"The potential for emergence of future pandemic viruses containing such pathogenic HAs is unknown. However, for the purposes of pandemic planning, we must now consider the emergence of pandemics with extreme pathogenicity and high fatality, a concern underscored by the apparent variability in pandemic influenza severity recorded over a period of more than 500 years. As we ponder the possibility of future influenza pandemics caused by viruses with other pathogenic HAs, we must also remember that the pathogenicity of the 1918 pandemic virus seems to have been inherent to an H1 HA subtype that remains in nature today. Thus, if current global population immunity to H1 viruses wanes, another H1 pandemic could arise with the same deadly consequences as those experienced in 1918. All such pathogenic HAs existing in nature therefore represent a fundamental threat and an important target for pre-pandemic vaccine development."
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Influenza
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