Modeling the critical care demand and antibiotics resources needed during the Fall 2009 wave of influenza A(H1N1) pandemic

While the H1N1 pandemic is reaching high levels of influenza activity in the Northern Hemisphere, the attention focuses on the ability of national health systems to respond to the expected massive influx of additional patients. Given the limited capacity of health care providers and hospitals and the limited supplies of antibiotics, it is important to predict the potential demand on critical care to assist planning for the management of resources and plan for additional stockpiling. We develop a disease model that considers the development of influenza-associated complications and incorporate it into a global epidemic model to assess the expected surge in critical care demands due to viral and bacterial pneumonia. Based on the most recent estimates of complication rates, we predict the expected peak number of intensive care unit beds and the stockpile of antibiotic courses needed for the current pandemic wave. The effects of dynamic vaccination campaigns, and of variations of the relative proportion of bacterial co-infection in complications and different length of staying in the intensive care unit are explored.

[1]  Stefano Merler,et al.  Age-prioritized use of antivirals during an influenza pandemic , 2009, BMC infectious diseases.

[2]  Steve Leach,et al.  Potential impact of antiviral drug use during influenza pandemic. , 2005 .

[3]  A. Flahault,et al.  Strategies for containing a global influenza pandemic. , 2006, Vaccine.

[4]  T. Geisel,et al.  Forecast and control of epidemics in a globalized world. , 2004, Proceedings of the National Academy of Sciences of the United States of America.

[5]  Alessandro Vespignani,et al.  Multiscale mobility networks and the spatial spreading of infectious diseases , 2009, Proceedings of the National Academy of Sciences.

[6]  M. Bonten,et al.  Antibiotics in pandemic flu , 2006, BMJ : British Medical Journal.

[7]  Alessandro Vespignani,et al.  influenza A(H1N1): a Monte Carlo likelihood analysis based on , 2009 .

[8]  Alessandro Vespignani,et al.  Predictability and epidemic pathways in global outbreaks of infectious diseases: the SARS case study , 2007, BMC medicine.

[9]  Paul A. Biedrzycki,et al.  The severity of pandemic H1N1 influenza in the United States, April – July 2009 , 2010, PLoS currents.

[10]  Gail E. Potter,et al.  The Transmissibility and Control of Pandemic Influenza A (H1N1) Virus , 2009, Science.

[11]  W. Edmunds,et al.  Delaying the International Spread of Pandemic Influenza , 2006, PLoS medicine.

[12]  Craig French,et al.  Life‐threatening respiratory failure from H1N1 influenza 09  (human swine influenza) , 2009, The Medical journal of Australia.

[13]  A Vespignani,et al.  Modeling vaccination campaigns and the Fall/Winter 2009 activity of the new A(H1N1) influenza in the Northern Hemisphere , 2009, Emerging health threats journal.

[14]  C. Fraser,et al.  Reducing the impact of the next influenza pandemic using household-based public health interventions. , 2006, Hong Kong medical journal = Xianggang yi xue za zhi.

[15]  K. Dietz,et al.  A structured epidemic model incorporating geographic mobility among regions. , 1995, Mathematical biosciences.

[16]  Anthony S Fauci,et al.  Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: implications for pandemic influenza preparedness. , 2008, The Journal of infectious diseases.

[17]  N. Arinaminpathy,et al.  Antiviral treatment for the control of pandemic influenza: some logistical constraints , 2008, Journal of The Royal Society Interface.

[18]  Mark A. Miller,et al.  Synchrony, Waves, and Spatial Hierarchies in the Spread of Influenza , 2006, Science.

[19]  M. Keeling,et al.  Estimating spatial coupling in epidemiological systems: a mechanistic approach , 2002 .

[20]  L. A. Rvachev,et al.  A mathematical model for the global spread of influenza , 1985 .

[21]  E. Lyons,et al.  Pandemic Potential of a Strain of Influenza A (H1N1): Early Findings , 2009, Science.

[22]  D. Cummings,et al.  Strategies for containing an emerging influenza pandemic in Southeast Asia , 2005, Nature.

[23]  H. Wunsch,et al.  Variation in critical care services across North America and Western Europe* , 2008, Critical care medicine.

[24]  Robert George,et al.  Bacterial Pneumonia and Pandemic Influenza Planning , 2008, Emerging infectious diseases.

[25]  J. H. Ellis,et al.  Erratum: Assessing the Impact of Airline Travel on the Geographic Spread of Pandemic Influenza , 2004, European Journal of Epidemiology.

[26]  S. Blower,et al.  Modeling influenza epidemics and pandemics: insights into the future of swine flu (H1N1) , 2009, BMC medicine.

[27]  R. Perez-Padilla,et al.  Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. , 2009, The New England journal of medicine.

[28]  Alicia M. Fry,et al.  Intensive-care patients with severe novel influenza A (H1N1) virus infection - Michigan, June 2009. , 2009, MMWR. Morbidity and mortality weekly report.

[29]  W. Lim Pandemic flu: clinical management of patients with an influenza-like illness during an influenza pandemic , 2007, Thorax.

[30]  C. Macken,et al.  Mitigation strategies for pandemic influenza in the United States. , 2006, Proceedings of the National Academy of Sciences of the United States of America.

[31]  Alessandro Vespignani,et al.  Modeling the Worldwide Spread of Pandemic Influenza: Baseline Case and Containment Interventions , 2007, PLoS medicine.

[32]  A. Nizam,et al.  Containing pandemic influenza with antiviral agents. , 2004, American journal of epidemiology.

[33]  A. Flahault First estimation of direct H1N1pdm virulence , 2009, PLoS currents.

[34]  C. Whitney,et al.  Bacterial coinfections in lung tissue specimens from fatal cases of 2009 pandemic influenza A (H1N1) - United States, May-August 2009. , 2009, MMWR. Morbidity and mortality weekly report.

[35]  Marc Lipsitch,et al.  Estimates of the Prevalence of Pandemic (H1N1) 2009, United States, April–July 2009 , 2009, Emerging infectious diseases.

[36]  J. Rello,et al.  Intensive care adult patients with severe respiratory failure caused by Influenza A (H1N1)v in Spain , 2009, Critical care.

[37]  D K Menon,et al.  Modelling the impact of an influenza A/H1N1 pandemic on critical care demand from early pathogenicity data: the case for sentinel reporting , 2009, Anaesthesia.

[38]  A. Flahault,et al.  A method for assessing the global spread of HIV-1 infection based on air travel. , 1992, Mathematical population studies.