Influenza has long been recognised as a disease which affects children; however, it is only fairly recently that the literature on this subject has switched focus from community settings towards the burden of hospitalisations. This issue carries an article by Frank Beard and colleagues which draws attention to the issue in Sydney, Australia and addresses the issue in a quantitative as well as a qualitative way.¹ It follows on from, and replicates the methodologies employed by similar pivotal studies in the USA and Hong Kong.^2,3

Most experienced commentators would agree that the foundations of our understanding of the burden of influenza in children, are based on data generated by a series of prospective community studies which took place in the 1960s and 1970s in the USA, all of which combined clinical surveillance with attempts at virus isolation and serological studies, to a greater or lesser extent. They are probably too large and too expensive to ever contemplate repeating in the present era. In Tecumseh, Michigan, between 100 and 300 families with at least one child were studied continuously for six years from 1966 to 1971—a period which included the emergence of influenza A/H3N2, the last pandemic virus, in 1968.⁴ In Seattle, Washington, a similar study took place between 1965 and 1969 and again from 1975 to 1979, involving over 215 families with young children.⁵ In Houston, Texas, similar observations were made over the period 1976 to 1984, including two influenza B epidemics.⁶ The findings of these major studies …