Household presentation of influenza and acute respiratory illnesses to a primary care sentinel network: retrospective database studies (2013-2018)

BACKGROUND:<br>Direct observation of the household spread of influenza and respiratory infections is limited; much of our understanding comes from mathematical models. The study aims to determine household incidence of influenza-like illness (ILI), lower (LRTI) and upper (URTI) respiratory inf...

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Main Authors: de Lusignan, S, Sherlock, J, Akinyemi, O, Pebody, R, Elliot, A, Byford, R, Yonova, I, Zambon, M, Joy, M
Format: Journal article
Language:English
Published: BioMed Central 2020
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author de Lusignan, S
Sherlock, J
Akinyemi, O
Pebody, R
Elliot, A
Byford, R
Yonova, I
Zambon, M
Joy, M
author_facet de Lusignan, S
Sherlock, J
Akinyemi, O
Pebody, R
Elliot, A
Byford, R
Yonova, I
Zambon, M
Joy, M
author_sort de Lusignan, S
collection OXFORD
description BACKGROUND:<br>Direct observation of the household spread of influenza and respiratory infections is limited; much of our understanding comes from mathematical models. The study aims to determine household incidence of influenza-like illness (ILI), lower (LRTI) and upper (URTI) respiratory infections within a primary care routine data and identify factors associated with the diseases' incidence. <br>METHODS:<br>We conducted two five-year retrospective analyses of influenza-like illness (ILI), lower (LRTI) and upper (URTI) respiratory infections using the England Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care sentinel network database; a cross-sectional study reporting incident rate ratio (IRR) from a negative binomial model and a retrospective cohort study, using a shared gamma frailty survival model, reporting hazard ratios (HR). We reported the following household characteristics: children &lt;&#x2009;5&#x2009;years old, each extra household member, gender, ethnicity (reference white), chronic disease, pregnancy, and rurality. <br>RESULTS:<br>The IRR where there was a child &lt;&#x2009;5&#x2009;years were 1&#xB7;62 (1&#xB7;38-1&#xB7;89, p&#x2009;&lt;&#x2009;0&#xB7;0001), 2&#xB7;40 (2.04-2.83, p&#x2009;&lt;&#x2009;0&#xB7;0001) and 4&#xB7;46 (3.79-5.255, p&#x2009;&lt;&#x2009;0&#xB7;0001) for ILI, LRTI and URTI respectively. IRR also increased with household size, rurality and presentations and by female gender, compared to male. Household incidence of URTI and LRTI changed little between years whereas influenza did and were greater in years with lower vaccine effectiveness. The HR where there was a child &lt;&#x2009;5&#x2009;years were 2&#xB7;34 (95%CI 1&#xB7;88-2&#xB7;90, p&#x2009;&lt;&#x2009;0&#xB7;0001), 2&#xB7;97 (95%CI 2&#xB7;76-3&#xB7;2, p&#x2009;&lt;&#x2009;0&#xB7;0001) and 10&#xB7;32 (95%CI 10.04-10.62, p&#x2009;&lt;&#x2009;0&#xB7;0001) for ILI, LRTI and URTI respectively. HR were increased with female gender, rurality, and increasing household size. <br>CONCLUSIONS:<br>Patterns of household incidence can be measured from routine data and may provide insights for the modelling of disease transmission and public health policy.
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spelling oxford-uuid:ad1417c9-f96d-4084-9136-bf6478674ada2022-03-27T03:33:12ZHousehold presentation of influenza and acute respiratory illnesses to a primary care sentinel network: retrospective database studies (2013-2018)Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ad1417c9-f96d-4084-9136-bf6478674adaEnglishSymplectic ElementsBioMed Central2020de Lusignan, SSherlock, JAkinyemi, OPebody, RElliot, AByford, RYonova, IZambon, MJoy, MBACKGROUND:<br>Direct observation of the household spread of influenza and respiratory infections is limited; much of our understanding comes from mathematical models. The study aims to determine household incidence of influenza-like illness (ILI), lower (LRTI) and upper (URTI) respiratory infections within a primary care routine data and identify factors associated with the diseases' incidence. <br>METHODS:<br>We conducted two five-year retrospective analyses of influenza-like illness (ILI), lower (LRTI) and upper (URTI) respiratory infections using the England Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care sentinel network database; a cross-sectional study reporting incident rate ratio (IRR) from a negative binomial model and a retrospective cohort study, using a shared gamma frailty survival model, reporting hazard ratios (HR). We reported the following household characteristics: children &lt;&#x2009;5&#x2009;years old, each extra household member, gender, ethnicity (reference white), chronic disease, pregnancy, and rurality. <br>RESULTS:<br>The IRR where there was a child &lt;&#x2009;5&#x2009;years were 1&#xB7;62 (1&#xB7;38-1&#xB7;89, p&#x2009;&lt;&#x2009;0&#xB7;0001), 2&#xB7;40 (2.04-2.83, p&#x2009;&lt;&#x2009;0&#xB7;0001) and 4&#xB7;46 (3.79-5.255, p&#x2009;&lt;&#x2009;0&#xB7;0001) for ILI, LRTI and URTI respectively. IRR also increased with household size, rurality and presentations and by female gender, compared to male. Household incidence of URTI and LRTI changed little between years whereas influenza did and were greater in years with lower vaccine effectiveness. The HR where there was a child &lt;&#x2009;5&#x2009;years were 2&#xB7;34 (95%CI 1&#xB7;88-2&#xB7;90, p&#x2009;&lt;&#x2009;0&#xB7;0001), 2&#xB7;97 (95%CI 2&#xB7;76-3&#xB7;2, p&#x2009;&lt;&#x2009;0&#xB7;0001) and 10&#xB7;32 (95%CI 10.04-10.62, p&#x2009;&lt;&#x2009;0&#xB7;0001) for ILI, LRTI and URTI respectively. HR were increased with female gender, rurality, and increasing household size. <br>CONCLUSIONS:<br>Patterns of household incidence can be measured from routine data and may provide insights for the modelling of disease transmission and public health policy.
spellingShingle de Lusignan, S
Sherlock, J
Akinyemi, O
Pebody, R
Elliot, A
Byford, R
Yonova, I
Zambon, M
Joy, M
Household presentation of influenza and acute respiratory illnesses to a primary care sentinel network: retrospective database studies (2013-2018)
title Household presentation of influenza and acute respiratory illnesses to a primary care sentinel network: retrospective database studies (2013-2018)
title_full Household presentation of influenza and acute respiratory illnesses to a primary care sentinel network: retrospective database studies (2013-2018)
title_fullStr Household presentation of influenza and acute respiratory illnesses to a primary care sentinel network: retrospective database studies (2013-2018)
title_full_unstemmed Household presentation of influenza and acute respiratory illnesses to a primary care sentinel network: retrospective database studies (2013-2018)
title_short Household presentation of influenza and acute respiratory illnesses to a primary care sentinel network: retrospective database studies (2013-2018)
title_sort household presentation of influenza and acute respiratory illnesses to a primary care sentinel network retrospective database studies 2013 2018
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