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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.

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