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Influenza: A Decade After the 2009 Pandemic

Edited by Prof Adrienne Randolph

Ten years ago, a novel strain of influenza virus caused panic as it spread worldwide, filling emergency rooms and hospitals beyond capacity. Starting April 2009, for one year at least 150,000 and up to 575,000 people worldwide died from influenza virus complications, the vast majority being healthy children and younger adults. Initially called by various names, including swine flu, the influenza A H1N1pdm09 virus highlighted the risk of an influenza pandemic similar to that of 1918 which wiped out approximately 1% of the population. During and after the 2009 pandemic, the critical care literature was replete with influenza-related articles. Then H1N1pdm09 became a seasonal strain, herd immunity increased, and annual influenza outbreaks continued their usual onslaught on the very young, the very old, and patients with chronic conditions. 

Unfortunately, the next influenza A pandemic is inevitable, therefore Critical Care has joined the Center for Disease Control and Prevention and others to update clinicians and researchers on progress made in the decade since 2009 by focusing on influenza critical illness with this series. In our first article, Drs. Chow, Doyle and Uyeki focus on prevention, early diagnosis and treatment of influenza-related critical illness -- a timely topic as pandemic and seasonal influenza-related severe complications often meet sepsis criteria. Our second article by Drs. Kalil and Thomas explains influenza virus pathophysiology and epidemiology.  Further articles in the series will soon follow.

This series of articles, published in Critical Care, has not been sponsored. All articles have undergone the journal’s standard peer review process overseen by the Series Editor, with final decisions made by the Editor in Chief. The Series Editor and Editor in Chief declare no competing interests.

We welcome the submission of original research relating to influenza critical illness to be a part of this series.

  1. Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by lung inflammation and pulmonary edema. Coronavirus disease 2019 (COVID-19) is associated with ARDS in the more sever...

    Authors: Jose Angel Lorente, Nicolas Nin, Palmira Villa, Dovami Vasco, Ana B. Miguel-Coello, Ignacio Rodriguez, Raquel Herrero, Oscar Peñuelas, Jesús Ruiz-Cabello and Jose L. Izquierdo-Garcia
    Citation: Critical Care 2021 25:390
  2. Cardiac injury is now a common complication of coronavirus disease (COVID-19), but it remains unclear whether cardiac injury-related biomarkers can be independent predictors of mortality and severe disease dev...

    Authors: Xinye Li, Xiandu Pan, Yanda Li, Na An, Yanfen Xing, Fan Yang, Li Tian, Jiahao Sun, Yonghong Gao, Hongcai Shang and Yanwei Xing
    Citation: Critical Care 2020 24:468
  3. Few viruses have shaped the course of human history more than influenza viruses. A century since the 1918–1919 Spanish influenza pandemic—the largest and deadliest influenza pandemic in recorded history—we hav...

    Authors: Taylor Kain and Robert Fowler
    Citation: Critical Care 2019 23:337
  4. Most people exposed to a new flu virus do not notice any symptoms. A small minority develops critical illness. Some of this extremely broad variation in susceptibility is explained by the size of the initial i...

    Authors: Sara Clohisey and John Kenneth Baillie
    Citation: Critical Care 2019 23:303
  5. Annual seasonal influenza epidemics of variable severity result in significant morbidity and mortality in the United States (U.S.) and worldwide. In temperate climate countries, including the U.S., influenza a...

    Authors: Eric J. Chow, Joshua D. Doyle and Timothy M. Uyeki
    Citation: Critical Care 2019 23:214

    The Letter to this article has been published in Critical Care 2020 24:72