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Influenza Burden of Illness
Estimates From a National Prospective Survey of Household Contacts in France
Fabrice Carrat, MD, PhD;
Camille Sahler, MPH;
Sylvie Rogez, PharmD, PhD;
Marianne Leruez-Ville, MD, PhD;
François Freymuth, MD, PhD;
Catherine Le Gales, PhD;
Martine Bungener, PhD;
Bruno Housset, MD;
Marlène Nicolas, MPH;
Christine Rouzioux, PhD
Arch Intern Med. 2002;162:1842-1848.
Background The burden of influenza among ambulatory patients is still relatively
unknown, although this knowledge is crucial for evaluating strategies against
influenza. We estimated the impact of influenza in terms of uncomplicated
morbidity and its consequences on health care utilization and lost workdays.
Methods A national prospective household contact study between January 4, 2000,
and March 15, 2000, in France recruited the households of 946 persons who
visited a physician (index cases); 395 households with influenza-positive
index cases completed the follow-up, which assessed the clinical impact of
influenza, medical visits, treatment, and lost workdays in these index cases
and their contacts.
Results Of 817 assessable household contacts, 313 developed clinical influenza
(secondary cases); 178 (57%) of them visited a physician at least once (consulting
secondary cases). The median duration of illness was 8 days (95% confidence
interval [CI], 7-8 days) in index cases, 7 days (95% CI, 7-8 days) in consulting
secondary cases, and 4 days (95% CI, 3-5 days) in nonconsulting secondary
cases (P<.001); the median duration of treatment
in these groups was 8 days (95% CI, 8-9 days), 8 days (95% CI, 7-10 days),
and 5 days (95% CI, 4-6 days), respectively (P<.001);
and their mean ± SD number of lost workdays was 4.0 ± 2.8, 2.9
± 2.5, and 0.3 ± 0.6, respectively, in working adults (P<.001).
Conclusions These results confirm the substantial burden of illness of influenza.
The results should be useful for evaluating the cost-effectiveness of strategies
against influenza.
From Institut National de la Santé et de la Recherche Médicale
(INSERM), Unit 444, Faculté de Médecine Saint-Antoine, Paris
(Dr Carrat and Ms Sahler); Laboratoire de Bactériologie, Virologie
et Hygiène, Centre Hospitalier Universitaire (CHU) Dupuytren, Limoges
(Dr Rogez); Laboratoire de Virologie, CHU Necker Enfants-Malades, Paris (Drs
Leruez-Ville and Rouzioux); Laboratoire de Virologie Humaine et Moléculaire,
CHU Côte de Nâcre, Caen (Dr Freymuth); INSERM Unit 537, Le Kremlin
Bicêtre (Dr Le Gales); INSERM Unit 502, Centre National de la Recherche
Scientifique (CNRS) Unit 8559, Paris (Dr Bungener); Service de Pneumologie,
Centre Hospitalier Inter-Communal, Créteil (Dr Housset); and Université
Paris II Panthéon–Assas, Paris (Ms Nicolas), France.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Time Lines of Infection and Disease in Human Influenza: A Review of Volunteer Challenge Studies
Carrat et al.
Am J Epidemiol 2008;167:775-785.
ABSTRACT
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Minerva
BMJ 2003;327:E178-178.
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Minerva
BMJ 2002;325:844-844.
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