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Swine flu: One year on

This time last year, swine flu was on the brink of becoming a major global health story. With hindsight we can be thankful that the pandemic was mild for most while serious for a small minority.

In retrospect was it all a huge, global over-reaction? Not according to a team of experts assembled by the Science Media Centre. Professor Robert Dingwall from the University of Nottingham wondered what journalists would have said had the pandemic turned out to have been as serious as that in 1918.

Professor Peter Openshaw from Imperial College London said the public-health response had been proportionate and that politicians had listened to the experts. The general tone of those assembled was that it's always better to prepare for the worst rather than simply hope for the best. Mike Grannatt, formerly of the Cabinet Office and now an expert in risk communication, said the government must not be afraid of crying wolf in the future, because "one day the wolf will come" in the form of a more serious pandemic.

There are lessons to be learned. Professor Neil Ferguson, a leading disease modeller, felt that although his team was able to quickly determine that the H1N1 virus was mild for most, it took much longer to assess what the effect would be on the health service.

Professor Ferguson, an epidemiologist at Imperial College London, said ball-park projections for the transmissibility and severity of the virus were calculated within weeks of the first cases being highlighted in Mexico. This meant when the virus began circulation in the UK, people were aware that it was worth taking note of, but there was no reason to panic. But transforming ball-park projections into more accurate ones was more problematic.

Professor Dingwall pointed out the pandemic is not over. We are at the beginning of the flu season in the southern hemisphere. "We can't relax our vigilance, especially since the historic evidence is that a more virulent second wave is possible," he said.

I should stress that most experts, including Professor Dingwall think it unlikely that the H1N1 virus will mutate into something much more serious. Unlikely, but not impossible. Neil Ferguson said there had recently been a resurgence of flu in some southern American states, notably Alabama.

So the H1N1 virus is still out there. Dr Stephen Gardner, influenza policy director at GlaxoSmithKline, said the H1N1 pandemic strain is now being incorporated into seasonal flu vaccines. Seasonal flu jabs are trivalent; in other words, they are effective against three different strains of influenza. That should greatly simplify the vaccination process, for patients and GPs, when the flu season begins this autumn.