David Morens

National Institutes of Health | NIH

Although influenza A viruses have caused pandemics for centuries, future pandemics cannot be predicted with our current understanding and resources. Concern about an H5N1 avian influenza pandemic has caused alarm since 1997, but there are many other possible routes to pandemic influenza.

Rocky Mountain spotted fever (RMSF) is a rapidly progressive and often fatal tick-borne disease caused by Rickettsia rickettsii. Its discovery and characterization by Howard Ricketts has been hailed as a remarkable historical example of detection and control of an emerging infectious disease, and subsequently led to the establishment of the Rocky M...

Viruses that replicate in the human respiratory mucosa without infecting systemically, including influenza A, SARS-CoV-2, endemic coronaviruses, RSV, and many other "common cold" viruses, cause significant mortality and morbidity and are important public health concerns. Because these viruses generally do not elicit complete and durable protective...

Influenza A viruses (IAVs) present major public health threats from annual seasonal epidemics and pandemics and from viruses adapted to a variety of animals including poultry, pigs, and horses. Vaccines that broadly protect against all such IAVs, so-called “universal” influenza vaccines, do not currently exist but are urgently needed. Here, we demo...

The 1918 influenza pandemic was the deadliest respiratory pandemic of the 20th century and determined the genomic make-up of subsequent human influenza A viruses (IAV). Here, we analyze both the first 1918 IAV genomes from Europe and the first from samples prior to the autumn peak. 1918 IAV genomic diversity is consistent with a combination of loca...

A debate has emerged over the potential socio-ecological drivers of wildlife-origin zoonotic disease outbreaks and emerging infectious disease (EID) events. This Review explores the extent to which the incidence of wildlife-origin infectious disease outbreaks, which are likely to include devastating pandemics like HIV/AIDS and COVID-19, may be link...

There is a common preconception that reaching an estimated herd immunity threshold through vaccination will end the COVID-19 pandemic. However, the mathematical models underpinning this estimate make numerous assumptions that may not be met in the real world. The protection afforded by vaccines is imperfect, particularly against asymptomatic infect...

Influenza A viruses (IAVs) present major public health threats from annual seasonal epidemics, from pandemics caused by novel virus subtypes, and from viruses adapted to a variety of animals including poultry, pigs and horses. Vaccines that broadly protect against all such IAVs, so-called “universal” influenza vaccines, do not currently exist, but...

Both the 1918 influenza pandemic and the 2019‒2021 COVID-19 pandemic are among the most disastrous infectious disease emergences of modern times. In addition to similarities in their clinical, pathological, and epidemiological features, the two pandemics, separated by more than a century, were each met with essentially the same, or very similar, pub...

Separated by a century, the influenza pandemic of 1918 and the COVID-19 pandemic of 2019-2021 are among the most disastrous infectious disease emergences of modern times. Although caused by unrelated viruses, the two pandemics are nevertheless similar in their clinical, pathological, and epidemiological features, and in the civic, public health, an...

The 1918 influenza pandemic was the deadliest respiratory pandemic of the 20th century and determined the genomic make-up of subsequent human influenza A viruses (IAV). Here, we analyze the first 1918 IAV genomes from Europe and from the first, milder wave of the pandemic. 1918 IAV genomic diversity is consistent with local transmission and frequen...

Each year in Latin America and the Caribbean, seasonal influenza is associated with an estimated 36,500 respiratory deaths and 400,000 hospitalizations. Since the 2009 influenza A(H1N1) pandemic, the Region has made significant advances in the prevention and control of seasonal influenza, including improved surveillance systems, burden estimates, a...

Dennis Carroll and colleagues call for a global early warning system to detect viruses with pandemic potential

This is a brief report of an unusual observation of COVID-19 infection in Hawaii. The State of Hawaii is one of the most remote of the Pacific islands with approximately 1.4 million persons. The racial and ethnic diversity is enormous. For example, the white Caucasians make up ∼25%, Asians including Japanese, Chinese and other Asians ∼30%, Hawaiian...

(Cell 182, 1077–1092; September 3, 2020) It has come to our attention that in preparing the final version of Table 4, an error was made in footnote 2. Inhalation was omitted as a method of acquiring anthrax, and person to person spread was mistakenly described for pulmonary anthrax, but it should have listed cutaneous anthrax. Footnote 2 should rea...

The conserved region of influenza hemagglutinin (HA) stalk (or stem) has gained attention as a potent target for universal influenza vaccines1, 2, 3, 4–5. Although the HA stalk region is relatively well conserved, the evolutionarily dynamic nature of influenza viruses⁶ raises concerns about the possible emergence of viruses carrying stalk escape mu...

Infectious diseases prevalent in humans and animals are caused by pathogens that once emerged from other animal hosts. In addition to these established infections, new infectious diseases periodically emerge. In extreme cases they may cause pandemics such as COVID-19; in other cases, dead end infections or smaller epidemics result. Established dise...

Neuraminidase (NA) is an influenza surface protein that helps to free viruses from mucin-associated decoy receptors and to facilitate budding from infected cells. Experiments have demonstrated that anti-NA antibodies protect animals against lethal influenza challenge by numerous strains, while decreasing pulmonary viral titers, symptoms, and lung l...

The COVID-19 pandemic is among the deadliest infectious diseases to have emerged in recent history. As with all past pandemics, the specific mechanism of its emergence in humans remains unknown. Nevertheless, a large body of virologic, epidemiologic, veterinary, and ecologic data establishes that the new virus, SARS-CoV-2, evolved directly or indir...

With great apprehension, the world is now watching the birth of a novel pandemic already causing tremendous suffering, death, and disruption of normal life. Uncertainty and dread are exacerbated by the belief that what we are experiencing is new and mysterious. However, deadly pandemics and disease emergences are not new phenomena: they have been c...

We need to understand and quantify the dominant variables that govern the SARS–CoV-2 outbreak, rather than relying exclusively on confirmed cases and their geospatial spread.

Background: Identification of correlates of protection against human influenza A virus infection is important in development of broadly protective ("universal") influenza vaccines. Certain assumptions underlie current vaccine developmental strategies, including that infection with a particular influenza A virus should offer long-term or lifelong p...

Just over a century ago in 1918-1919, the "Spanish" influenza pandemic appeared nearly simultaneously around the world and caused extraordinary mortality-estimated at 50-100 million fatalities-associated with unexpected clinical and epidemiological features. The pandemic's sudden appearance and high fatality rate were unprecedented, and 100 years l...

The 2018–2019 period marks the centennial of the “Spanish” influenza pandemic, which caused at least 50 million deaths worldwide. The unprecedented nature of the pandemic’s sudden appearance and high fatality rate serve as a stark reminder of the threat influenza poses. Unusual features of the 1918–1919 pandemic, including age-specific mortality an...

The year 2018 marked the 100th anniversary of the deadliest event in human history. In 1918-1919, pandemic influenza spread globally and caused an estimated 50-100 million deaths associated with unexpected clinical and epidemiological features. The descendants of the 1918 virus continue to circulate as annual epidemic viruses causing significant mo...

Since 2014, acute flaccid myelitis (AFM), a long-recognized condition associated with polioviruses, nonpolio enteroviruses, and various other viral and nonviral causes, has been reemerging globally in epidemic form. This unanticipated reemergence is ironic, given that polioviruses, once the major causes of AFM, are now at the very threshold of glob...

The increasing geographical spread and disease incidence of arboviral infections are among the greatest public health concerns in the Americas. The region has observed an increasing trend in dengue incidence in the last decades, evolving from low to hyperendemicity. Yellow fever incidence has also intensified in this period, expanding from sylvatic...

Audio Interview Interview with Dr. David Morens on lessons from the 1918 influenza pandemic and the threat of a similar global health disaster. (10:50)Download This year marks the centennial of an influenza pandemic that killed 50 million to 100 million people globally — arguably the single deadliest event in recorded human history. Evidence sugges...

This year marks the 100th anniversary of the deadliest event in human history. In 1918–1919, pandemic influenza appeared nearly simultaneously around the globe and caused extraordinary mortality (an estimated 50–100 million deaths) associated with unexpected clinical and epidemiological features. The descendants of the 1918 virus remain today; as e...

Neuraminidase (NA) plays an essential role in influenza virus replication, facilitating multicycle infection predominantly by releasing virions from infected cells. NA-inhibiting antibodies provide resistance to disease and NA-specific antibodies contribute to vaccine efficacy. The primary reason NA vaccine content and immunogenicity was not routin...

Diagnosing streptococcal pharyngitis in children on the basis of clinical appearance and throat culture is complicated by high colonisation rates and by the ability of other pathogens to cause clinically similar disease. To characterise the epidemiology of Lancefield Group A, C and G β-haemolytic streptococcus (GAS, GCS and GGS, respectively) in ch...

To the Editor Drs Chen and Hamer summarized public health challenges posed by global shortages of yellow fever (YF) virus vaccines and new vaccination strategies adopted to control deadly ongoing YF outbreaks.¹ A single subcutaneous dose of live-attenuated YF vaccine will elicit lifelong protective immunity within 10 days in nearly all vaccinees. T...

For almost 50 years, ebolaviruses and related filoviruses have been repeatedly reemerging across the vast equatorial belt of the African continent to cause epidemics of highly fatal hemorrhagic fever. The 2013-2015 West African epidemic, by far the most geographically extensive, most fatal, and longest lasting epidemic in Ebola's history, presented...

Christmas, 2008. Richard M. Krause stands at the Nashville, Tennessee, gravesite of his hero Oswald T. Avery (1877–1955), the Rockefeller scientist who developed bacterial disease immunotherapy and studied the mysterious phenomenon of pneumococcal transformation. The transforming factor turned out to be DNA. Richard used the above image in a talk,...

The explosive pandemic of Zika virus infection occurring throughout South America, Central America, and the Caribbean (see map) and potentially threatening the United States is the most recent of four unexpected arrivals of important arthropod-borne viral diseases in the Western Hemisphere over the past 20 years. It follows dengue, which entered th...

Dr Fauci and coauthors discuss the Lasker Awards that have been granted to scientists for discoveries underlying vaccine development.Since 1945, the Lasker Foundation has recognized research advances with the greatest potential to improve global human health.1 Therefore, it is entirely fitting that vaccines, which save millions of lives every year...

The recent measles epidemic in the United States has aroused public disbelief that a disease well-controlled for decades is reemerging to threaten children in the United States. Controversy surrounds measles vaccination in the United States; some parents have even avoided vaccinating their healthy children by exposing them to measles-infected child...

A US army-wide measles outbreak in 1917-18 resulted in more than 95 000 cases and more than 3000 deaths. An outbreak investigation implicated measles and streptococcal co-infections in most deaths, and also characterised a parallel epidemic of primary streptococcal pneumonia in soldiers without measles. For the first time, the natural history and p...

Background. Surveillance for respiratory diseases in domestic National Army and National Guard training camps began after the United States’ entry into World War I, 17 months before the “Spanish influenza” pandemic appeared. Methods. Morbidity, mortality, and case-fatality data from 605 625 admissions and 18 258 deaths recorded for 7 diagnostic cat...

Abstract This review is focused on sex and gender effects on immunological alterations occurring during space flight. Sex differences in immune function and the outcome of inflammatory, infectious, and autoimmune diseases are well documented. The work of the Immunology Workgroup identified numerous reasons why there could be sex and/or gender diffe...

Emerging viral diseases pose ongoing health threats, particularly in an era of globalization; however, new biomedical research technologies such as genome sequencing and structure-based vaccine and drug design have improved our ability to respond to viral threats.

In 2008, we noted that the global reemergence of dengue fever threatened U.S. residents.(1) An outbreak of locally acquired dengue subsequently occurred in Florida, and the risk of U.S. dengue outbreaks will probably continue indefinitely. We now face a new threat posed by the unrelated chikungunya virus, which causes a disease clinically similar t...

Background / Purpose: Here is a study of the natural history, pathogenesis, and epidemiology of fatal measles. Main conclusion: Measles bronchopneumonia was characterized as a distinct pathologic process. The 1917 Army measles epidemics represented a moment in time when medicine became recognizably modern.

Influenza A viruses are globally enzootic in swine populations. Swine influenza has been recognised only since 1918, but an anecdotal report suggests that a swine-influenza epizootic might have occurred in England in 1892, at the same time as an explosive epidemic (or pandemic recurrence) of human influenza. This outbreak suggests that the ecobiolo...

We thank Nicholas Evans for his comments (1). There has been much recent discussion of how best to balance the public health needs of mitigating the impact of emerging infectious diseases with the concerns of biosafety and biosecurity that dual-use research entails (2–4). In our recent article (5), we sought to inform this discussion from the persp...

Influenza A viruses (IAV) are significant pathogens able to repeatedly switch hosts to infect multiple avian and mammalian species, including humans. The unpredictability of IAV evolution and interspecies movement creates continual public health challenges, such as the emergence of the 2009 pandemic H1N1 virus from swine, as well as pandemic threat...

The ongoing H7N9 influenza epizootic in China once again presents us questions about the origin of pandemics and how to recognize them in early stages of development. Over the past ~135 years, H7 influenza viruses have neither caused pandemics nor been recognized as having undergone human adaptation. Yet several unusual properties of these viruses,...

The inevitable, but unpredictable, appearance of new infectious diseases has been recognized for millennia, well before the discovery of causative infectious agents. Today, however, despite extraordinary advances in development of countermeasures (diagnostics, therapeutics, and vaccines), the ease of world travel and increased global interdependenc...

In the Robert Frost poem "The Road Not Taken," a traveler recalls a time when his forest path forked and wonders where he would have ended up had he chosen the other path. Some viruses encounter analogous evolutionary divergence points, and they may not all take linear paths to inevitable outcomes. For instance, a novel avian influenza A (H7N9) vir...

Background: The reasons for the unusual age-specific mortality patterns of the 1918-1919 influenza pandemic remain unknown. Here we characterize pandemic-related mortality by single year of age in a unique statewide Kentucky data set and explore breakpoints in the age curves. Methods: Individual death certificates from Kentucky during 1911-1919...

The “Spanish” influenza pandemic of 1918–1919 stands as the deadliest single event in recorded human history, killing approximately 50 million people. The cause of the 1918 pandemic and the determinants of its severity remained one of the most discussed medical mysteries throughout most of the 20th century. PCR technology, however, made it possible...

Twenty years ago (1992), a landmark Institute of Medicine report entitled “Emerging Infections: Microbial Threats to Health in the United States” underscored the important but often underappreciated concept of emerging infectious diseases (EIDs). A review of the progress made and setbacks experienced over the past 2 decades suggests that even thoug...

Background. The reasons for the unusual age-specific mortality patterns of the 1918-19influenza pandemic remain unknown. Here we characterize pandemic-related mortality by single year of age in a unique statewide Kentucky datasetand explore breakpoints in the age curves.Methods. Individual death certificates from Kentucky were abstracted by medical...

Please cite this paper as: Memoli et al. (2012) Influenza in pregnancy. Influenza and Other Respiratory Viruses 00(00), 000–000. The 2009 pandemic served as a strong reminder that influenza-induced disease can have a great impact on certain at-risk populations and that pregnant women are one such important population. The increased risk of fatal an...

ABSTRACT The influenza pandemic of 1918-1919 killed approximately 50 million people. The unusually severe morbidity and mortality associated with the pandemic spurred physicians and scientists to isolate the etiologic agent, but the virus was not isolated in 1918. In 1996, it became possible to recover and sequence highly degraded fragments of infl...

Dengue is a systemic arthropod-borne viral disease of major global public health importance. At least 2.5 billion people who live in areas of the world where dengue occurs are at risk of developing dengue fever (DF) and its severe complications, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Repeated reemergences of dengue in sudde...

In celebrating the 125th anniversary of the National Institutes of Health (NIH) in August 2012, NIH has been examining its origins, its history, and the visionary men and women whose research have contributed to the saving and/or improving the quality of life of millions of people throughout the world. This minireview examines Joseph James Kinyoun...

Highly pathogenic H5N1 influenza shares the same neuraminidase (NA) subtype with the 2009 pandemic (H1N1pdm09), and cross-reactive NA immunity might protect against or mitigate lethal H5N1 infection. In this study, mice were either infected with a sublethal dose of H1N1pdm09 or were vaccinated and boosted with virus-like particles (VLP) consisting...

Two studies of H5N1 avian influenza viruses that had been genetically engineered to render them transmissible between ferrets have proved highly controversial. Divergent opinions exist about the importance of these studies of influenza transmission and about potential 'dual use' research implications. No consensus has developed yet about how to bal...

During the past 200 years, our understanding of infectious diseases has radically evolved from the identification of microbes, to defining their genetic structure, to the development of focused antimicrobial therapies, to the realization of vector biology. This article highlights the tremendous advances that have been made in the field.

Shanks and Brundage offer thought-provoking hypotheses about influenza pathogenesis during the catastrophic 1918–1919 pandemic (1). Although we neither agree nor disagree with their views, its central hypothesis of T-cell–mediated immunopathogenesis begs examination of past events in light of modern immunologic and virologic understanding. We also...

The 1918 to 1919 "Spanish" influenza pandemic virus killed up to 50 million people. We report here clinical, pathological, bacteriological, and virological findings in 68 fatal American influenza/pneumonia military patients dying between May and October of 1918, a period that includes ~4 mo before the 1918 pandemic was recognized, and 2 mo (Septemb...

Mota and Qaranyo, why are they notplowed?. I came from there to here withoutseeing an ox.-Line from Ethiopian poem[1, 2], 1890sAfter more than a decade of effortby the Global Rinderpest EradicationProgramme (GREP) of the UN Foodand Agricultural Organization (FAO), theOrganisation mondiale de la sante´(Office international des e´pizooties[OIE]), and...

For at least five centuries, major epidemics and pandemics of influenza have occurred unexpectedly and at irregular intervals. Despite the modern notion that pandemic influenza is a distinct phenomenon obeying such constant (if incompletely understood) rules such as dramatic genetic change, cyclicity, "wave" patterning, virus replacement, and predi...

Histopathologic changes associated with a 1918 type II pneumococcal pneumonia case and DNA sequence of a portion of the hemoglobin beta gene..