Pandemic Influenza Preparedness: Adaptive Responses to an Evolving Challenge

In the United States, preparation for a potential influenza pandemic is receiving heightened media coverage and scrutiny. Scientific attention is focused on the potential for the current Southeastern Asian avian flu virus, influenza A (H5N1), to become a pandemic threat through genetic mutation and viral reassortment. It is imperative that we act now, as we face an evolving and advancing disease state with insufficient national preparation. Existing preparedness plans address laboratory and disease surveillance, community containment and border protection, and mass dispensing and vaccination strategies. However, little attention has been directed to identifying and managing psychological and social factors likely to influence human behavior during a pandemic. All of our health and medical strategies require people to behave in prescribed ways to avoid exposure, prevent infection, or halt disease transmission. This article provides timely expert panel recommendations for pandemic influenza response and recovery by addressing human behavior and adaptation.