Influenza Burden of Illness

Carrat, Fabrice; Sahler, Camille; Ranger-Rogez, Sylvie; Leruez‐Ville, Marianne; Freymuth, F.; Galès, Catherine Le; Bungener, Martine; Housset, B.; Nicolas, Marlène; Rouzioux, Christine

doi:10.1001/archinte.162.16.1842

Cited by 115 publications

(41 citation statements)

References 29 publications

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“…The mean number of work days lost because of influenza in our study was similar to that reported from other countries such as France, Finland, Italy, Japan, and the United States 11, 27, 28, 29, 30. Our results were in keeping with various studies that suggest that indirect costs comprise the bulk of the economic burden associated with influenza illness in middle‐ and high‐income countries 5, 31, 32.…”

Section: Discussionsupporting

confidence: 91%

A population‐based estimate of the economic burden of influenza in Peru, 2009–2010

Tinoco

Azziz‐Baumgartner

Rázuri

et al. 2016

Influenza Resp Viruses

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IntroductionInfluenza disease burden and economic impact data are needed to assess the potential value of interventions. Such information is limited from resource‐limited settings. We therefore studied the cost of influenza in Peru.MethodsWe used data collected during June 2009–December 2010 from laboratory‐confirmed influenza cases identified through a household cohort in Peru. We determined the self‐reported direct and indirect costs of self‐treatment, outpatient care, emergency ward care, and hospitalizations through standardized questionnaires. We recorded costs accrued 15‐day from illness onset. Direct costs represented medication, consultation, diagnostic fees, and health‐related expenses such as transportation and phone calls. Indirect costs represented lost productivity during days of illness by both cases and caregivers. We estimated the annual economic cost and the impact of a case of influenza on a household.ResultsThere were 1321 confirmed influenza cases, of which 47% sought health care. Participants with confirmed influenza illness paid a median of $13 [interquartile range (IQR) 5–26] for self‐treatment, $19 (IQR 9–34) for ambulatory non‐medical attended illness, $29 (IQR 14–51) for ambulatory medical attended illness, and $171 (IQR 113–258) for hospitalizations. Overall, the projected national cost of an influenza illness was $83–$85 millions. Costs per influenza illness represented 14% of the monthly household income of the lowest income quartile (compared to 3% of the highest quartile).ConclusionInfluenza virus infection causes an important economic burden, particularly among the poorest families and those hospitalized. Prevention strategies such as annual influenza vaccination program targeting SAGE population at risk could reduce the overall economic impact of seasonal influenza.

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Section: Discussionsupporting

confidence: 91%

A population‐based estimate of the economic burden of influenza in Peru, 2009–2010

Tinoco

Azziz‐Baumgartner

Rázuri

et al. 2016

Influenza Resp Viruses

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“…OECD statistics on employment rates were used, representing the population of working age (15–64 years). The expected number of days taken off work for adults in this study was estimated as the product of the probability of taking time off (91% for sickness from influenza), [42] and the average duration of time off for influenza sickness, 4 days [42, 43]. This was applied to all countries and for all adult target groups.…”

Section: Methodsmentioning

confidence: 99%

Annual public health and economic benefits of seasonal influenza vaccination: a European estimate

et al. 2014

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BackgroundVaccination is currently the most effective means of preventing influenza infection. Yet evidence of vaccine performance, and the impact and value of seasonal influenza vaccination across risk groups and between seasons, continue to generate much discussion. Moreover, vaccination coverage is below recommended levels.MethodsA model was generated to assess the annual public health benefits and economic importance of influenza vaccination in 5 WHO recommended vaccination target groups (children 6 – 23 months of age; persons with underlying chronic health conditions; pregnant women; health care workers; and, the elderly, 65 years of age) in 27 countries of the European Union. Model estimations were based on standard calculation methods, conservative assumptions, age-based and country-specific data.ResultsOut of approximately 180 million Europeans for whom influenza vaccination is recommended, only about 80 million persons are vaccinated. Seasonal influenza vaccination currently prevents an annual average of between 1.6 million and 2.1 million cases of influenza, 45,300 to 65,600 hospitalizations, and 25,200 to 37,200 deaths. To reach the 75% vaccination coverage target set by the EU Council Recommendation in 2009, an additional 57.4 million person would need to be vaccinated in the elderly and other risk groups. By achieving the 75% target rate set in EU-27 countries, average annual influenza- related events averted would increase from current levels to an additional +1.6 to +1.7 million cases, +23,800 to +31,400 hospitalization, +9,800 to +14,300 deaths, +678,500 to +767,800 physician visits, and +883,800 to +1,015,100 lost days of work yearly. Influenza-related costs averted because of vaccination would increase by an additional + €190 to + €226 million yearly, in vaccination target groups.ConclusionsFull implementation of current influenza vaccination recommendations of 75% vaccination coverage rate (VCR) in Europe by the 2014–2015 influenza season could immediately reduce an important public health and economic burden.

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“…The interpandemic influenza SAR values in the literature vary widely, with some values in the 0.13-0.15 range, and others at 0.38 (Carrat et al, 2002) (which drops to 0.362 after accounting for coinfections Ferguson et al, 2005) and even higher (Carrat et al, 2002). Although the degree of population immunity plays a role in the SAR, one of the main reasons for this heterogeneity is the differences in how a case is defined: the higher values include low-grade illnesses (e.g., with no fever) and do not obtain lab confirmation of influenza (Carrat et al, 2002), and the lower numbers require severe symptoms that do not include more than one-third of the lab-confirmed cases. Hence, our SAR is near the lower end of the empirical range, which is also consistent with our assumption that all infecteds withdraw to the bedroom (i.e., have severe symptoms).…”

Section: Interpandemic Influenzamentioning

confidence: 99%

Quantifying the Routes of Transmission for Pandemic Influenza

2008

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Motivated by the desire to assess nonpharmaceutical interventions for pandemic influenza, we seek in this study to quantify the routes of transmission for this disease. We construct a mathematical model of aerosol (i.e., droplet-nuclei) and contact transmission of influenza within a household containing one infected. An analysis of this model in conjunction with influenza and rhinovirus data suggests that aerosol transmission is far more dominant than contact transmission for influenza. We also consider a separate model of a close expiratory event, and find that a close cough is unlikely ( approximately 1% probability) to generate traditional droplet transmission (i.e., direct deposition on the mucous membranes), although a close, unprotected and horizontally-directed sneeze is potent enough to cause droplet transmission. There are insufficient data on the frequency of close expiratory events to assess the relative importance of aerosol transmission and droplet transmission, and it is prudent to leave open the possibility that droplet transmission is important until proven otherwise. However, the rarity of close, unprotected and horizontally-directed sneezes-coupled with the evidence of significant aerosol and contact transmission for rhinovirus and our comparison of hazard rates for rhinovirus and influenza-leads us to suspect that aerosol transmission is the dominant mode of transmission for influenza.

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Influenza Burden of Illness

Abstract: These results confirm the substantial burden of illness of influenza. The results should be useful for evaluating the cost-effectiveness of strategies against influenza.

Cited by 115 publications

References 29 publications

A population‐based estimate of the economic burden of influenza in Peru, 2009–2010

A population‐based estimate of the economic burden of influenza in Peru, 2009–2010

Annual public health and economic benefits of seasonal influenza vaccination: a European estimate

Quantifying the Routes of Transmission for Pandemic Influenza

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