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Smallpox is a disease that followed humanity for thousands of years up until thirty years ago. It was possible to eradicate, since an effective live vaccine from crossreacting vaccinia could be developed. Twenty years passed since vaccinations stopped and very few people are protected against the disease today. Variola today has become an object of discussion due to the possibility that it can be used as a bioweapon. Due to the number of complications that can be expected a general vaccination is probably not possible. Research is ongoing to develop new vaccines. Many countries are improving their capabilities to respond to a renewed threat of a smallpox epidemic.

Excess mortality in a population is one of the hallmarks of an influenza epidemic. Apart from the pandemic years, 1918-1919, 1957 and 1968-1969, annual excess mortality has occurred 16 times in Sweden during the period 1911-1988. An unusually high mortality was caused by Influenza A Sichuan 2/87 (H3N2), the unexpected appearance of which at the beginning of November 1988 started an intensive epidemic in Sweden, while other European countries had a relatively mild influenza season. Swedish deaths in December totalled 10,500-2,200 more than expected; age groups over 65 years accounted for 95 per cent of the mortality, and those over 80 (N = 350,000 in Sweden) for 1,400 deaths. 0.4 percent of those over 80 died. The excess mortality is to be explained by the high proportion of the elderly in the Swedish population and the very low rate of influenza vaccination before the outbreak. As the increase in the proportion of the very elderly can be expected to continue, future influenza epidemics will result in even higher mortality unless adequate prophylactic measures are taken.