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. 2018 Jan;12(1):171-182.
doi: 10.1111/irv.12506.

Effects of seasonal and pandemic influenza on health-related quality of life, work and school absence in England: Results from the Flu Watch cohort study

Ellen B Fragaszy  1   2 , Charlotte Warren-Gash  2 , Peter J White  3   4 , Maria Zambon  5 , William J Edmunds  2 , Jonathan S Nguyen-Van-Tam  6 , Andrew C Hayward  1   7 ; Flu Watch Group
Affiliations

Effects of seasonal and pandemic influenza on health-related quality of life, work and school absence in England: Results from the Flu Watch cohort study

Ellen B Fragaszy et al. Influenza Other Respir Viruses. 2018 Jan.

Abstract

Background: Estimates of health-related quality of life (HRQoL) and work/school absences for influenza are typically based on medically attended cases or those meeting influenza-like-illness (ILI) case definitions and thus biased towards severe disease. Although community influenza cases are more common, estimates of their effects on HRQoL and absences are limited.

Objectives: To measure quality-adjusted life days and years (QALDs and QALYs) lost and work/school absences among community cases of acute respiratory infections (ARI), ILI and influenza A and B and to estimate community burden of QALY loss and absences from influenza.

Patients/methods: Flu Watch was a community cohort in England from 2006 to 2011. Participants were followed up weekly. During respiratory illness, they prospectively recorded daily symptoms, work/school absences and EQ-5D-3L data and submitted nasal swabs for RT-PCR influenza testing.

Results: Average QALD lost was 0.26, 0.93, 1.61 and 1.84 for ARI, ILI, H1N1pdm09 and influenza B cases, respectively. 40% of influenza A cases and 24% of influenza B cases took time off work/school with an average duration of 3.6 and 2.4 days, respectively. In England, community influenza cases lost 24 300 QALYs in 2010/11 and had an estimated 2.9 million absences per season based on data from 2006/07 to 2009/10.

Conclusions: Our QALDs and QALYs lost and work and school absence estimates are lower than previous estimates because we focus on community cases, most of which are mild, may not meet ILI definitions and do not result in healthcare consultations. Nevertheless, they contribute a substantial loss of HRQoL on a population level.

Keywords: EQ-5D; costs and cost analysis; human; influenza; quality of life; respiratory tract infections; work and school absences.

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Figures

Figure 1
Figure 1
EQ‐5D‐3L domains comparing baseline and worst day of illness (for the respective domain) for (A) ARI (B) ILI, (C) H1N1pdm09 and (D) influenza B illnesses
Figure 2
Figure 2
EQ‐VAS and EQ‐5D QALD weights comparing background and worst day of illness by illness outcome
Figure 3
Figure 3
VAS and EQ‐5D‐3L QALD weight at baseline and by day of illness for (A) H1N1pdm09 illnesses and (B) Influenza B illnesses over the number of cases reporting symptoms on that day
See this image and copyright information in PMC

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