Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 9, Number 5—May 2003
Research

Pandemic Influenza and Healthcare Demand in the Netherlands: Scenario Analysis

Marianne L.L. van Genugten*Comments to Author , Marie-Louise A. Heijnen*, and Johannes C. Jager*
Author affiliations: *National Institute for Public Health and the Environment, Bilthoven, the Netherlands

Main Article

Table 1

Assumptions made for influenza pandemic scenario analysis, the Netherlands

Scenario Assumptions in base case Assumptions in sensitivity analysis
No intervention
Gross attack rate of 30%; age-specific attack, hospitalization, and death rates as in regular epidemic; and healthcare utilization as in regular epidemic.
Gross attack rate of 10% and 50%; age-specific attack rates (see Table 4); and complication rates for a) persons <64 y of age x 2 and b) persons at low risk equal to persons at high risk.
Influenza vaccination of
risk groups (including persons >65 y of age) and healthcare workers
Gross attack rate of 30%; age-specific attack, hospitalization, and death rates as in regular epidemic; and vaccine efficacy 80% (<64 y of age) (13,14) and 56% (>65 y) (15) to prevent hospitalizations and deaths
Gross attack rate of 10% and 50%; age-specific attack rates (see Table 4); complication rates for a) age group <64 y times 2 and b) persons at low risk equal to persons at high risk; influenza vaccine efficacy a) 80% for all ages and b) 40% for age group <64a and 30% for age group >65b.
Pneumococcal vaccination of influenza of risk groups (including persons aged >65 y)
Gross attack rate of 30%; age-specific attack, hospitalization, and death rates as in regular epidemic; 50% pneumococcal-related hospitalizations; and vaccine efficacy 64% against invasive infections (16,17).
Gross attack rate of 10% and 50%; age-specific attack rates (see Table 4); complication rates for a) persons <64 y of age x 2 and b) persons at low risk equal to persons at high risk; 25% and 75% pneumococcal-related hospitalizations; and vaccine efficacy 25% and 75%.
Therapeutic use of neuraminidase inhibitors for all patients with influenzalike illness Gross attack rate of 30%; age-specific attack, hospitalization, and death rates as in regular epidemic; and 50% reduction of hospitalizations and deaths. Gross attack rate of 10% and 50%; age-specific attack rates (see Table 4); complication rates for a) persons <64 y of age times 2 and b) persons at low risk equal to persons at high risk.; and 25% to 75% reduction of hospitalizations and deaths.

aMinimum variant based (9).
bMaximum variant assumes 80% efficacy for all ages

Main Article

References
  1. Yuen  KY, Chan  PKS, Peiris  M, Tsang  DNC, Que  TL, Shortridge  KF, Clinical features and rapid viral diagnosis of human disease associated with avian influenza A H5N1 virus. Lancet. 1998;351:46771. DOIPubMedGoogle Scholar
  2. Claas  ECJ, Osterhaus  ADME, van Beek  R, de Jong  JC, Rimmelzwaan  GF, Senne  DA, Human influenza A H5N1 virus related to a highly pathogenic avian influenza virus. Lancet. 1998;351:4727. DOIPubMedGoogle Scholar
  3. Patriarca  PA, Cox  NJ. Influenza pandemic preparedness plan for the United States. J Infect Dis. 1997;176(Suppl 1):S47. DOIPubMedGoogle Scholar
  4. Belshe  RB. Influenza as a zoonosis: how likely is a pandemic? [Commentary]. Lancet. 1998;351:4601. DOIPubMedGoogle Scholar
  5. World Health Organization, Department of Communicable Disease Surveillance and Response. Influenza pandemic plan. The role of the WHO and guidelines for national and regional planning. 1999 Apr. Available from: URL: www.who.int/emc-documents/influenza
  6. Snacken  R, Kendal  AP, Haaheim  LR, Wood  JM. The next influenza pandemic: lessons from Hong Kong, 1997. Emerg Infect Dis. 1999;5:1959. DOIPubMedGoogle Scholar
  7. Osterhaus  ADME, de Jong  JC. The control of influenza: antivirals as an adjunct to vaccines. Vaccine. 1999;18:77980. DOIPubMedGoogle Scholar
  8. Centers for Disease Control and Prevention. Neuraminidase inhibitors for treatment of influenza A and B infections. MMWR Recomm Rep. 1999;48:19.PubMedGoogle Scholar
  9. Meltzer  MI, Cox  NJ, Fukuda  K. The economic impact of pandemic influenza in the United States: priorities for intervention. Emerg Infect Dis. 1999;5:65971. DOIPubMedGoogle Scholar
  10. Scuffham  PA, West  PA. Economic evaluation of strategies for the control and management of influenza in Europe. Vaccine. 2002;20:256278. DOIPubMedGoogle Scholar
  11. van Genugten  MLL, Rutten  FFH, Jager  JC. Scenario development and costing in health care. Methodological accomplishments and practical guidelines. Utrecht (Netherlands): International Books; 1996.
  12. van Genugten  MLL, Heijnen  MLA, Jager  JC. Scenario analysis of the expected number of hospitalizations and deaths due to pandemic influenza in the Netherlands. Bilthoven (Netherlands): National Institute of Public Health and the Environment; 2002. RIVM report 282701002/2002. Available from: URL: www.rivm.nl/bibliotheek/rapporten/282701002.pdf
  13. Cox  NJ, Subbarao  K. Influenza. Lancet. 1999;354:127782. DOIPubMedGoogle Scholar
  14. Couch  RB. Prevention and treatment of influenza. N Engl J Med. 2000;343:177887. DOIPubMedGoogle Scholar
  15. Gross  PA, Hermogenes  AW, Sacks  HS, Lau  JL, Levandowski  RA. The efficacy of influenza vaccine in elderly persons. A meta-analysis and review of the literature. Ann Intern Med. 1995;123:51827.PubMedGoogle Scholar
  16. Postma  MJ, Heijnen  MLA, Jager  JC. Cost-effectiveness analysis of pneumococcal vaccination for elderly individuals in the Netherlands. Pharmacoeconomics. 2001;19:21522. DOIPubMedGoogle Scholar
  17. Shapiro  ED, Berg  AT, Austrian  R, Schroeder  D, Parcells  V, Margolis  A, The protective efficacy of polyvalent pneumococcal polysaccharide vaccine. N Engl J Med. 1991;325:145360. DOIPubMedGoogle Scholar
  18. Health Council. Commissie vaccinatie tegen influenza. Vaccinatie bij een griep pandemie. Den Haag: Gezondheidsraad; 2000. Publication no. 2000/1.
  19. Gubareva  LV, Kaiser  L, Hayden  FG. Influenza virus neuraminidase inhibitors. Lancet. 2000;355:82735. DOIPubMedGoogle Scholar
  20. Hayden  FG, Osterhaus  ADME, Treanor  JJ, Fleming  DM, Aoki  FY, Nicholson  KG, Efficacy and safety of the neuraminidase inhibitor Zanamivir in the treatment of influenza virus infections. N Engl J Med. 1997;337:87480. DOIPubMedGoogle Scholar
  21. MIST study group. Randomised trial of efficacy and safety of inhaled Zanamivir in treatment of influenza A and B virus infections. Lancet. 1998;352:187781. DOIPubMedGoogle Scholar
  22. Mäkelä  MJ, Pauksens  K, Rostila  T, Fleming  DM, Man  CY, Keene  ON, Clinical efficacy and safety of the orally inhaled neuaraminadase inhibitor Zanamivir in the treatment of influenza: a randomized, double-blind, placebo-controlled European study. J Infect. 2000;40:428. DOIPubMedGoogle Scholar
  23. Treanor  JJ, Hayden  FG, Vrooman  PS, Barbarash  R, Bettis  R, Riff  D, Efficacy and safety of the oral neuraminidase inhibitor oseltamivir in treating acute influenza: a randomized controlled trial. JAMA. 2000;283:101624. DOIPubMedGoogle Scholar
  24. Nicholson  KG, Aoki  FY, Osterhaus  ADME, Trottier  S, Carewicz  O, Mercier  CH, Efficacy and safety of oseltamivir in treatment of acute influenza: a randomised controlled trial. Lancet. 2000;355:184550. DOIPubMedGoogle Scholar
  25. Hedrick  JA, Barzilai  A, Behre  U, Henderson  FW, Hammond  J, Reilly  L, Zanamivir for treatment of symptomatic influenza A and B infection in children five to twelve years of age: a randomized controlled trial. Pediatr Infect Dis J. 2000;19:4107. DOIPubMedGoogle Scholar
  26. Whitley  RJ, Hayden  FG, Reisinger  KS, Young  N, Dutkowski  R, Ipe  D, Oral oseltamivir treatment of influenza in children. Pediatr Infect Dis J. 2001;20:12733. DOIPubMedGoogle Scholar
  27. Monto  AS, Robinson  DP, Herlocher  ML, Hinson  JM, Elliott  MJ, Crisp  A. Zanamivir in the prevention of influenza among healthy adults: a randomized controlled trial. JAMA. 1999;282:315. DOIPubMedGoogle Scholar
  28. Murphy  KR, Eivindson  A, Pauksens  K, Stein  WJ, Tellier  G, Watts  R, Efficacy and safety of inhaled Zanamivir for the treatment of influenza in patients with asthma or COPD–a double-blind, randomized, placebo-controlled, multicentre study. Clin Drug Investig. 2000;20:33749. DOIGoogle Scholar
  29. Lalezari  J, Campion  K, Keene  O, Silagy  C. Zanamivir for the treatment of influenza A and B infection in high risk patients. Arch Intern Med. 2001;161:2127. DOIPubMedGoogle Scholar
  30. Hayden  FG, Gubareva  LV, Monto  AS, Klein  TC, Elliott  MJ, Hammond  JM, Inhaled Zanamivir for the prevention of influenza in families. N Engl J Med. 2000;343:12829. DOIPubMedGoogle Scholar
  31. Welliver  R, Monto  AS, Carewicz  O, Schatteman  E, Hassman  M, Hedrick  J, Effectiveness of oseltamivir in preventing influenza in household contacts: a randomized clinical trial. JAMA. 2001;285:74854. DOIPubMedGoogle Scholar
  32. Hayden  FG, Atmar  RL, Schilling  M, Johnson  C, Poretz  D, Paar  D, Use of the selective oral neuraminidase inhibitor to prevent influenza. N Engl J Med. 1999;341:133643. DOIPubMedGoogle Scholar
  33. Gubareva  LV, Matrosovich  MN, Brenner  MK, Bethell  RC, Webster  RG. Evidence for zanamivir resistance in an immunocompromised child infected with influenza B virus. J Infect Dis. 1998;178:125762. DOIPubMedGoogle Scholar
  34. McNichol  IR, McNichol  JJ. Neuraminidase inhibitors: zanamivir and oseltamivir. Ann Pharmacother. 2001;35:5770. DOIPubMedGoogle Scholar
  35. MacDonald  L. New influenza drugs Zanamivir (Relenza) and oseltamivir (Tamiflu): unexpected serious reactions. CMAJ. 2000;163:87981.PubMedGoogle Scholar
  36. Williamson  JC. Respiratory distress associated with zanamivir. N Engl J Med. 2000;342:6612. DOIPubMedGoogle Scholar
  37. Cliff  AD. Statistical modeling of measles and influenza outbreaks. Stat Methods Med Res. 1993;2:4373. DOIPubMedGoogle Scholar
  38. van Weel  C. William Pickles Lecture 1992: what our practices teach us. Br J Gen Pract. 1992;42:2069.PubMedGoogle Scholar
  39. Knottnerus  JA, Metsemakers  J, Höppener  P, Limonard  C. Chronic illness in the community and the concept of ‘social prevalence’. Fam Pract. 1992;9:1521. DOIPubMedGoogle Scholar
  40. Lamberts  H, Hofmans-Okkes  I. Episode of care: a core concept in family practice. J Fam Pract. 1996;42:1617.PubMedGoogle Scholar
  41. Bartelds  AIM. Continue morbiditeits registration peilstations Nederland 1999. Utrecht (Netherlands): Netherlands Institute of Health Services Research; 2000.
  42. Tacken  M, Braspenning  J, van Paassen  J, van den Hoogen  H, de Bakker  D, Grol  R. Nine years of influenza vaccination in the Netherlands in general practice [in Dutch]. Huisarts Wet. 2000;43:5667.
  43. Vademecum gezondheidsstatistiek, 1999 [in Dutch]. Statistics Netherlands, Heerlen (Netherlands): Voorburg; 1999.
  44. Baltussen  RMPM, Reinders  A, Sprenger  MJW, Postma  MJ, Jager  JC, Ament  AJHA, Estimating influenza related hospitalization in the Netherlands. Epidemiol Infect. 1998;121:12938. DOIPubMedGoogle Scholar
  45. Sprenger  MJW, Mulder  PGH, Beyer  WEP, van Strik  R, Masurel  N. Impact of influenza on mortality in relation to age and underlying disease, 1967–1989. Int J Epidemiol. 1993;22:33440. DOIPubMedGoogle Scholar

Main Article

Page created: December 08, 2010
Page updated: December 08, 2010
Page reviewed: December 08, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external