Pandemic influenza in Papua New Guinea: a modelling study comparison with pandemic spread in a developed country

Milne, George J; Baskaran, Pravin; Halder, Nilimesh; Karl, Stephan; Kelso, Joel

A substantial number of pandemic influenza models have been constructed in the past decade; however their primary focus is on examining intervention effectiveness in developed (e.g. the USA and European countries [7] [8] [9] [10] ) and middle income countries (e.g. Thailand [11, 12] ). These models, and analyses using them, give limited guidance as to the impact which an influenza pandemic may have on lowincome countries such as PNG and those in sub-Saharan Africa [13] . These countries have markedly different demographic and community structure and limited resources and infrastructural constraints in comparison with developed countries. Significantly, it has been shown that co-morbidity is a strong predictor for severe and fatal outcomes following influenza infection [14] . High rates of co-morbidity arising from influenza infection coupled with disease conditions generally absent in developed countries (such as chronic malnutrition, malaria, tuberculosis, pneumonia and HIV) will result in a significantly increased burden on health infrastructures in low-income countries already operating above capacity.