In conclusion, we have shown that the sH5 3 protein produced in mammalian cells elicited protective immune responses in mice and chickens when adjuvanted with Stimune. Chickens protected against the lethal H5N1 challenge also did not shed the virus at day 7 post infection. As these recombinant HA vaccines can be manufactured with high yields and a relatively short lead time, they offer an attractive alternative vaccination strategy, which will allow a rapid response to circulating and potentially pandemic influenza viruses. Hospital Triage System for Adult Patients Using an Influenza-Like Illness Scoring System during the 2009 Pandemic—Mexico BACKGROUND: Pandemic influenza A (H1N1) virus emerged during 2009. To help clinicians triage adults with acute respiratory illness, a scoring system for influenza-like illness (ILI) was implemented at Hospital Civil de Guadalajara, Mexico. METHODS: A medical history, laboratory and radiology results were collected on emergency room (ER) patients with acute respiratory illness to calculate an ILI-score. Patients were evaluated for admission by their ILI-score and clinicians' assessment of risk for developing complications. Nasal and throat swabs were collected from intermediate and high-risk patients for influenza testing by RT-PCR. The disposition and ILI-score of those oseltamivir-treated versus untreated, clinical characteristics of 2009 pandemic influenza A (H1N1) patients versus test-negative patients were compared by Pearson's Χ(2), Fisher's Exact, and Wilcoxon rank-sum tests. RESULTS: Of 1840 ER patients, 230 were initially hospitalized (mean ILI-score = 15), and the rest were discharged, including 286 ambulatory patients given oseltamivir (median ILI-score = 11), and 1324 untreated (median ILI-score = 5). Fourteen (1%) untreated patients returned, and 3 were hospitalized on oseltamivir (median ILI-score = 19). Of 371 patients tested by RT-PCR, 104 (28%) had pandemic influenza and 42 (11%) had seasonal influenza A detected. Twenty (91%) of 22 imaged hospitalized pandemic influenza patients had bilateral infiltrates compared to 23 (38%) of 61 imaged hospital test-negative patients (p<0.001). One patient with confirmed pandemic influenza presented 6 days after symptom onset, required mechanical ventilation, and died. CONCLUSIONS: The triaging system that used an ILI-score complimented clinicians' judgment of who needed oseltamivir and inpatient care and helped hospital staff manage a surge in demand for services. The severity of seasonal influenza epidemics is unpredictable and influenced by the predominant circulating virus strains and level of immunity in the population [1] . During peak community influenza activity, hospitals and emergency rooms may be overwhelmed by patients presenting with influenza-like illness (ILI) and more severe disease [2, 3] . Illness attack rates may be higher among most age groups during pandemics than observed for seasonal influenza due to limited immunity among exposed populations [4] . The re-emergence of highly pathogenic avian influenza A (H5N1) virus among poultry with sporadic transmission to exposed persons and the resulting high mortality has stimulated global influenza pandemic preparedness [5] .