Conceptional considerations for a German influenza pandemic preparedness plan.
A pandemic appearance of influenza A virus must be expected at any time. The limitations of health preserving and life-saving resources, which will inevitably be reached in the event of a pandemic, will be accompanied by ethical and possibly social conflicts, which can be lessened or resolved only through precautionary planning, clearly specified competencies and transparent decisions within a social consensus. In case of a shortage of vaccines and virostatic agents, decisions will have to be made with regard to the segment of the population that absolutely must be vaccinated. It is currently estimated that a (monovalent) vaccine developed for a new pandemic strain would only suffice for the single vaccination of approximately half of the German population after a year; only 10-14 million vaccine dosages would be available to provide basic immunization and single boosters to personnel required to maintain basic medical care and essential infrastructure after half a year. In the event of local influenza outbreaks, antiviral chemotherapeutic agents could be used to close the gap until a vaccine can become effective. Even if suitable influenza vaccines and virostatic agents are not sufficiently available at the start of a pandemic, it is still possible to at least prevent an outbreak of two of the most feared secondary infections that accompany influenza: pneumococcal pneumonia or meningitis and illnesses resulting from Haemophilus influenzae. Agreement still needs to be reached with manufacturers for guaranteeing the necessary vaccine production or ensuring that they have a sufficient stock to meet the minimum demand for antiviral agents and agents for symptomatic treatment.
Fock
R
R
Robert Koch Institute, Nordufer 20, 13352 Berlin, Germany. FockR@rki.de
Bergmann
H
H
Bussmann
H
H
Fell
G
G
Finke
E-J
EJ
Koch
U
U
Niedrig
M
M
Peters
M
M
Scholz
D
D
Wirtz
A
A
D000998:Antiviral Agents / Q000627:therapeutic use; D018890:Chemoprevention; D003140:Communicable Disease Control; D004196:Disease Outbreaks / Q000517:prevention & control*; D005858:Germany / Q000453:epidemiology; D006285:Health Planning; D006801:Humans; D009980:Influenza A virus / Q000472:pathogenicity; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control*; D011018:Pneumonia, Pneumococcal / Q000517:prevention & control; D014611:Vaccination
D000998:Antiviral Agents; D007252:Influenza Vaccines