The history of avian and human influenza pandemics showed a high case fatality and devastating socioeconomic impact on the developing world. The global epidemiology of the human influenza of 1918, 1957 and 1968 pandemics had few similarities. One of which was mass human migration, whether it being troop deployment or trade routes. How much the perennial flight patterns of wild bird had on its spread is another question for consideration? The avian influenza virus does not readily cross the species barrier, though there is a potential for genetic re-assortment and cross infection. The main finding of this review suggest a lack of historic epidemiological data from the developing world on previous influenza pandemics, a poorly developed surveillance system and lack of health service delivery capacity to effectively combat an outbreak of influenza, should it occur. The developing world already heavily burdened with endemic diseases such as malaria, HIV, Tuberculosis and other respiratory tract infections will find it difficult to cope with an influenza pandemic. A preparedness plan for developing countries should include health systems strengthening especially that providing expertise and improved surveillance tools
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