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Brian Vastag

JAMA. 2004;291:1429-1430.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

As global health workers keep close tabs on the avian influenza outbreak in southeast Asia, their counterparts in the laboratory are concocting vaccines for a worst-case scenario—the spread of a pandemic strain, unseen since the 1918 scourge that claimed at least 20 million lives.

Outbreaks of avian influenza have necessitated the culling of millions of poultry. (Photo credit: AP/Wide World Photos)

While the number of human cases of H5N1 influenza in Vietnam and Thailand remains small—32 at press time—epidemiologists stay awake nights shuddering over the nearly 70% mortality rate. In contrast, the annual influenza (both type A and type B) epidemic that hits North America each winter kills about 1% of those it infects.

"We do have unprecedented human exposure to highly pathogenic [influenza] viruses," said Nancy Cox, PhD, chief of the influenza branch at the Centers for Disease Control (CDC) and Prevention, Atlanta. "So there is a . . . [Full Text of this Article]