The article by Shieh et al on the pathology and patho-genesis of the 2009 pandemic H1N1 influenza A virus is a landmark work in the long evolution of our understanding of this ever-threatening public health challenge. During the intervals between the pandemics of 1889, 1918, 1957, 1968, and 2009, most of the public, including physicians, did not distinguish between colds and the flu. Influenza A virus is not well controlled in the overall population by antiviral drugs and vaccination, and even during these interpandemic periods, the toll from seasonal influenza in the United States was a remarkable 36,000 deaths annually. Therefore, pathologists have much to potentially contribute to the better understanding the pathogenesis of influenza.
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