Abstract

Another influenza pandemic, following the 1918, 1957 and the 1968 pandemic, is likely if not inevitable. In a 'regular' influenza-epidemic 5-20% of the population is to become clinically ill; during a pandemic this percentage can mount to 30 or even 50%. A pandemic could cause substantial social disruption, insofar it would involve a large proportion of the population contracting a serious or less serious form of the illness. In order to minimise the effects on the population of such a potential pandemic the Dutch Ministry on Health has drawn up an influenza pandemic plan to be prepared on coping with large morbidity and health care use. The objective of this study is to calculate the expected number of hospital admissions and mortality in case of pandemic influenza. As many uncertainties are involved in this type of studies, we have developed alternative scenarios and consulted experts to give their opinion on these scenarios and on the underlying model and assumptions. The intervention scenarios are compared on their effect in terms of avoided hospitalisation and mortality. Possible intervention strategies are influenza vaccination or pneumococcal (one of the possible complications of influenza) vaccination of certain groups or prescription (within 48 hours after first symptoms) of antivirals for each person with an influenza like illness. Describing and comparing the alternatives gives insight and is therefore helpful to policy makers on national and on a local level. The availability of the underlying decision support model gives the opportunity to (quickly) update estimations on hospitalisation and mortality based on foreign monitoring data.