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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This project was supported by the U.S. Department of Health and Human Services’ National Institutes of Health (Contract No. N01-OD-4-2139, TO#129), Centers for Disease Control and Prevention (200-2000-00629, TO#25), and Food and Drug Administration; U.S. Agency for International Development; U.S. Department of Defense (Contract No. DAMD-17-03-P-1331), U.S. Department of State; U.S. Department of Veterans Affairs (V101(93)P-2159); U.S. Department of Agriculture; American Society for Microbiology; Aventis Pasteur; Burroughs Wellcome Fund; Pfizer; GlaxoSmithKline; and The Merck Company Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

This report is based on the proceedings of a workshop that was sponsored by the Forum on Microbial Threats. It is prepared in the form of a workshop summary by and in the name of the editors, with the assistance of staff and consultants, as an individually authored document. Sections of the workshop summary not specifically attributed to an individual reflect the views of the editors and not those of the Forum on Microbial Threats. The content of those sections is based on the presentations and the discussions that took place during the workshop.

Library of Congress Cataloging-in-Publication Data

The threat of pandemic influenza : are we ready? : workshop summary / prepared for Forum on Microbial Threats, Board on Global Health ; Stacey L. Knobler … [et al.], editors.

p. ; cm.

Includes bibliographical references.

ISBN 0-309-09504-2 (pbk.) — ISBN 0-309-54685-0 (pdf)

1. Influenza—Epidemiology. 2. Influenza—Government policy—United States.

[DNLM: 1. Influenza—prevention & control. 2. Communicable Disease Control—organization & administration. 3. Disease Outbreaks—prevention & control. 4. Influenza Vaccines. 5. Influenza, Avian—prevention & control. ] I. Knobler, Stacey. II. Institute of Medicine (U.S.). Forum on Microbial Threats.

RA644.I6T48 2005

614.5′18—dc22

2005000369

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Copyright 2005 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America.

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

COVER: A detailed section of a stained glass window 21 × 56″ depicting the natural history of influenza viruses and zoonotic exchange in the emergence of new strains was used to design the front cover. Based on the work done at St. Jude Children’s Research Hospital supported by American Lebanese Syrian Associated Charities (ALSAC) and the National Institute of Allergy and Infectious Diseases (NIAID). Artist: Jenny Hammond, Highgreenleycleugh, Northumberland, England.



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