A pandemic that's not bird flu? Pigs might fly

• With the recent outbreak of swine influenza, the world may be facing this century's first influenza pandemic. • In Mexico, around 2000 patients have been hospitalised with respiratory illness and almost 150 people have died. Several other countries have reported smaller numbers of suspected and confirmed cases of swine influenza. • This 2009 influenza A virus is a strain of the H1N1 subtype, and appears to be a human - avian reassortment swine virus influenza. • It is likely that sustained human-to-human transmission of swine influenza has occurred, at least in Mexico. • Despite there being so many hospitalised patients in Mexico, cases outside Mexico have demonstrated a mild influenza-like illness, with only one fatality to date. • In contrast to the 1918 influenza pandemic, we now have a more robust public health system, with widespread global networks; vaccines can be developed rapidly; and there are antiviral medications to which the swine influenza A(H1N1) virus is sensitive. • Many resources have been invested in pandemic preparedness programs in the health care and public health systems in Australia over the past few years.