Age groups from 65 yrs of age accounted for nearly 99 percent of influenza related deaths in 1918. However, people under age groups of 65 yrs in 1957 and 1968 accounted only 36 and 48percent influenza related deaths (Simonsen et al; 1998). On the basis of recent survey done on pandemic influenza outbreak, it has been estimated for USA alone to result with 2,07,000 deaths and 7,34,000 hospitalizations, 47 million additional illness and 42 million outpatient visits(Meltzer et al, 1999).
This graph estimates the number of residents that were affected during an influenza pandemic outbreaks (from 1917- 2006).
However, during an influenza pandemic, large proportions of deaths are a result of secondary bacterial infections. By 1979, the influenza strain started infecting pigs in the European territory thereby establishing a stable viral lineage with the dormant pandemic strain (Ludwig, et al; 1995). One extra-ordinary situation has a significant mark in the history of world global pandemic, wherein a family living in a village in Sumatra, seven members were infected with influenza ‘A’ strain virus (Wulandri and Lyn, 2006), thereby indicating an extended chain of human transmission(Butler, 2006,p.554).
In all, if we analyze the cases of likely number of death cases from the previous influenza epidemics, the estimated death rates are between 4.4 and 6.7 per 1000 persons (Brundage, 2006). The national and international government health organizations have developed country and regional level public communicating materials for pandemic preparedness (Horwarth et al, 2006; Barret et al, 2005, Jennings and lush, 2004).
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