Institute of Health Informatics, University College London, London, UK.
Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK.
Influenza Other Respir Viruses. 2018 Jan;12(1):171-182. doi: 10.1111/irv.12506.
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.
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.
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.
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.
健康相关生活质量（HRQoL）和流感相关的工作/上学缺勤的评估通常基于就医病例或符合流感样疾病（ILI）病例定义的病例，因此偏向于严重疾病。尽管社区流感病例更为常见，但评估其对 HRQoL 和缺勤的影响的研究有限。
衡量急性呼吸道感染（ARI）、ILI 和流感 A 和 B 社区病例的质量调整生命天数（QALDs）和质量调整生命年（QALYs）损失以及工作/上学缺勤情况，并评估流感导致的 QALY 损失和缺勤的社区负担。
患者/方法：Flu Watch 是 2006 年至 2011 年期间在英格兰进行的一项社区队列研究。参与者每周接受随访。在呼吸道疾病期间，他们前瞻性地记录每日症状、工作/上学缺勤情况和 EQ-5D-3L 数据，并提交鼻拭子进行 RT-PCR 流感检测。
ARI、ILI、H1N1pdm09 和流感 B 病例的平均 QALD 损失分别为 0.26、0.93、1.61 和 1.84。40%的流感 A 病例和 24%的流感 B 病例缺勤，平均缺勤时间分别为 3.6 天和 2.4 天。在英格兰，2010/11 年社区流感病例导致 24300 个 QALYs 损失，根据 2006/07 年至 2009/10 年的数据，估计每个流感季节缺勤人数为 290 万。
我们的 QALDs 和 QALYs 损失以及工作和上学缺勤评估低于之前的评估，因为我们关注的是社区病例，其中大多数为轻症，可能不符合 ILI 定义，且不会导致医疗咨询。然而，它们对人群水平的 HRQoL 造成了实质性的损失。
