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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

Fragaszy, Ellen B.; Warren-Gash, Charlotte; White, Peter J.; Zambon, Maria; Edmunds, William J.; Nguyen-Van-Tam, Jonathan S.; Hayward, Andrew C.

Authors

Ellen B. Fragaszy

Charlotte Warren-Gash

Peter J. White

Maria Zambon

William J. Edmunds

Jonathan S. Nguyen-Van-Tam

Andrew C. Hayward



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.

Journal Article Type Article
Publication Date Feb 19, 2018
Print ISSN 1750-2640
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 12
Issue 1
Pages 171-182
APA6 Citation Fragaszy, E. B., Warren-Gash, C., White, P. J., Zambon, M., Edmunds, W. J., Nguyen-Van-Tam, J. S., & Hayward, A. C. (2018). 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. Influenza and Other Respiratory Viruses, 12(1), 171-182. doi:10.1111/irv.12506
DOI https://doi.org/10.1111/irv.12506
Publisher URL https://onlinelibrary.wiley.com/doi/full/10.1111/irv.12506
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