Giuseppe
Emeritus
[Source: PLoS ONE, full text: (LINK). Abstract, edited.]
Epidemiologic and Economic Burden of Influenza in the Outpatient Setting: A Prospective Study in a Subtropical Area of China
Ru-ning Guo<SUP>1</SUP>, Hui-zhen Zheng<SUP>1</SUP><SUP>*</SUP>, Li-qun Huang<SUP>2</SUP>, Yong Zhou<SUP>2</SUP>, Xin Zhang<SUP>3</SUP>, Chan-kun Liang<SUP>2</SUP>, Jin-yan Lin<SUP>4</SUP>, Jian-feng He<SUP>1</SUP>, Jin-qing Zhang<SUP>1</SUP>
1 Institute of Infectious Disease Prevention and Control, Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China, 2 Zhuhai Municipal Center for Disease Control and Prevention, Zhuhai, China, 3 Institute of Pathogenic Microorganisms, Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China, 4 Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China
Abstract
Objectives
To understand the incidence of outpatient influenza cases in a subtropical area of China and the associated economic burden on patients' families.
Methods
A hospital-based prospective study was conducted in Zhuhai City during 2008?2009. All outpatient influenza-like illness (ILI) cases were identified in 28 sentinel hospitals. A representative sample of throat swabs from ILI cases were collected for virus isolation using Madin-Darby canine kidney cells. The incidence of outpatient influenza cases in Zhuhai was estimated on the basis of the number of influenza patients detected by the sentinel sites. A telephone survey on the direct costs associated with illness was conducted as a follow-up.
Results
The incidence of influenza was estimated to be 4.1 per 1,000 population in 2008 and 19.2 per 1,000 population in 2009. Children aged <5 years were the most-affected population, suffering from influenza at the highest rates (34.3 per 1,000 population in 2008 and 95.3 per 1,000 population in 2009). A high incidence of 29.2?40.9 per 1000 population was also seen in young people aged 5?24 years in 2009. ILI activity and influenza virus isolations adopted a consistent seasonal pattern, with a summer peak in July 2008 and the longest epidemic period lasting from July?December 2009. The medical costs per episode of influenza among urban patients were higher than those for rural patients. A total of $1.1 million in direct economic losses were estimated to be associated with outpatient influenza during 2008?2009 in Zhuhai community.
Conclusions
Influenza attacks children aged <5 years in greater proportions than children in other age groups. Seasonal influenza 2008 and Pandemic influenza A (H1N1) 2009 had different epidemiological and etiological characteristics. Direct costs (mostly medical costs) impose an enormous burden on the patient family. Vaccination strategies for high-risk groups need to be further strengthened.
Citation: Guo R-n, Zheng H-z, Huang L-q, Zhou Y, Zhang X, et al. (2012) Epidemiologic and Economic Burden of Influenza in the Outpatient Setting: A Prospective Study in a Subtropical Area of China. PLoS ONE 7(7): e41403. doi:10.1371/journal.pone.0041403
Editor: Benjamin J. Cowling, University of Hong Kong, Hong Kong
Received: January 13, 2012; Accepted: June 25, 2012; Published: July 20, 2012
Copyright: ? 2012 GUO et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The work was supported by grants from the World Health Organization (WP/2008/CHN/02/CSR/PE 15.01), and Medical Research Foundation of Guangdong Province, China (project number: A2007079). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
* E-mail: zhzgdcdc@163.com
- --------Ru-ning Guo<SUP>1</SUP>, Hui-zhen Zheng<SUP>1</SUP><SUP>*</SUP>, Li-qun Huang<SUP>2</SUP>, Yong Zhou<SUP>2</SUP>, Xin Zhang<SUP>3</SUP>, Chan-kun Liang<SUP>2</SUP>, Jin-yan Lin<SUP>4</SUP>, Jian-feng He<SUP>1</SUP>, Jin-qing Zhang<SUP>1</SUP>
1 Institute of Infectious Disease Prevention and Control, Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China, 2 Zhuhai Municipal Center for Disease Control and Prevention, Zhuhai, China, 3 Institute of Pathogenic Microorganisms, Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China, 4 Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China
Abstract
Objectives
To understand the incidence of outpatient influenza cases in a subtropical area of China and the associated economic burden on patients' families.
Methods
A hospital-based prospective study was conducted in Zhuhai City during 2008?2009. All outpatient influenza-like illness (ILI) cases were identified in 28 sentinel hospitals. A representative sample of throat swabs from ILI cases were collected for virus isolation using Madin-Darby canine kidney cells. The incidence of outpatient influenza cases in Zhuhai was estimated on the basis of the number of influenza patients detected by the sentinel sites. A telephone survey on the direct costs associated with illness was conducted as a follow-up.
Results
The incidence of influenza was estimated to be 4.1 per 1,000 population in 2008 and 19.2 per 1,000 population in 2009. Children aged <5 years were the most-affected population, suffering from influenza at the highest rates (34.3 per 1,000 population in 2008 and 95.3 per 1,000 population in 2009). A high incidence of 29.2?40.9 per 1000 population was also seen in young people aged 5?24 years in 2009. ILI activity and influenza virus isolations adopted a consistent seasonal pattern, with a summer peak in July 2008 and the longest epidemic period lasting from July?December 2009. The medical costs per episode of influenza among urban patients were higher than those for rural patients. A total of $1.1 million in direct economic losses were estimated to be associated with outpatient influenza during 2008?2009 in Zhuhai community.
Conclusions
Influenza attacks children aged <5 years in greater proportions than children in other age groups. Seasonal influenza 2008 and Pandemic influenza A (H1N1) 2009 had different epidemiological and etiological characteristics. Direct costs (mostly medical costs) impose an enormous burden on the patient family. Vaccination strategies for high-risk groups need to be further strengthened.
Citation: Guo R-n, Zheng H-z, Huang L-q, Zhou Y, Zhang X, et al. (2012) Epidemiologic and Economic Burden of Influenza in the Outpatient Setting: A Prospective Study in a Subtropical Area of China. PLoS ONE 7(7): e41403. doi:10.1371/journal.pone.0041403
Editor: Benjamin J. Cowling, University of Hong Kong, Hong Kong
Received: January 13, 2012; Accepted: June 25, 2012; Published: July 20, 2012
Copyright: ? 2012 GUO et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The work was supported by grants from the World Health Organization (WP/2008/CHN/02/CSR/PE 15.01), and Medical Research Foundation of Guangdong Province, China (project number: A2007079). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
* E-mail: zhzgdcdc@163.com