Abstract

An estimated 50 million people died during the 1918-1919 influenza pandemic, and approximately one-third of the world’s population was infected.¹ Although at the time the responsible organism had not yet been identified, influenza pandemics were not a new occurrence; they had simply not infected and killed with such efficiency and had not been as well documented.

Medical science has advanced considerably over the past 100 years. Yet despite the discovery and manufacture of powerful antibacterial and antiviral medications, influenza remains a significant cause of morbidity and mortality. Each year, over 30,000 deaths result from influenza in the United States — a rate that has risen over the past 2 decades, partly owing to the aging population.² The ability to contain regional outbreaks of the disease, and thereby slow the progression of an emerging pandemic, is essentially lost in an era in which an infected person can relocate to any place on the planet within 24 hours. For this reason, today’s emergency clinician must be keenly aware of emerging global infections. The approach to containing a potential epidemic relies on rapid identification, treatment, and in some cases prophylaxis. The ED plays a key role in monitoring and in early recognition of disease outbreaks.

This issue of Emergency Medicine Practice presents a critical appraisal of the most current literature on influenza. Recent studies on clinical presentation, diagnosis, and treatment are reviewed, providing recommendations for the evaluation and management of patients suspected of having influenza. Special attention is focused on the novel H1N1 influenza pandemic of 2009.

Keywords: emergency department, epidemic, pandemic, swine influenza, and novel H1N1

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