Public health officials have a surveillance system for monitoring seasonal and “novel” influenzas, which can appear at any time.

Right now, for example.

H1N1 is a “novel” form because it recombined with other forms to produce a strain never seen. H1N1 is A viruses plus avian flu plus swine flu. You can see why calling this the swine flu is not the right name at all.

Although Medpage Today editors say that the world was “better prepared for a pandemic than it has ever been,” better was not good enough.”

Those responsible agree. In fact, the experts themselves are the source of the better-than-ever-but-not-good-enough assessment.

As the story below says, infectious disease researchers were watching the chickens.

They should have been watching the pigs.

Influenza is highly unpredictable.

Avian flu is classified as “highly pathogenic,” meaning it is more dangerous, and the monitoring of this form is better developed because it is so dangerous.

Medpage Today

“The scientific community expected the next pandemic to be avian (H5N1), which behaves differently than swine and which behaves differently than the “novel” H1N1 we have—-a combination of A viruses, avian and swine.

“That was one of the key factors that slowed the response to the 2009 H1N1 pandemic flu, experts said here at the Interscience Conference on Antimicrobial Agents and Chemotherapy.Although the world was better prepared for a pandemic flu than it had ever been, the H1N1 strain blindsided scientists, who had expected the next pandemic to arise from an avian strain, probably the highly pathogenic H5N1 influenza that has been raging among poultry.

“Instead, it came from pigs. And it was missed because flu surveillance — good and getting better in birds — was spotty at best in swine, according to Nancy Cox, PhD, chief of the CDC’s influenza division. (Emphasis added)

“Indeed, Cox said here, experts still don’t know where and how the so-called triple reassortant H1N1 strain arose or how it got into humans. There is a gaping hole in the genetic record of several years between genes in the current H1N1 pandemic flu and their nearest known ancestors, she said. (Emphasis added)

“We still haven’t found that missing link and we may never find it,” she said.

“That gap in surveillance led to a major gap in pandemic planning, according to Jon McCullers, MD, of St. Jude Children’s Research Hospital in Memphis, Tenn.

“Planners had assumed — because they were watching the birds — that they’d have enough warning of a pandemic strain to get mitigation schemes in place to slow its spread, perhaps even long enough to get vaccines ready before the flu really took off. (Emphasis added)

“That part of the planning “basically failed completely,” McCullers said. “The thing was all over the world by the time the CDC figured out we had a few cases in the U.S.” (Emphasis added)

Source: Medpage Today, September 20, 2009, Special Report on H1N1 Influenza

Source: Meeting Coverage: Interscience Conference on Antimicrobial Agents and Chemotherapy Meeting, September 20, 2009