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FluAid is a test version of software created by programmers at the Centers for Disease Control and Prevention (CDC). It is designed to assist state and local level planners in preparing for the next influenza pandemic by providing estimates of potential impact specific to their locality. FluAid provides only a range of estimates of impact in terms of deaths, hospitalizations, and outpatients visits due to pandemic influenza. The software cannot describe when or how people will become ill, nor how a pandemic may spread through a society over time. For more information on FluAid and its utility in pandemic influenza planning, please click on the following links:
Introduction
Influenza pandemics have occurred three times in the 20th century: 1918, 1957, and 1968. Experts predict that another influenza pandemic is highly likely, if not inevitable. The impact of an influenza pandemic can be devastating. For example, it has been estimated that over 20 million people died during the pandemic of 1918. Prepandemic planning, therefore, is essential if influenza pandemic-related morbidity, mortality, and social disruption are to be minimized. Unfortunately, no one can predict when the next pandemic will occur, nor can they accurately forecast who will become ill and suffer adverse health outcomes such as death and hospitalization. State and local-level influenza pandemic plansPart of the national influenza pandemic plan calls for each state to develop its own state-specific plan to deal with an influenza pandemic. To develop such plans, state and local level public health planners need to have estimates of the potential impact of a pandemic in their state or locality. National level estimates of impact may not be useful when creating state or local level plans. FluAid was developed to provide state and local level planners with estimates of potential impact specific to their localities. A set of guidelines for state and local officials on pandemic influenza preparedness can be accessed at http://www.cdc.gov/od/nvpo/pandemicflu.htm. FluAid is designed to provide a range of estimates of impact in terms of deaths, hospitalizations, and outpatient visits due to pandemic influenza. The methodology used to design the software is similar to that used to calculate national level estimates of impact (Meltzer, Cox and Fukuda, 1999a, 1999b). The one notable difference is that, unlike the model used to calculate national level estimates, the software does not use Monte-Carlo methodologies to provide ranges of estimates. Instead, the software requires that the user supply minimum, most likely, and maximum estimates of some inputs (e.g., rates of death per 1,000 population). These data are then used by the program to provide estimates of the minimum, most likely, and maximum impact of an influenza pandemic. Another important difference between the state and local level model and the national level model is that the latter included a predefined age distribution of cases. For simplicity, this assumption was omitted from the state and local level model. Data sourcesGiven this uncertainty, it is advisable to run this model several times. Once you have become adept at using FluAid, you may wish to consider a plan wherein you systematically alter the values of input variables. You may alter one variable at a time (univariate sensitivity analysis), or alter the values of two or more variables simultaneously (multivariate sensitivity analysis). Different results due to different values for the input variables will help you obtain a sense of the relative importance of each variable in determining the size of the estimated impacts. Given the inherent uncertainty associated with trying to estimate the potential impact of the next influenza pandemic, it is recommended that you avoid the temptation of using the software to obtain a single set of estimates describing the potential impact. Rather, FluAid should be used to obtain a range of estimates of potential impact. Although decision makers, the media, and the public may expect a single estimate of impact, the interest of public health may be better served if the degree of uncertainty is at least partially explained. Users are encouraged
to download the FluAid 2.0 User's Manual to obtain additional
information regarding the use and interpretation of results, as well
as comments on the general modeling philosophy used in designing
FluAid. In addition to the resources listed in the References
section, two scientific papers that address the economic impact of
an influenza pandemic can be found at the CDC's Web site, or by
clicking on the links provided below:
1. Meltzer MI, Cox NJ, Fukuda K. The economic
impact of pandemic influenza in the United States: Implications for
setting priorities for interventions. Emerg Infect Dis 1999:5(5);
659-671. http://www.cdc.gov/ncidod/EID/vol5no5/meltzer.htm
2. Meltzer MI, Cox NJ, Fukuda K. Modeling the
economic impact of pandemic influenza in the United States:
Implications for setting priorities for intervention. Background
paper. http://www.cdc.gov/ncidod/EID/vol5no5/melt_back.htm 1. CDC.
Prevention and Control of Influenza: Recommendations of the CDC
Advisory Committee on Immunization Practices (ACIP). MMWR
1999;48(RR-04):1-28. 2. Cliff AD, Haggett
P. Statistical modeling of measles and influenza outbreaks. Statl
Methods Med Res 1993;2:43-73. 3. Meltzer MI, Cox NJ, Fukuda K.
1999a. The economic impact of pandemic influenza in the United
States: Implications for setting priorities for intervention. Emerg
Infect Dis 1999:5(5). Available on the Web at: http://www.cdc.gov/ncidod/eid/vol5no5/meltzer.htm 4. Meltzer MI, Cox NJ, Fukuda K.
1999b. Modeling the economic impact of pandemic influenza in
the United States: Implications for setting priorities for
intervention. Background paper: available on the Web at:
http://www.cdc.gov/ncidod/eid/vol5no5/melt_back.htm 5. Simonsen L, Clarke MJ, Williamson GD, et al.
The impact of influenza epidemics on mortality: Introducing a
severity index. Am J Public Health
1997;87:1944-1950. 6. U.S. Bureau of the Census. 1999a.
International database, Table -094 Midyear population, by age
and sex, 1997. [online database] Feb 1999: Available from: http://www.census.gov 7. U.S. Bureau of the Census.
1999b. Estimates of the population of the U.S., regions, and
states, by selected age groups and sex: Annual time series, July 1,
1990 to July 1, 1997. [online database] Feb 1999: Available
from: http://www.census.gov
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Control and Prevention |