Comparing national and international responses to the threat of pandemic disease: Examining national and international responses to the 'swine flu' of 1976

The identification of a novel strain of influenza (Hsw1N1, dubbed 'swine flu') in an influenza epidemic at Fort Dix, New Jersey in February 1976 captured the attention of influenza and public health experts around the world. Intensive epidemiologic investigation of the outbreak was combined with prevailing scientific facts, theories, hypotheses, and the history of the influenza virus and pandemics to evaluate the threat to public health. From this common pool of information, the United States decided to mount a massive program to safeguard the public from a potential pandemic of swine flu by injecting every citizen with a preventative vaccine. Conversely, international influenza experts concluded that the available information did not justify such a widespread immunization campaign and instead adopted a watchful waiting posture reliant upon international surveillance of influenza cases.; The United States rapidly made the decision to initiate the massive program. President Ford authorized the program based upon the scientific interpretation that this new flu strain represented a potential pandemic and the fact that a massive immunization campaign was logistically feasible. The international interpretation of the new virus was also quickly reached. International influenza experts developed a milder scientific interpretation of the pandemic potential of swine flu and this view shaped the recommendations of the World Health Organization. The differing interpretations of the virus by United States and international influenza experts lead to suggestions that the respective decisions were based on unscientific rationales.