John Oxford is the Scientific Director of Retroscreen Virology Ltd and Professor of Virology at St Bartholomew's and the Royal London Hospital, Queen Mary's School of Medicine. As a virologist, he has spent the majority of his working life looking at flu and trying to better understand how it adapts, mutates and affects people. Here he explains how looking at past pandemics helps us to understand what might happen in the future.
Prof John Oxford has been researching previous flu pandemics
The worldwide influenza pandemic in 1918-1919 was a singular event in the history of the world - the largest outbreak of any infectious disease before or since.
The social and medical consequences far exceeded those of the Black Death or the recent, expanding epidemics of HIV. Particularly devastating was the high death rate in young people. In fact the elderly were completely spared.
Our most recent studies focus on the genetic nature of viruses before 1918, from lung samples in our pathology collection from 1908-1915. Working with J Taubenberger in the USA we are starting an analysis of a 1915 virus.
The nature of this preceding pandemic from 1889 to 1918 could explain why the older people were so immune in 1918.
We also want to highlight how quickly pandemic influenza virus can spread. Our studies on the origin of the 1918 virus, in the army camps of North East France, pinpoint early outbreaks in 1917 involving just hundreds of soldiers but with a startling mortality of 40-50%, similar to H5N1 in SE Asia today.
Will the 50 deaths in 2003-2005 turn into 50 million in the next year as they did between 1917 and 1918?
The conundrum can be framed another way: If we prepare ourselves with the new scientific discoveries of antivirals and vaccines of the last decade, then communities throughout the world could, for the first time in history, build a dyke to break the effects of the multiple waves of the first pandemic of the 21st century.