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Could an influenza pandemic like the one in 1918-1920 happen today? Volume 6, issue 4, Juillet-Août 2007

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Département EGERIES, École nationale de la santé publique (ENSP), Avenue du Prof. Léon Bernard, 35043 Rennes cedex

The scale of the international preparation to cope with a possible influenza pandemic in the years to come is due in part to memories of the great pandemic of 1918. The objective of this study was to model the development of an epidemic with a virus similar to the current highly pathogenic avian influenza virus (H5N1) and show possible epidemiologic differences according to the context then and now. Should an epidemic occur, it will probably be recognized before a pandemic is unleashed. Data used for this study indicate that we should expect on the order of 4,000 cases at the beginning of the epidemic, with 1,000 deaths in less than three weeks. The established international surveillance system should be able to detect and react to these numbers. According to current scientific data, therefore, a major influenza pandemic appears rather improbable, unless it begins in a situation where a deterioration in health and health care has already made case reporting more difficult. Our model shows that the age groups most strongly affected may be those aged 10-50 years, mainly people in the labor market and more women than men. If these hypotheses are correct, they indicate flaws in some aspects of current pandemic preparedness planning.