Petrie Joshua G, Cheng Caroline, Malosh Ryan E, VanWormer Jeffrey J, Flannery Brendan, Zimmerman Richard K, Gaglani Manjusha, Jackson Michael L, King Jennifer P, Nowalk Mary Patricia, Benoit Joyce, Robertson Anne, Thaker Swathi N, Monto Arnold S, Ohmit Suzanne E
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.
Marshfield Clinic Research Foundation, Marshfield, Wisconsin.
Clin Infect Dis. 2016 Feb 15;62(4):448-455. doi: 10.1093/cid/civ952. Epub 2015 Nov 12.
Influenza causes significant morbidity and mortality, with considerable economic costs, including lost work productivity. Influenza vaccines may reduce the economic burden through primary prevention of influenza and reduction in illness severity.
We examined illness severity and work productivity loss among working adults with medically attended acute respiratory illnesses and compared outcomes for subjects with and without laboratory-confirmed influenza and by influenza vaccination status among subjects with influenza during the 2012-2013 influenza season.
Illnesses laboratory-confirmed as influenza (ie, cases) were subjectively assessed as more severe than illnesses not caused by influenza (ie, noncases) based on multiple measures, including current health status at study enrollment (≤7 days from illness onset) and current activity and sleep quality status relative to usual. Influenza cases reported missing 45% more work hours (20.5 vs 15.0; P < .001) than noncases and subjectively assessed their work productivity as impeded to a greater degree (6.0 vs 5.4; P < .001). Current health status and current activity relative to usual were subjectively assessed as modestly but significantly better for vaccinated cases compared with unvaccinated cases; however, no significant modifications of sleep quality, missed work hours, or work productivity loss were noted for vaccinated subjects.
Influenza illnesses were more severe and resulted in more missed work hours and productivity loss than illnesses not confirmed as influenza. Modest reductions in illness severity for vaccinated cases were observed. These findings highlight the burden of influenza illnesses and illustrate the importance of laboratory confirmation of influenza outcomes in evaluations of vaccine effectiveness.
流感会导致严重的发病和死亡，并带来可观的经济成本，包括工作生产力的损失。流感疫苗可通过对流感的一级预防和减轻疾病严重程度来减轻经济负担。
我们研究了因急性呼吸道疾病就医的在职成年人的疾病严重程度和工作生产力损失，并比较了2012 - 2013年流感季节中实验室确诊流感和未确诊流感的受试者以及确诊流感受试者的流感疫苗接种状况的结果。
根据多种指标，包括研究入组时（发病后≤7天）的当前健康状况以及相对于平常的当前活动和睡眠质量状况，实验室确诊为流感的疾病（即病例）主观上被评估为比非流感引起的疾病（即非病例）更严重。流感病例报告的误工小时数比非病例多45%（20.5对15.0；P <.001），并且主观上评估其工作生产力受到的阻碍程度更大（6.0对5.4；P <.001）。与未接种疫苗的病例相比，接种疫苗的病例的当前健康状况和相对于平常的当前活动主观上被评估为略好但有显著差异；然而，未观察到接种疫苗的受试者在睡眠质量、误工小时数或工作生产力损失方面有显著改善。
与未确诊为流感的疾病相比，流感疾病更严重，导致更多的误工小时数和生产力损失。观察到接种疫苗病例的疾病严重程度有适度降低。这些发现突出了流感疾病的负担，并说明了在评估疫苗有效性时对流感结果进行实验室确认的重要性。
