Although we already know a great deal about influenza, and although the World Health Organization is constantly collecting detailed information from its chain of influenza reference laboratories throughout the world, it is extremely difficult for epidemiologists, who study infectious disease, to predict when and where the next flu epidemic will occur, and how severe it will be.
There are three kinds of influenza virus, known as A, B and C. Influenza C virus is relatively stable and causes mild infections that do not spread far through the population. The A and B types are unstable, and are responsible for the epidemics that cause frequent concern. Following any virus attack, the human body builds up antibodies which confer immunity to that strain of virus, but a virus with the capacity to change its character is able to by-pass this protection. Variability is less developed in the influenza B virus, which affects only human beings. An influenza B virus may cause a widespread epidemic but will have little effect if introduced into the same community soon afterwards, since nearly everyone will have built up antibodies and will be immune. The influenza A virus, which affects animals also, is extremely unstable and is responsible for some of the worst outbreaks of the disease, such as the unparalleled pandemic, or world epidemic, of 1918-19, when about half the world's population were infected and about twenty million people died, some from pneumonia caused by the virus itself and some from secondary complications caused by bacteria.
Accurate prediction is difficult because of the complication of the factors. A particular virus may be related to one to which some of the population have partial involved immunity. The extent to which it will spread will depend on factors such as its own strength, or virulence the ease with which it can be transmitted and the strength of the opposition it encounters. Scientists, however, have a reliable general picture of the world situation, influenza A attacks us in waves every two or three years, while influenza B, which travels more slowly, launches its main assaults every three to six years. The outbreaks vary from isolated cases to epidemic involving a tenth or more of the population. We may confidently prophesy that sooner or later large numbers of people will be feeling the unpleasant effects of some kind of influenza virus.