title: Impact of medical and behavioural factors on influenza-like illness, healthcare-seeking, and antiviral treatment during the 2009 H1N1 pandemic: USA, 2009-2010.
abstract: We analysed a cross-sectional telephone survey of U.S. adults to assess the impact of selected characteristics on healthcare-seeking behaviours and treatment practices of people with influenza-like illness (ILI) from September 2009 to March 2010. Of 216,431 respondents, 8.1% reported ILI. After adjusting for selected characteristics, respondents aged 18-64 years with the following factors were more likely to report ILI: a diagnosis of asthma [adjusted odds ratio (aOR) 1.88, 95% CI 1.67-2.13] or heart disease (aOR 1.41, 95% CI 1.17-1.70), being disabled (aOR 1.75, 95% CI 1.57-1.96), and reporting financial barriers to healthcare access (aOR 1.63, 95% CI 1.45-1.82). Similar associations were seen in respondents aged ≥ 65 years. Forty percent of respondents with ILI sought healthcare, and 14% who sought healthcare reported receiving influenza antiviral treatment. Treatment was not more frequent in patients with high-risk conditions, except those aged 18-64 years with heart disease (aOR 1.90, 95% CI 1.03-3.51). Of patients at high risk for influenza complications, self-reported ILI was greater but receipt of antiviral treatment was not, despite guidelines recommending their use in this population.
authors.affiliation: Epidemiology and Prevention Branch, Influenza Division, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Biggerstaff
authors.forename: M A
authors.initials: MA
authors.lastname: Jhung
authors.forename: C
authors.initials: C
authors.lastname: Reed
authors.forename: S
authors.initials: S
authors.lastname: Garg
authors.forename: L
authors.initials: L
authors.lastname: Balluz
authors.forename: A M
authors.initials: AM
authors.lastname: Fry
authors.forename: L
authors.initials: L
authors.lastname: Finelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058873:Pandemics; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D062486:Public Health Surveillance; D012307:Risk Factors
chemical_list: D000998:Antiviral Agents