Centenary of the 1918 influenza pandemic

As we commemorate 100 years since the 1918 pandemic, research has advanced our knowledge of influenza virulence and pathogenesis, and has highlighted the role of animal reservoirs in the emergence of pandemic strains. Future efforts in understanding viral ecology, zoonosis and in integrating human and animal epidemiology should aid pandemic preparedness.

Increasingly, the pathogens that pose the greatest threats to humans are those that evolve to escape prior immunity and pharmaceutical interventions. In response, we need to employ evolutionary thinking to manage infectious disease.

It is unclear why pregnant women are at high risk of severe influenza infection. Allogeneic pregnancy in mice is now shown to alter both innate and adaptive responses to influenza virus infection, enabling the emergence of more virulent virus variants.

Influenza B virus causes substantial illness globally, particularly in children. Treatment options are limited, as the most widely used antiviral drug appears to be less effective than against influenza A. A new antibody targeting the influenza B neuraminidase shows promise in mice as a therapeutic option.

Clear links between human genes and susceptibility to influenza disease are scarce. A recent study uncovers a gene variant coupled to severe influenza, and shows how it hampers the expression of an antiviral gene that is key to immune cell survival.

The quest to improve influenza vaccines is aided by research into the immune response that they generate. Two recent studies have focused their attention on the specificities of antibodies induced after vaccination with conventional inactivated influenza vaccines.