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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 19 (2008), Issue 2, Pages 185-192
http://dx.doi.org/10.1155/2008/538975
Original Article

Mathematical Assessment of Canada’s Pandemic Influenza Preparedness Plan

Abba B Gumel,1 Miriam Nuño,2 and Gerardo Chowell3,4

1Department of Mathematics, University of Manitoba, Winnipeg, Manitoba, Canada
2Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA
3Center for Nonlinear Studies, Mathematical Modeling and Analysis Group (MS B284), Los Alamos National Laboratory, Los Alamos, New Mexico, USA
4School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, USA

Received 25 April 2007; Accepted 4 September 2007

Copyright © 2008 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

OBJECTIVE: The presence of the highly pathogenic avian H5N1 virus in wild bird populations in several regions of the world, together with recurrent cases of H5N1 influenza arising primarily from direct contact with poultry, have highlighted the urgent need for prepared-ness and coordinated global strategies to effectively combat a potential influenza pandemic. The purpose of the present study was to evaluate the Canadian pandemic influenza preparedness plan.

PATIENTS AND METHODS: A mathematical model of the transmission dynamics of influenza was used to keep track of the population according to risk of infection (low or high) and infection status (susceptible, exposed or infectious). The model was parametrized using available Canadian demographic data. The model was then used to evaluate the key components outlined in the Canadian plan.

RESULTS: The results indicated that the number of cases, mortalities and hospitalizations estimated in the Canadian plan may have been underestimated; the use of antivirals, administered therapeutically, prophylactically or both, is the most effective single intervention followed by the use of a vaccine and basic public health measures; and the combined use of pharmaceutical interventions (antivirals and vaccine) can dramatically minimize the burden of the pending influenza pandemic in Canada. Based on increasing concerns of Oseltamivir resistance (wide-scale implementation), coupled with the expected unavailability of a suitable vaccine during the early stages of a pandemic, the present study evaluated the potential impact of non-pharmaceutical interventions (NPIs) which were not emphasized in the current Canadian plan. To this end, the findings suggest that the use of NPIs can drastically reduce the burden of a pandemic in Canada.

CONCLUSIONS: A deterministic model was designed and used to assess Canada’s pandemic preparedness plan. The study showed that the estimates of pandemic influenza burden given in the Canada pandemic preparedness plan may be an underestimate, and that Canada needs to adopt NPIs to complement its preparedness plan.