World renowned virologist Professor Albert Osterhaus told participants at Europe's largest conference on infectious diseases that the outbreak of influenza A H1N1 is without question the most important event of the past 40 years in human influenza. And he stressed that the current H1N1 threat is a serious one.

Osterhaus, who is Head of Virology at the Erasmus Medical Centre in Rotterdam and led efforts to identify human infection with the avian influenza strain (H5N1) in 1997, outlined the three cornerstones of medical preparedness in the face of swine-origin flu: good surveillance and diagnostics; effective treatment/antiviral therapy; and vaccination, the foundation of prevention. But he also cautioned that we must be prepared to expect the unexpected as the course of this influenza virus unravels.

Osterhaus was speaking at a late-breaker session jointly organized by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and The Lancet, which was added to the programme of the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) taking place in Helsinki.

Addressing the issue of an A H1N1 vaccination, Osterhaus stressed that there was room for improvement in the production of all influenza vaccines. "We have to do better", he told representatives from the scientific, medical and pharmaceutical industry. "We must improve the influenza vaccine production systems and capacity, regardless of whether we develop an A H1N1 vaccine. Currently we have capacity to produce doses that could protect in the event of a pandemic an estimated 1 billion people - yet with a global population of some 6.7 billion, clearly there is not enough for all." Osterhaus also stressed the need to improve the seasonal flu vaccine production capacity.

Focusing on the outbreak from a clinician's perspective, Professor Javier Garau, the new President of ESCMID and Head of Medicine at the Hospital Universitari Mutua de Terrassa in Barcelona, highlighted priorities in the treatment of swine-origin flu. "We know from experience that secondary infections - which in the case of influenza include pneumonia - can be deadly, which means that adequate stockpiles of antibiotics, as well as antivirals and vaccines, must be included as part of our response".

The Editor of The Lancet Infectious Diseases, John McConnell, said, "We must not underestimate this virus. As Professor Osterhaus reminded us, this outbreak is unlikely to disappear spontaneously so we must be vigilant in monitoring the spread of the virus. "

Video highlights from the session will be available from Wednesday 20 May at The Lancet's H1N1 Flu resource Centre at TheLancet/H1N1-flu and www.escmid/

The Lancet

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