title: Illness Severity and Work Productivity Loss Among Working Adults With Medically Attended Acute Respiratory Illnesses: US Influenza Vaccine Effectiveness Network 2012-2013.
abstract: BACKGROUND
  Influenza causes significant morbidity and mortality, with considerable economic costs, including lost work productivity. Influenza vaccines may reduce the economic burden through primary prevention of influenza and reduction in illness severity.
  
  
  METHODS
  We examined illness severity and work productivity loss among working adults with medically attended acute respiratory illnesses and compared outcomes for subjects with and without laboratory-confirmed influenza and by influenza vaccination status among subjects with influenza during the 2012-2013 influenza season.
  
  
  RESULTS
  Illnesses laboratory-confirmed as influenza (ie, cases) were subjectively assessed as more severe than illnesses not caused by influenza (ie, noncases) based on multiple measures, including current health status at study enrollment (≤7 days from illness onset) and current activity and sleep quality status relative to usual. Influenza cases reported missing 45% more work hours (20.5 vs 15.0; P < .001) than noncases and subjectively assessed their work productivity as impeded to a greater degree (6.0 vs 5.4; P < .001). Current health status and current activity relative to usual were subjectively assessed as modestly but significantly better for vaccinated cases compared with unvaccinated cases; however, no significant modifications of sleep quality, missed work hours, or work productivity loss were noted for vaccinated subjects.
  
  
  CONCLUSIONS
  Influenza illnesses were more severe and resulted in more missed work hours and productivity loss than illnesses not confirmed as influenza. Modest reductions in illness severity for vaccinated cases were observed. These findings highlight the burden of influenza illnesses and illustrate the importance of laboratory confirmation of influenza outcomes in evaluations of vaccine effectiveness.
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.
authors.forename: Joshua G
authors.initials: JG
authors.lastname: Petrie
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.
authors.forename: Caroline
authors.initials: C
authors.lastname: Cheng
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.
authors.forename: Ryan E
authors.initials: RE
authors.lastname: Malosh
authors.affiliation: Marshfield Clinic Research Foundation, Marshfield, Wisconsin.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: VanWormer
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Brendan
authors.initials: B
authors.lastname: Flannery
authors.affiliation: University of Pittsburgh Schools of the Health Sciences and University of Pittsburgh Medical Center, Pennsylvania.
authors.forename: Richard K
authors.initials: RK
authors.lastname: Zimmerman
authors.affiliation: Scott and White Health, Texas A&M University Health Science Center College of Medicine, Temple.
authors.forename: Manjusha
authors.initials: M
authors.lastname: Gaglani
authors.affiliation: Group Health Research Institute, Seattle, Washington.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Jackson
authors.affiliation: Marshfield Clinic Research Foundation, Marshfield, Wisconsin.
authors.forename: Jennifer P
authors.initials: JP
authors.lastname: King
authors.affiliation: University of Pittsburgh Schools of the Health Sciences and University of Pittsburgh Medical Center, Pennsylvania.
authors.forename: Mary Patricia
authors.initials: MP
authors.lastname: Nowalk
authors.affiliation: Group Health Research Institute, Seattle, Washington.
authors.forename: Joyce
authors.initials: J
authors.lastname: Benoit
authors.affiliation: Scott and White Health, Texas A&M University Health Science Center College of Medicine, Temple.
authors.forename: Anne
authors.initials: A
authors.lastname: Robertson
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Swathi N
authors.initials: SN
authors.lastname: Thaker
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.
authors.forename: Arnold S
authors.initials: AS
authors.lastname: Monto
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Ohmit
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004526:Efficiency; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control*; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines
keywords: illness severity; medically attended acute respiratory illness; medically attended influenza; vaccine effectiveness; work productivity