title: Influenza-attributable burden in United Kingdom primary care.
abstract: Influenza is rarely laboratory-confirmed and the outpatient influenza burden is rarely studied due to a lack of suitable data. We used the Clinical Practice Research Datalink (CPRD) and surveillance data from Public Health England in a linear regression model to assess the number of persons consulting UK general practitioners (GP episodes) for respiratory illness, otitis media and antibiotic prescriptions attributable to influenza during 14 seasons, 1995-2009. In CPRD we ascertained influenza vaccination status in each season and risk status (conditions associated with severe influenza outcomes). Seasonal mean estimates of influenza-attributable GP episodes in the UK were 857 996 for respiratory disease including 68 777 for otitis media, with wide inter-seasonal variability. In an average season, 2·4%/0·5% of children aged <5 years and 1·3%/0·1% of seniors aged ⩾75 years had a GP episode for respiratory illness attributed to influenza A/B. Two-thirds of influenza-attributable GP episodes were estimated to result in prescription of antibiotics. These estimates are substantially greater than those derived from clinically reported influenza-like illness in surveillance programmes. Because health service costs of influenza are largely borne in general practice, these are important findings for cost-benefit assessment of influenza vaccination programmes.
authors.affiliation: 9 Dowles Close,Birmingham,UK(independent consultant).
authors.forename: D M
authors.initials: DM
authors.lastname: Fleming
authors.affiliation: Sage Analytica,Bethesda,MD,USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Taylor
authors.affiliation: GSK Vaccines,Wavre,Belgium.
authors.forename: F
authors.initials: F
authors.lastname: Haguinet
authors.affiliation: Sage Analytica,Bethesda,MD,USA.
authors.forename: C
authors.initials: C
authors.lastname: Schuck-Paim
authors.affiliation: GSK R&D,Uxbridge,Middlesex,UK.
authors.forename: J
authors.initials: J
authors.lastname: Logie
authors.affiliation: GSK R&D,Uxbridge,Middlesex,UK.
authors.forename: D J
authors.initials: DJ
authors.lastname: Webb
authors.affiliation: Sage Analytica,Bethesda,MD,USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Lustig
authors.affiliation: GSK Vaccines,Wavre,Belgium.
authors.forename: G
authors.initials: G
authors.lastname: Matias
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000900:Anti-Bacterial Agents; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D016208:Databases, Factual; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D009980:Influenza A virus; D009981:Influenza B virus; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D008875:Middle Aged; D010033:Otitis Media / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012621:Seasons; D006113:United Kingdom / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D007252:Influenza Vaccines
keywords: Epidemiology; GP surveillance systems; infectious disease; influenza; influenza vaccines