socalled “universal” influenza vaccines, we must, before any other consideration,
look back from the vantage point of 2018 to that century-old tragedy and ask:
what are we trying to prevent, and how do we expect a vaccine to prevent it?


Keywords: Influenza A; Pandemic Influenza; Spanish Flu; Vaccines.


On the #Centenary of the #SpanishFlu: Being Prepared for the Next #Pandemic (Virol Sin., summary)

[Source: Virologica Sinica, full page: (LINK). Summary, edited.]

On the Centenary of the Spanish Flu: Being Prepared for the Next Pandemic

Authors and affiliations: William J. Liu, Yuhai Bi, Dayan Wang, George F. Gao

First Online: 20 December 2018


Influenza is one of the oldest infectious diseases affecting humans. Every influenza pandemic in history has ended with disastrous outcomes regarding public health and the social economy. This year marks the 100th anniversary of the Spanish flu (H1N1) outbreak of 1918, which is recognized as the most lethal natural event in recent history. In spite of limited travel and transportation at that time, the Spanish flu pandemic of 1918 reached peak activity on multiple continents simultaneously within several months after its emergence in late 1917 from different hypothesized origins, such as US military camps, the state of Kansas, or the troop staging and hospital camp in Étaples, France (Patterson and Pyle 1991; Oxford et al. 2005; Shanks 2016). However, in some islands of the Pacific region, such as in New Caledonia, the pandemic’s lethal effects lasted for over 3 years, until July 1921 (Shanks et al. 2018). The pandemic flu is estimated to have infected more than 500 million people,…



We are grateful to Drs. Zijian Feng, Zijun Wang, Zhongjie Li, Luzhao Feng, and Tao Chen for their excellent suggestions on the preparation of the figure in this manuscript. This work was supported by the National Key Research and Development Program of China (grant 2017YFC1200202), the Major Special Projects for Infectious Disease Research of China (grant 2016ZX10004222-003), the National Natural Science Foundation of China (grants 81401312 and 81373141). William J. Liu is supported by the Excellent Young Scientist Program of the NSFC (81822040). George F. Gao is a leading principal investigator of the National Natural Science Foundation of China Innovative Research Group (grant 81621091).

Conflict of interest

The authors declare that they have no conflict of interest.

Animal and Human Rights Statement

This article does not contain any studies with human or animal subjects performed by any of the authors.

Keywords: Pandemic Influenza; Influenza A; H1N1; Spanish Flu.


[#NZ] New Zealand’s #experience of the 1918-19 #influenza #pandemic: a systematic review after 100 years (N Z Med J., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

N Z Med J. 2018 Dec 14;131(1487):54-69.

New Zealand’s experience of the 1918-19 influenza pandemic: a systematic review after 100 years.

Summers JA1, Baker M2, Wilson N2.

Author information: 1 Postdoctoral Research Fellow in Medical Statistics, School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom. 2 Professor of Public Health, Department of Public Health, University of Otago, Wellington.




The 1918-1919 influenza pandemic has been New Zealand’s most severe disaster event (around 9,000 deaths). We aimed to review the literature related to this pandemic in New Zealand and among New Zealanders overseas, to identify any remaining research gaps (given ongoing risks of future influenza pandemics and from new pathogens, eg, synthetic bioweapons).


Systematic literature searches and comparisons with international findings for this pandemic to facilitate identification of research gaps.


A total of 61 relevant publications were identified. The epidemiological patterns reported were largely consistent with the international literature for this pandemic. These features included the w-shaped age-distribution for mortality, and the much higher mortality rates for indigenous people (ie, seven-fold for Māori vs New Zealand European). But some novel risk factors were identified (eg, large chest size as a risk factor for death in military personnel), and there was an extremely high mortality troop ship outbreak (probably related to crowding). In contrast to some international work, there was an apparent lack of a socio-economic gradient in mortality rates in two studies using modern analytical methods. New Zealand work has clearly shown how the pandemic spread via the rail network and internal shipping routes and the rarity of successful measures to prevent spread in contrast to some other jurisdictions. It has also found a marked lack of memorials to the pandemic (in contrast to war memorials). Nevertheless, some research gaps remain, including on the apparent marked reduction in birth rates in 1918-1919 and the reasons for no socio-economic gradient despite other New Zealand evidence for occupational class variation in lifespan at this time.


This is a relatively well-studied disaster event but there remain important research questions relating to this pandemic in New Zealand. Filling these gaps may contribute to improved planning for managing future pandemics.

PMID: 30543612

Keywords: Pandemic Influenza; Spanish Flu; New Zealand.


#Influenza #Cataclysm, 1918 (N Engl J Med., summary)

[Source: The New England Journal of Medicine, full page: (LINK). Summary, edited.]

Influenza Cataclysm, 1918

David M. Morens, M.D., and Jeffery K. Taubenberger, M.D., Ph.D.

December 13, 2018 / N Engl J Med 2018; 379:2285-2287 / DOI: 10.1056/NEJMp1814447


Audio Interview

Interview with Dr. David Morens on lessons from the 1918 influenza pandemic and the threat of a similar global health disaster. 

This year marks the centennial of an influenza pandemic that killed 50 million to 100 million people globally — arguably the single deadliest event in recorded human history. Evidence suggests that another pandemic at least as severe may occur one day.


Disclosure forms provided by the authors are available at

Author Affiliations: From the Office of the Director (D.M.M.) and the Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases (J.K.T.), National Institute of Allergy and Infectious Diseases, Bethesda, MD.

Keywords: Pandemic Influenza; Spanish Flu; H1N1; History.


#Spanishflu in #Italy: new #data, new questions (Infez Med., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Infez Med. 2018 Mar 1;26(1):97-106.

Spanish flu in Italy: new data, new questions.

Fornasin A1, Breschi M2, Manfredini M3.

Author information: 1 Department of Economics and Statistics, University of Udine, Italy. 2 Department of Economics and Business, University of Sassari, Italy. 3 Department of Life Sciences, University of Parma, Italy.



This paper proposes a new estimate for the number of victims of Spanish flu in Italy and highlights some aspects of mortality closely linked to the First World War. The sources used are official death statistics and the Albo d’oro, a roll of honor of the Italians fallen in the First World War. The new estimate of deaths from the flu is 410,000 for 1918, which should be raised to 466,000 when the numbers are taken up to 1920. Deaths from Spanish flu among the military were about 70,000. The time sequence of deaths recognizes two distinct peaks, one in October and one in November 1918. Between these two peaks, the lowest number of deaths falls in the week of the armistice between Italy and Austria-Hungary (signed 4 November 1918). This suggests links between Spanish flu and WWI that cannot be merely explained in terms of movement of people and contagion.

PMID: 29525806[Indexed for MEDLINE] Free full text

Keywords: Pandemic Influenza; Spanish Flu; H1N1; Italy; Society; Wars.


#Natality #Decline and Spatial #Variation in Excess #Death Rates During the 1918-1920 #Influenza #Pandemic in #Arizona, #USA (Am J Epidemiol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Am J Epidemiol. 2018 Dec 1;187(12):2577-2584. doi: 10.1093/aje/kwy146.

Natality Decline and Spatial Variation in Excess Death Rates During the 1918-1920 Influenza Pandemic in Arizona, United States.

Dahal S1, Mizumoto K1,2, Bolin B3, Viboud C, Chowell G1,4.

Author information: 1 Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia. 2 Graduate School of Medicine, Hokkaido University, Hokkaido, Japan. 3 School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona. 4 Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland.



A large body of epidemiologic research has concentrated on the 1918 influenza pandemic, but more work is needed to understand spatial variation in pandemic mortality and its effects on natality. We collected and analyzed 35,151 death records from Arizona for 1915-1921 and 21,334 birth records from Maricopa county for 1915-1925. We estimated the number of excess deaths and births before, during, and after the pandemic period, and we found a significant decline in the number of births occurring 9-11 months after peak pandemic mortality. Moreover, excess mortality rates were highest in northern Arizona counties, where Native Americans were historically concentrated, suggesting a link between ethnic and/or sociodemographic factors and risk of pandemic-related death. The relationship between birth patterns and pandemic mortality risk should be further studied at different spatial scales and in different ethnic groups.

PMID: 30508194 DOI: 10.1093/aje/kwy146

Keywords: Pandemic Influenza; H1N1; Spanish Flu; Society; USA; Arizona.