Canberra infectious diseases specialist warns that Australia's hospitals could not cope if there was an outbreak of influenza more virulent that last year's swine flu.

Professor Peter Collignon has studied the swine flu outbreak and discovered a number of problems associated with the response to the health emergency.

Intensive-care units in Australia managed to cope with the large numbers of generally younger influenza patients but had major problems and were worrying very stretched, said Prof Collignon in the Medical Journal of Australia.

This demonstrated the lack of spare capacity in our hospitals and ICUs a problem most apparent every winter.

Australia's population mortality rate from swine flu was 0.9 per 100,000. If a more virulent virus with a 1 per cent case-fatality rate infected 30 per cent of the population, our hospitals and ICUs could not cope.

Australia's work and school absenteeism during the outbreaks was comparable to the levels reported in the winter three years ago.

The 191 associated deaths were substantially fewer than the 3,000 estimated yearly deaths from seasonal influenza in Australia, said Prof Collignon.

Although, there may have been additional influenza-associated deaths that were not diagnosed by laboratory testing.

Being one of the first countries to produce, and distribute the vaccine, Australia's vaccination was only available at the end of September after the end of the epidemic.

In the future, it could be worthwhile to consider another approach to vaccination.

Currently, effective vaccines are only available after the horse has bolted. Because of poor matching, seasonal influenza vaccine efficacy varies from 50 per cent to 80 per cent, said Prof Collignon.

Australia Medicine