Influenza-like Illness, the Time to Seek Healthcare, and Influenza Antiviral Receipt During the 2010–2011 Influenza Season—United States

Abstract

Background Few data exist describing health care seeking behaviors among persons with influenza-like illness (ILI) or adherence to influenza antiviral treatment recommendations. Methods We analyzed adult responses to the Behavioral Risk Factor Surveillance System in 31 states and the District of Columbia (D.C.) and pediatric responses in 25 states and D.C. for January – April 2011 by demographics and underlying health conditions. Results Among 75,088 adult and 15,649 child respondents, 8.9% and 33.9%, respectively, reported ILI. ILI was more frequent among adults with asthma (16%), chronic obstruction pulmonary disease (COPD; 26%), diabetes (12%), heart disease (19%), kidney disease (16%), or obesity (11%). Forty-five percent of adults and 57% of children sought health care for ILI. Thirty-five percent of adults sought care ≤2 days after ILI onset. Seeking care ≤2 days was more frequent among adults with COPD (48%) or heart disease (55%). Among adults with a self-reported physician diagnosis of influenza, 34% received treatment with antiviral medications. The only underlying health condition with a higher rate of treatment was diabetes (46%). Conclusion Adults with underlying health conditions were more likely to report ILI, but the majority did not seek care promptly, missing opportunities for early influenza antiviral treatment.

Predictors of influenza among older adults in the emergency department

“…Similarly, in other studies of community-dwelling adults, patients with influenza most commonly sought healthcare 3–7 days after symptom onset [8, 27]. A recent meta-analysis showed that early treatment (within two days of symptom onset) with neuraminidase inhibitors is associated with decreased mortality risk compared to later treatment [28].…”

Incidence of medically attended influenza during pandemic and post-pandemic seasons through the Influenza Incidence Surveillance Project, 2009–13

“…Identification of patients aged 65 years or older was low, but representative of differences in primary care use and incidence of influenza-like illness by age. 31 Notably, we used the case definition of influenza-like illness for surveillance to conserve resources and guide diagnostic testing, but it does not represent the full scope of influenza illness; therefore, we hope that the incidence of visits for influenza-associated influenza-like illness presented in this report will inform studies to estimate the much broader scope of influenza disease burden.…”

Estimating the United States Demand for Influenza Antivirals and the Effect on Severe Influenza Disease During a Potential Pandemic

“…To do so, we used assumptions regarding the clinical attack rate [22], the proportion of the population that would likely require treatment, seek medical care and be prescribed NAIs [25, 26], the number of regimens that may be dispensed for chemoprophylaxis or saved for a personal stockpile, and the proportion of those with non-influenza illness who may also receive NAI treatment [27]. We modeled the provision of antiviral treatment using the 16 scenarios described above.…”