Influenza and influenza-like syndromes: the subjects’ beliefs, the attitude to prevention and treatment, and the impact in Italian general population

Abstract

BackgroundInfluenza and influenza-like syndromes (I-LSs) are infectious diseases occurring on a seasonal basis which can lead to upper (URTI) and lower respiratory tract illness (LRTI) of different severity. The approach to these disorders is unfortunately not uniform. Aim of the study was to investigate real-life people beliefs, the attitude to their prevention and treatment, and their impact in general population.MethodsA cross-sectional survey via Computer Assisted Telephone Interview (CATI) was carried out using a specific questionnaire investigating influenza episode rates, subjects behavior in case of influenza and I-LSs, and prescribed therapy.Results1,202 subjects completed the questionnaire: median age was 46, 49% male, 20% active smokers. 57% of respondents experienced at least one episode of influenza or I-LS in the previous 12 months; episodes were usually home-managed, shorter than 2 weeks and more frequent in fall and winter (73% of the total). GP resulted the first health-care option (56%); almost 3% of respondents referred to the emergency room, and hospitalization occurred in 1%. Mucolytics resulted the most prescribed drugs (55%) followed by antibiotics and aerosol therapy (37–38%). Even if more than 70% of subjects considered vaccination essential, only 14% received influenza vaccination yearly and almost 60% had never received vaccination. Approximately 36% of respondents regarded homeopathy (namely Oscillococcinum) as an helpful alternative because of perceived as safer.ConclusionsSeasonal prevalence of I-LSs and influenza partially overlap. As virus identification is not a common procedure in daily practice, only a clinical discrimination is possible. Antibiotic prescription is still too high and largely inappropriate. Influenza vaccination is strongly encouraged, but different strategies are also used. Other approaches are receiving increasing attention in general population, and subjects’ willingness to spend out-of-pocket for effective remedies is also increasing. The discrepancy between subjects’ beliefs and health care actions likely reflects the insufficiency of institutional preventive strategies. In general, the approach to influenza and I-LSs appear variable and highly dependent of subjects’ and their GPs’ cultural beliefs.

Registered incidence of acute upper respiratory tract infections diagnosed by primary care physicians in Poland – 5-year retrospective analysis of the national health insurance database

“…Influenza tends to occur in late autumn and winter, while other URTIs have a much more diffuse occurrence throughout the year. Similar results were also reported by the authors of other studies [21,22]. The influenza-related burden varies by age and season [28,29,30].…”

“…In that study, 93% of patients seeking professional medical help were consulted by GPs, which is slightly lower than in the current study [22]. NHS figures for 2012-2013, show that, in Scotland, patients were most likely to consult a doctor or nurse for URTI symptoms such as coughing, wheezing or shortness of breath, with 70% of them seeking advice from a GP [23].…”

Cost of acute cough in Italian children

“…Concerning the therapeutic approach, in agreement with data from previous studies, 28 – 30 the majority of pediatricians’ home prescriptions consist of antibiotics, followed by corticosteroid (mostly via the inhalation route), mucolytics, antitussive drugs, and nonsteroidal anti-inflammatory agents. The reported characteristics of cough episodes would have suggested the occurrence of an upper airway viral infection in the majority of cases, and the immediate prescription of antibiotics and/or oral steroids should then have been regarded as an inappropriate first-line therapeutic choice.…”

Understanding the Global Burden of Influenza in Adults Aged 18–64 years: A Systematic Literature Review from 2012 to 2022

“…The SLR identified 23 studies that reported the clinical burden, exerted by at least one of influenza-associated hospital or ICU admissions or ER or outpatient visits, while 10 studies were identified reporting influenza-related mortality in the general population aged 18–64 years. Influenza-related hospitalization was reported in eight countries where most studies were conducted in the US ( n = 5) [ 20 , 22 – 25 ], followed by Spain ( n = 3) [ 21 , 26 , 27 ], two in Japan [ 28 , 29 ], and only one in Italy [ 30 ], Germany [ 31 ], France [ 32 ], China [ 33 ], and Brazil [ 34 ], as shown in Fig. 4 .…”