Comparing the impact of two concurrent infectious disease outbreaks on The Netherlands population, 2009, using disability-adjusted life years.
In 2009 two notable outbreaks, Q fever and the novel influenza A(H1N1)pdm09, occurred in The Netherlands. Using a composite health measure, disability-adjusted life years (DALYs), the outbreaks were quantified and compared. DALYs were calculated using standardized methodology incorporating age- and sex-stratified data in a disease progression model; years lost due to disability and years of life lost were computed by outcome. Nationally, influenza A(H1N1)pdm09 caused more DALYs (24 484) than Q fever (5797). However, Q fever was 8·28 times more severe [497 DALYs/1000 symptomatic cases (DP1SC)] than A(H1N1)pdm09 (60 DP1SC). The A(H1N1)pdm09 burden is largely due to mortality while the Q fever burden is due primarily to long-term sequelae. Intervention prioritization for influenza should support patients in a critical condition while for Q fever it should target immediate containment and support for patients with long-term sequelae. Burden estimates provide guidance for focusing intervention options during outbreaks of infectious diseases.
University Medical Center Utrecht,Utrecht,The Netherlands.
R J
RJ
Brooke
National Institute for Public Health and the Environment,Bilthoven,The Netherlands.
A
A
Van Lier
NIVEL,Netherlands Institute of Health Services Research, Utrecht,The Netherlands.
G A
GA
Donker
National Institute for Public Health and the Environment,Bilthoven,The Netherlands.
W
W
Van Der Hoek
University Medical Center Utrecht,Utrecht,The Netherlands.
M E E
ME
Kretzschmar
D000328:Adult; D003140:Communicable Disease Control; D016208:Databases, Factual; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000453:epidemiology* / Q000821:virology; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011778:Q Fever / Q000175:diagnosis / Q000453:epidemiology*; D019057:Quality-Adjusted Life Years; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015996:Survival Rate