Latest news with #MauriceHilleman
Chicago Tribune
5 days ago
- Health
- Chicago Tribune
Doctors: The US must concentrate on the unvaccinated to fight measles outbreak
The father of modern vaccines was a microbiologist named Maurice Hilleman, who developed a number of effective vaccines including that for measles. His work probably saved as many lives as that of any scientist in history. When measles resurfaced in the U.S. in the early 2000s, he was asked whether public education about vaccines could avoid the suffering of children with measles again. He answered with brutal honesty, 'No, I think children are once again going to have to suffer this disease in order for us to be aware of how bad it can be.' So far he has been proven correct. Last month, measles cases in the U.S. for 2025 passed 1,000, the highest figure since 2019. Measles is the most communicable disease known to man and although many consider it a trivial disease, three people have died in the ongoing U.S. outbreak — two children and one adult. More than 10% of U.S. cases have required hospitalization, a quarter of whom were children under 5. In our lifetime, few medical interventions have been as effective as measles vaccination. Before a measles vaccine was introduced in the mid-1960s, hundreds of thousands, and in some years millions of cases occurred annually, often resulting in hundreds and sometimes thousands of deaths. As long as U.S. vaccination rates remained above 95%, measles cases remained below 1 per million population: the country had established relative herd immunity (although even a high overall vaccination rate does not guarantee against a limited outbreak in an unvaccinated community.) In the past decade, vaccination rates have dropped to between 92% and 93%, a small decrease, but enough to create pockets of infection. Cases spiked above 2 per million in 2014, 2019, and this year. The direct and immediate challenge for Secretary of Health and Human Services Robert F. Kennedy Jr. is to concentrate on the unvaccinated fraction of the population — where measles spreads. To do this, he must shelve the idea that the measles vaccine plays a role in autism (that study has been debunked many times over) and further, he cannot leave the decision to vaccinate to individual whim, as he has suggested. He must address the reasons parents withhold measles vaccine from their children. The vaccine-hesitant are not limited to one ethnic or social class, or income group. Some are quite affluent, as evidenced by a 2014-2015 Disneyland outbreak among wealthier parkgoers. This year's final episode of the popular television medical drama 'The Pitt' concerns the interplay between the emergency room doctors and an upper middle class anti-vax mother of a teenager with life-threatening measles. Some vaccine-hesitant individuals will eventually accept vaccination for themselves and their children. First and foremost, this demands sensitive face-to-face discussions with parents, along with a nonjudgmental and empathic attitude. Parents of all social strata want the best for their children and many will listen to public health workers with communications expertise or trusted pediatricians and family physicians. Here's what will turn people off: reciting the medical facts in a condescending manner and turning the discussion political. Another relatively unvaccinated group are religious communities. No major religion forbids vaccination, but some religious communities have seen measles outbreaks in the unvaccinated. The current North American outbreak took hold in Mennonite communities in the U.S., Mexico and Canada. Once again, this means sensitive discussions with religious leaders to encourage vaccination in their communities. The final group of concern are foreign entries into the country. Migrants from low- to middle-income countries tend to be under-vaccinated, but their numbers are actually small compared to numbers of international tourists, who may be unvaccinated or inadequately vaccinated (and are not counted in vaccination statistics.) Foreign travelers have been the source of past measles outbreaks in Australia, Europe and North America. Mexico's outbreak is believed to have originated with a traveler returning from Texas. Travel medicine specialists play an important — but underutilized — role in preventing the risk of measles when people travel abroad. Currently, measles is not simply a domestic problem. While the media concentrate on reporting U.S. measles cases, where the current incidence is 3 patients per million population, it is lower than in Europe or Mexico. The situation is most serious in Canada, where the 2025 incidence of measles stands at 50 per million, more than 15 times higher than in the U.S. The vaccination rate in Canada is under 85%, another illustration of the importance of vaccination. There are definite indications the outbreak is slowing nationally and in Texas, the hardest hit state. If we are lucky, the outbreak may soon burn itself out — the pool of most susceptible will be exhausted and the school year is ending. But school will reopen in the fall and we should never depend on luck if there is a better alternative. In this case, vaccination. Memo to Robert F. Kennedy Jr.: You are on record as wanting better health for our children. If you are sincere, you must pay attention to Dr. Hilleman's words and put away any personal reservations you have about the measles vaccine. Have the federal and local public health officials in your charge implement vaccine solutions for the unvaccinated — without delay. Dr. Cory Franklin is a retired intensive care physician. Dr. Robert Weinstein is an infectious disease specialist at Rush University Medical Center.
Yahoo
06-03-2025
- Health
- Yahoo
What to know about the measles outbreak, the measles vaccine and prevention
With measles currently having a resurgence in West Texas and popping up in other parts of the country, it is important to stay up to date on vaccinations and records to protect yourself from the measles virus. Detecting measles is a complex process, even for the Oklahoma State Department of Health, which conducts numerous tests to determine whether measles has been detected in the Sooner State. Measles is one of the world's most contagious diseases, with one person being able to infect nine out of 10 of their unvaccinated close contacts. Here's an answer to some of the most necessary questions to protect yourself and others from contracting measles. Measles has been making a resurgence since January, primarily around the west Texas-New Mexico border. The Centers for Disease Control and Prevention reports that as of Feb. 27, there were 164 total cases in 2025—the most among children aged 5-19 (79) and those unvaccinated or without vaccination status (95%). There has been one confirmed death from measles in 2025. Since March 4, Texas has confirmed 159 measles cases and New Mexico has confirmed 9 cases. More: How does Oklahoma test for measles? What to know amid national outbreak According to CDC data, there were 285 confirmed measles cases in 2024 across 32 states and Washington, D.C., including Oklahoma. They predominantly were in children under 5 years old (120) and in the unvaccinated or unknown status (89%). If you do not know your MMR vaccination status, check your shot records with the state Health Department at The best way to defend against measles is to get the measles vaccine. The vaccine is usually given alongside the rubella and mumps vaccine, effectively naming it the MMR vaccine. It is recommended for all children ages 12 to 15 months and again at 4-6 years old. If someone does not receive a second dose of the vaccine from ages 4-6, it may be administered at any age thereafter. The two doses of vaccine normally provide lifelong immunity. More: Measles outbreak: What to know about symptoms, treatment, cases in Oklahoma Taking two doses of the measles vaccine, typically at 12 to 15 months old and again at 4-6 years old, normally provides lifelong immunity, according to the state Health Department. The first measles vaccine was licensed for public use in 1963. Another weaker vaccine was released in 1968, but it wasn't until 1971 when Dr. Maurice Hilleman combined the vaccines against measles, mumps and rubella into the MMR vaccine that we got the structure we know today. According to the National Library of Medicine, in 1979, 17 states had school laws that included measles vaccines by way of controlling the outbreak. By 1980, all 50 states had them. The laws required every child entering public school kindergarten to be vaccinated. Since then, states have also provided ways for people to be exempt from vaccines if there are religious or personal reasons. In Oklahoma, families can make an exemption from vaccines for religious and personal reasons. Measles can still be contracted by individuals who have the vaccine; however, it is at a much lower rate than those who are unvaccinated. The CDC reports that 3 out of 100 people who get two doses of the MMR vaccine will get measles if exposed to the virus. However, they are more likely to have a milder illness and less likely to spread to others. In 2023, an estimated 107,500 people died of measles globally. Primarily children under the age of 5. According to the University of Chicago Medicine, 3 in 1,000 children who contract measles will die. While that number only represents .3% of children who contract measles, the disease has a chance of resetting your immune system by causing immune amnesia. By doing so, the body's immune system can become a 'babylike' state, compromising its ability to fight new infections. Contact your physician to schedule an MMR vaccine. According to the CDC, the vaccine can be given at any age. This article originally appeared on Oklahoman: Do you need the measles vaccine? What to know about the outbreak
CNN
09-02-2025
- Health
- CNN
US dodged a bird flu pandemic in 1957 thanks to eggs and luck. Can we do it again?
Editor's note: The views expressed in this commentary are solely those of the writer. CNN is showcasing the work of The Conversation, a collaboration between journalists and academics to provide news analysis and commentary. The content is produced solely by The Conversation. In recent months, Americans looking for eggs have faced empty shelves in their grocery stores. The escalating threat of avian flu has forced farmers to kill millions of chickens to prevent its spread. Nearly 70 years ago, Maurice Hilleman, an expert in influenza, also worried about finding eggs. Hilleman, however, needed eggs not for his breakfast, but to make the vaccines that were key to stopping a potential influenza pandemic. Hilleman was born a year after the notorious 1918 influenza pandemic swept the world, killing 20 million to 100 million people. By 1957, when Hilleman began worrying about the egg supply, scientists had a significantly more sophisticated understanding of influenza than they had previously. This knowledge led them to fear that a pandemic similar to that of 1918 could easily erupt, killing millions again. As a historian of medicine, I have always been fascinated by the key moments that halt an epidemic. Studying these moments provides some insight into how and why one outbreak may become a deadly pandemic, while another does not. Influenza is one of the most unpredictable of diseases. Each year, the virus mutates slightly in a process called antigenic drift. The greater the mutation, the less likely that your immune system will recognize and fight back against the disease. Every now and then, the virus changes dramatically in a process called antigenic shift. When this occurs, people become even less immune, and the likelihood of disease spread dramatically increases. Hilleman knew that it was just a matter of time before the influenza virus shifted and caused a pandemic similar to the one in 1918. Exactly when that shift would occur was anyone's guess. READ MORE: Norovirus, aka the winter vomiting bug, is on the rise – an infectious disease expert explains the best ways to stay safe In April 1957, Hilleman opened his newspaper and saw an article about 'glassy-eyed' patients overwhelming clinics in Hong Kong. The article was just eight sentences long. But Hilleman needed only the four words of the headline to become alarmed: 'Hong Kong Battling Influenza.' Within a month of learning about Hong Kong's influenza epidemic, Hilleman had requested, obtained and tested a sample of the virus from colleagues in Asia. By May, Hilleman and his colleagues knew that Americans lacked immunity against this new version of the virus. A potential pandemic loomed. The U.S. prioritized vaccinating military personnel over the public in 1957. Here, members of a West German Navy vessel hand over a jar of vaccine to the U.S. transport ship General Patch for 134 people sick with flu. Henry Brueggemann/AP Photo During the 1920s and 1930s, the American government had poured millions of dollars into influenza research. By 1944, scientists not only understood that influenza was caused by a shape-shifting virus – something they had not known in 1918 – but they had also developed a vaccine. Antigenic drift rendered this vaccine ineffective in the 1946 flu season. Unlike the polio or smallpox vaccine, which could be administered once for lifelong protection, the influenza vaccine needed to be continually updated to be effective against an ever-changing virus. READ MORE: Some viruses prefer mosquitoes to humans – why people get sick anyway However, Americans were not accustomed to the idea of signing up for a yearly flu shot. In fact, they were not accustomed to signing up for a flu shot, period. After seeing the devastating impact of the 1918 pandemic on the nation's soldiers and sailors, officials prioritized protecting the military from influenza. During and after World War II, the government used the influenza vaccine for the military, not the general public. In the spring of 1957, the government called for vaccine manufacturers to accelerate production of a new influenza vaccine for all Americans. Traditionally, farmers have often culled roosters and unwanted chickens to keep their costs low. Hilleman, however, asked farmers to not cull their roosters, because vaccine manufacturers would need a huge supply of eggs to produce the vaccine before the virus fully hit the United States. But in early June, the virus was already circulating in the U.S. The good news was that the new virus was not the killer its 1918 predecessor had been. READ MORE: Bird flu flares up again in Michigan poultry Hoping to create an 'alert but not an alarmed public,' Surgeon General Leroy Burney and other experts discussed influenza and the need for vaccination in a widely distributed television show. The government also created short public service announcements and worked with local health organizations to encourage vaccination. A 1957 film informing Americans how the U.S. was responding to an influenza rates were, however, only 'moderate' – not because Americans saw vaccination as problematic, but because they did not see influenza as a threat. Nearly 40 years had dulled memories of the 1918 pandemic, while the development of antibiotics had lessened the threat of the deadly pneumonia that can accompany influenza. If death and devastation defined the 1918 pandemic, luck defined the 1957 pandemic. It was luck that Hilleman saw an article about rising rates of influenza in Asia in the popular press. It was luck that Hilleman made an early call to increase production of fertilized eggs. And it was luck that the 1957 virus did not mirror its 1918 relative's ability to kill. Get CNN Health's weekly newsletter Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team. Recognizing that they had dodged a bullet in 1957, public health experts intensified their monitoring of the influenza virus during the 1960s. They also worked to improve influenza vaccines and to promote yearly vaccination. Multiple factors, such as the development of the polio vaccine as well as a growing recognition of the role vaccines played in controlling diseases, shaped the creation of an immunization-focused bureaucracy in the federal government during the 1960s. READ MORE: Bird flu cases surging in UK but risk to humans remains low Inoculating eggs with live virus was the first step to producing a vaccine. AP PhotoOver the past 60 years, the influenza virus has continued to drift and shift. In 1968, a shift once again caused a pandemic. In 1976 and 2009, concerns that the virus had shifted led to fears that a new pandemic loomed. But Americans were lucky once again. Today, few Americans remember the 1957 pandemic – the one that sputtered out before it did real damage. Yet that event left a lasting legacy in how public health experts think about and plan for future outbreaks. Assuming that the U.S. uses the medical and public health advances at its disposal, Americans are now more prepared for an influenza pandemic than our ancestors were in 1918 and in 1957. But the virus's unpredictability makes it impossible to know even today how it will mutate and when a pandemic will emerge.
Yahoo
09-02-2025
- Health
- Yahoo
US dodged a bird flu pandemic in 1957 thanks to eggs and luck. Can we do it again?
The views expressed in this commentary are solely those of the writer. CNN is showcasing the work of The Conversation, a collaboration between journalists and academics to provide news analysis and commentary. The content is produced solely by The Conversation. In recent months, Americans looking for eggs have faced empty shelves in their grocery stores. The escalating threat of avian flu has forced farmers to kill millions of chickens to prevent its spread. Nearly 70 years ago, Maurice Hilleman, an expert in influenza, also worried about finding eggs. Hilleman, however, needed eggs not for his breakfast, but to make the vaccines that were key to stopping a potential influenza pandemic. Hilleman was born a year after the notorious 1918 influenza pandemic swept the world, killing 20 million to 100 million people. By 1957, when Hilleman began worrying about the egg supply, scientists had a significantly more sophisticated understanding of influenza than they had previously. This knowledge led them to fear that a pandemic similar to that of 1918 could easily erupt, killing millions again. As a historian of medicine, I have always been fascinated by the key moments that halt an epidemic. Studying these moments provides some insight into how and why one outbreak may become a deadly pandemic, while another does not. Influenza is one of the most unpredictable of diseases. Each year, the virus mutates slightly in a process called antigenic drift. The greater the mutation, the less likely that your immune system will recognize and fight back against the disease. Every now and then, the virus changes dramatically in a process called antigenic shift. When this occurs, people become even less immune, and the likelihood of disease spread dramatically increases. Hilleman knew that it was just a matter of time before the influenza virus shifted and caused a pandemic similar to the one in 1918. Exactly when that shift would occur was anyone's guess. READ MORE: Norovirus, aka the winter vomiting bug, is on the rise – an infectious disease expert explains the best ways to stay safe In April 1957, Hilleman opened his newspaper and saw an article about 'glassy-eyed' patients overwhelming clinics in Hong Kong. The article was just eight sentences long. But Hilleman needed only the four words of the headline to become alarmed: 'Hong Kong Battling Influenza.' Within a month of learning about Hong Kong's influenza epidemic, Hilleman had requested, obtained and tested a sample of the virus from colleagues in Asia. By May, Hilleman and his colleagues knew that Americans lacked immunity against this new version of the virus. A potential pandemic loomed. The U.S. prioritized vaccinating military personnel over the public in 1957. Here, members of a West German Navy vessel hand over a jar of vaccine to the U.S. transport ship General Patch for 134 people sick with flu. Henry Brueggemann/AP Photo During the 1920s and 1930s, the American government had poured millions of dollars into influenza research. By 1944, scientists not only understood that influenza was caused by a shape-shifting virus – something they had not known in 1918 – but they had also developed a vaccine. Antigenic drift rendered this vaccine ineffective in the 1946 flu season. Unlike the polio or smallpox vaccine, which could be administered once for lifelong protection, the influenza vaccine needed to be continually updated to be effective against an ever-changing virus. READ MORE: Some viruses prefer mosquitoes to humans – why people get sick anyway However, Americans were not accustomed to the idea of signing up for a yearly flu shot. In fact, they were not accustomed to signing up for a flu shot, period. After seeing the devastating impact of the 1918 pandemic on the nation's soldiers and sailors, officials prioritized protecting the military from influenza. During and after World War II, the government used the influenza vaccine for the military, not the general public. In the spring of 1957, the government called for vaccine manufacturers to accelerate production of a new influenza vaccine for all Americans. Traditionally, farmers have often culled roosters and unwanted chickens to keep their costs low. Hilleman, however, asked farmers to not cull their roosters, because vaccine manufacturers would need a huge supply of eggs to produce the vaccine before the virus fully hit the United States. But in early June, the virus was already circulating in the U.S. The good news was that the new virus was not the killer its 1918 predecessor had been. READ MORE: Bird flu flares up again in Michigan poultry Hoping to create an 'alert but not an alarmed public,' Surgeon General Leroy Burney and other experts discussed influenza and the need for vaccination in a widely distributed television show. The government also created short public service announcements and worked with local health organizations to encourage vaccination. A 1957 film informing Americans how the U.S. was responding to an influenza rates were, however, only 'moderate' – not because Americans saw vaccination as problematic, but because they did not see influenza as a threat. Nearly 40 years had dulled memories of the 1918 pandemic, while the development of antibiotics had lessened the threat of the deadly pneumonia that can accompany influenza. If death and devastation defined the 1918 pandemic, luck defined the 1957 pandemic. It was luck that Hilleman saw an article about rising rates of influenza in Asia in the popular press. It was luck that Hilleman made an early call to increase production of fertilized eggs. And it was luck that the 1957 virus did not mirror its 1918 relative's ability to kill. Recognizing that they had dodged a bullet in 1957, public health experts intensified their monitoring of the influenza virus during the 1960s. They also worked to improve influenza vaccines and to promote yearly vaccination. Multiple factors, such as the development of the polio vaccine as well as a growing recognition of the role vaccines played in controlling diseases, shaped the creation of an immunization-focused bureaucracy in the federal government during the 1960s. READ MORE: Bird flu cases surging in UK but risk to humans remains low Inoculating eggs with live virus was the first step to producing a vaccine. AP PhotoOver the past 60 years, the influenza virus has continued to drift and shift. In 1968, a shift once again caused a pandemic. In 1976 and 2009, concerns that the virus had shifted led to fears that a new pandemic loomed. But Americans were lucky once again. Today, few Americans remember the 1957 pandemic – the one that sputtered out before it did real damage. Yet that event left a lasting legacy in how public health experts think about and plan for future outbreaks. Assuming that the U.S. uses the medical and public health advances at its disposal, Americans are now more prepared for an influenza pandemic than our ancestors were in 1918 and in 1957. But the virus's unpredictability makes it impossible to know even today how it will mutate and when a pandemic will emerge.
CNN
09-02-2025
- Health
- CNN
US dodged a bird flu pandemic in 1957 thanks to eggs and luck. Can we do it again?
Editor's note: The views expressed in this commentary are solely those of the writer. CNN is showcasing the work of The Conversation, a collaboration between journalists and academics to provide news analysis and commentary. The content is produced solely by The Conversation. In recent months, Americans looking for eggs have faced empty shelves in their grocery stores. The escalating threat of avian flu has forced farmers to kill millions of chickens to prevent its spread. Nearly 70 years ago, Maurice Hilleman, an expert in influenza, also worried about finding eggs. Hilleman, however, needed eggs not for his breakfast, but to make the vaccines that were key to stopping a potential influenza pandemic. Hilleman was born a year after the notorious 1918 influenza pandemic swept the world, killing 20 million to 100 million people. By 1957, when Hilleman began worrying about the egg supply, scientists had a significantly more sophisticated understanding of influenza than they had previously. This knowledge led them to fear that a pandemic similar to that of 1918 could easily erupt, killing millions again. As a historian of medicine, I have always been fascinated by the key moments that halt an epidemic. Studying these moments provides some insight into how and why one outbreak may become a deadly pandemic, while another does not. Influenza is one of the most unpredictable of diseases. Each year, the virus mutates slightly in a process called antigenic drift. The greater the mutation, the less likely that your immune system will recognize and fight back against the disease. Every now and then, the virus changes dramatically in a process called antigenic shift. When this occurs, people become even less immune, and the likelihood of disease spread dramatically increases. Hilleman knew that it was just a matter of time before the influenza virus shifted and caused a pandemic similar to the one in 1918. Exactly when that shift would occur was anyone's guess. READ MORE: Norovirus, aka the winter vomiting bug, is on the rise – an infectious disease expert explains the best ways to stay safe In April 1957, Hilleman opened his newspaper and saw an article about 'glassy-eyed' patients overwhelming clinics in Hong Kong. The article was just eight sentences long. But Hilleman needed only the four words of the headline to become alarmed: 'Hong Kong Battling Influenza.' Within a month of learning about Hong Kong's influenza epidemic, Hilleman had requested, obtained and tested a sample of the virus from colleagues in Asia. By May, Hilleman and his colleagues knew that Americans lacked immunity against this new version of the virus. A potential pandemic loomed. The U.S. prioritized vaccinating military personnel over the public in 1957. Here, members of a West German Navy vessel hand over a jar of vaccine to the U.S. transport ship General Patch for 134 people sick with flu. Henry Brueggemann/AP Photo During the 1920s and 1930s, the American government had poured millions of dollars into influenza research. By 1944, scientists not only understood that influenza was caused by a shape-shifting virus – something they had not known in 1918 – but they had also developed a vaccine. Antigenic drift rendered this vaccine ineffective in the 1946 flu season. Unlike the polio or smallpox vaccine, which could be administered once for lifelong protection, the influenza vaccine needed to be continually updated to be effective against an ever-changing virus. READ MORE: Some viruses prefer mosquitoes to humans – why people get sick anyway However, Americans were not accustomed to the idea of signing up for a yearly flu shot. In fact, they were not accustomed to signing up for a flu shot, period. After seeing the devastating impact of the 1918 pandemic on the nation's soldiers and sailors, officials prioritized protecting the military from influenza. During and after World War II, the government used the influenza vaccine for the military, not the general public. In the spring of 1957, the government called for vaccine manufacturers to accelerate production of a new influenza vaccine for all Americans. Traditionally, farmers have often culled roosters and unwanted chickens to keep their costs low. Hilleman, however, asked farmers to not cull their roosters, because vaccine manufacturers would need a huge supply of eggs to produce the vaccine before the virus fully hit the United States. But in early June, the virus was already circulating in the U.S. The good news was that the new virus was not the killer its 1918 predecessor had been. READ MORE: Bird flu flares up again in Michigan poultry Hoping to create an 'alert but not an alarmed public,' Surgeon General Leroy Burney and other experts discussed influenza and the need for vaccination in a widely distributed television show. The government also created short public service announcements and worked with local health organizations to encourage vaccination. A 1957 film informing Americans how the U.S. was responding to an influenza rates were, however, only 'moderate' – not because Americans saw vaccination as problematic, but because they did not see influenza as a threat. Nearly 40 years had dulled memories of the 1918 pandemic, while the development of antibiotics had lessened the threat of the deadly pneumonia that can accompany influenza. If death and devastation defined the 1918 pandemic, luck defined the 1957 pandemic. It was luck that Hilleman saw an article about rising rates of influenza in Asia in the popular press. It was luck that Hilleman made an early call to increase production of fertilized eggs. And it was luck that the 1957 virus did not mirror its 1918 relative's ability to kill. Get CNN Health's weekly newsletter Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team. Recognizing that they had dodged a bullet in 1957, public health experts intensified their monitoring of the influenza virus during the 1960s. They also worked to improve influenza vaccines and to promote yearly vaccination. Multiple factors, such as the development of the polio vaccine as well as a growing recognition of the role vaccines played in controlling diseases, shaped the creation of an immunization-focused bureaucracy in the federal government during the 1960s. READ MORE: Bird flu cases surging in UK but risk to humans remains low Inoculating eggs with live virus was the first step to producing a vaccine. AP PhotoOver the past 60 years, the influenza virus has continued to drift and shift. In 1968, a shift once again caused a pandemic. In 1976 and 2009, concerns that the virus had shifted led to fears that a new pandemic loomed. But Americans were lucky once again. Today, few Americans remember the 1957 pandemic – the one that sputtered out before it did real damage. Yet that event left a lasting legacy in how public health experts think about and plan for future outbreaks. Assuming that the U.S. uses the medical and public health advances at its disposal, Americans are now more prepared for an influenza pandemic than our ancestors were in 1918 and in 1957. But the virus's unpredictability makes it impossible to know even today how it will mutate and when a pandemic will emerge.
