title: Estimates of the impact of a future influenza pandemic in China.
abstract: BACKGROUND
  The next influenza pandemic will create a surge in demand for health resources in China, with its current population of >1·3 billion persons and under-developed medical care and public health system. However, few pandemic impact data are available for China.
  
  
  OBJECTIVE
  We estimated the effects of a future influenza pandemic in China by examining pandemic scenarios of varying severity and described the time distribution of cases during a first wave.
  
  
  METHODS
  We used a Monte-Carlo simulation model and death rates, hospitalizations and outpatient visits for 1918- and 1968- like pandemic scenarios and data from the literature or experts' opinion to estimate four health outcomes: deaths, hospitalizations, outpatient medical visits and clinical illness for which medical care was not sought. For each of the two scenarios we estimated outcomes by week using a normal distribution.
  
  
  RESULTS
  We estimated that a 1968 scenario in China would result in 460,000-700,000 deaths, 1·94-2·27 million hospitalizations, 111-117 million outpatient visits and 192-197 million illnesses for which medical care was not sought. Fifty-two percent of hospitalizations occurred during the two-peak weeks of the first wave. We estimated that patients at high-risk of influenza complications (10-17% of the population) would account for 61-75% of all deaths. For a 1918 scenario, we estimated that 4·95-6·95 million deaths, 20·8-22·7 million hospitalizations and 101-108 million outpatient visits could occur.
  
  
  CONCLUSIONS
  Even a 1968 pandemic scenario will pose substantial challenges for the medical and public health system in China, and planning to manage these challenges is essential.
authors.affiliation: Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention (China CDC), Beijing, People's Republicof China.
authors.forename: Hongjie
authors.initials: H
authors.lastname: Yu
authors.forename: Luzhao
authors.initials: L
authors.lastname: Feng
authors.forename: Zhibin
authors.initials: Z
authors.lastname: Peng
authors.forename: Zijian
authors.initials: Z
authors.lastname: Feng
authors.forename: David K
authors.initials: DK
authors.lastname: Shay
authors.forename: Weizhong
authors.initials: W
authors.lastname: Yang
mesh_terms: D002681:China / Q000453:epidemiology; D004196:Disease Outbreaks; D005544:Forecasting; D006285:Health Planning / Q000379:methods*; D006295:Health Resources; D006760:Hospitalization; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology* / Q000401:mortality* / Q000503:physiopathology; D009010:Monte Carlo Method; D009819:Office Visits; D058873:Pandemics