Being prepared

The Boy Scouts have an admirable motto: Be Prepared. ‘Be prepared for what?’ someone asked their founder Lord Baden‐Powell. ‘Why for any old thing’, he replied. These surely are words of wisdom at a time when the spectre of biological warfare has become a grim reality and the next influenza pandemic might be lurking around the corner. Being prepared is surely the lowest common denominator in successfully dealing with an outbreak of any infectious disease, and whatever public health measures are in place for one can only benefit the others. ‘We should be worried less about a specific pathogen or about whether an infectious disease emergency is naturally‐occurring or deliberately‐induced and more about the type of health systems we want to build to deal with the spread of infectious disease in a rapidly shrinking world’ said Monica Schoch‐Spana from the Center for Civilian Biodefense Studies at Johns Hopkins University (Baltimore, MD).Transmission electron photograph of influenza A. Photo courtesy of Dr Erskine Palmer, US Centers for Disease Control and Prevention![][1] Indeed, no one knows which organisms have fallen into the terrorists' hands or which other diseases may naturally re‐emerge and spread. Influenza, on the other hand, is an all too familiar enemy that returns every year with admirable reliability. But, for all its mundaneness, influenza is a killer and has the potential to cause global havoc. The first pandemic was documented in 1580, a further 31 have been described since and it is just a matter of time until the next. These sporadic worldwide epidemics are characterised by their high morbidity and their high mortality: up to 40 million people died in the 1918–1919 pandemic and 1.5 million in the 1957 and 1968 outbreaks combined. If a virus of comparable virulence to the strain circulating in 1918 was to emerge … [1]: /embed/graphic-1.gif