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Chung E, Wang Y, Chow EJ, Emanuels A, Heimonen J, Ogokeh CE, Rolfes MA, Hughes JP, Uyeki TM, Starita LM, Hoag S, Boeckh M, Englund JA, Chu HY. Absenteeism and Health Behavior Trends Associated With Acute Respiratory Illness Before and During the COVID-19 Pandemic in a Community Household Cohort, King County, Washington. AJPM FOCUS 2024; 3:100248. [PMID: 39045125 PMCID: PMC11264170 DOI: 10.1016/j.focus.2024.100248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Introduction Longitudinal data on how acute respiratory illness (ARI) affects behavior, namely school or work participation, and nonpharmaceutical intervention (NPI) usage before and during the COVID-19 pandemic is limited. The authors assessed how ARIs and specific symptoms affected school, work, and health-related behaviors over time. Methods From November 2019 to June 2021, participating households with children in King County, Washington, were remotely monitored for ARI symptoms weekly. Following ARIs, participants reported illness-related effects on school, work, and NPI use. Using logistic regression with generalized estimating equations, the authors examined associations between symptoms and behaviors. Results Of 1,861 participants, 581 (31%) from 293 households reported 884 ARIs and completed one-week follow-up surveys. Compared with the prepandemic period, during the period of the pandemic pre-COVID-19 vaccine, ARI-related school (56% vs 10%, p<0.001) absenteeism decreased and masking increased (3% vs 28%, p<0.001). After vaccine authorization in December 2020, more ARIs resulted in masking (3% vs 48%, p<0.001), avoiding contact with non-household members (26% vs 58%, p<0.001), and staying home (37% vs 69%, p<0.001) compared with the prepandemic period. Constitutional symptoms such as fever were associated with work disruptions (OR=1.91; 95% CI=1.06, 3.43), staying home (OR=1.55; 95% CI=1.06, 2.27), and decreased contact with non-household members (OR=1.58; 95% CI=1.05, 2.36). Conclusions This remote household study permitted uninterrupted tracking of behavioral changes in families with children before and during the COVID-19 pandemic, identifying increased use of some NPIs when ill but no additional illness-associated work or school disruptions.
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Affiliation(s)
- Erin Chung
- Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, Washington
| | - Yongzhe Wang
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington
| | - Eric J. Chow
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington
- Public Health - Seattle & King County, Seattle, Washington
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Anne Emanuels
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington
| | - Jessica Heimonen
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington
| | - Constance E. Ogokeh
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
- Military and Health Research Foundation, Laurel, Maryland
| | - Melissa A. Rolfes
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - James P. Hughes
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Timothy M. Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lea M. Starita
- Brotman Baty Institute for Precision Medicine, Seattle, Washington
- Department of Genome Sciences, University of Washington, Seattle, Washington
| | - Samara Hoag
- Student Health Services, Seattle Public Schools, Seattle, Washington
| | - Michael Boeckh
- Fred Hutchinson Cancer Research Center, Seattle, Washington
- University of Washington School of Medicine, Seattle, Washington
| | - Janet A. Englund
- Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, Washington
| | - Helen Y. Chu
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington
| | - Seattle Flu Study Investigators
- Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, Washington
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington
- Public Health - Seattle & King County, Seattle, Washington
- Department of Epidemiology, University of Washington, Seattle, Washington
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
- Military and Health Research Foundation, Laurel, Maryland
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Biostatistics, University of Washington, Seattle, Washington
- Brotman Baty Institute for Precision Medicine, Seattle, Washington
- Department of Genome Sciences, University of Washington, Seattle, Washington
- Student Health Services, Seattle Public Schools, Seattle, Washington
- Fred Hutchinson Cancer Research Center, Seattle, Washington
- University of Washington School of Medicine, Seattle, Washington
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Atkins N, Harikar M, Duggan K, Zawiejska A, Vardhan V, Vokey L, Dozier M, de los Godos EF, Mcswiggan E, Mcquillan R, Theodoratou E, Shi T. What are the characteristics of participatory surveillance systems for influenza-like-illness? J Glob Health 2023; 13:04130. [PMID: 37856769 PMCID: PMC10587643 DOI: 10.7189/jogh.13.04130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Background Seasonal influenza causes significant morbidity and mortality, with an estimated 9.4 million hospitalisations and 290 000-650 000 respiratory related-deaths globally each year. Influenza can also cause mild illness, which is why not all symptomatic persons might necessarily be tested for influenza. To monitor influenza activity, healthcare facility-based syndromic surveillance for influenza-like illness is often implemented. Participatory surveillance systems for influenza-like illness (ILI) play an important role in influenza surveillance and can complement traditional facility-based surveillance systems to provide real-time estimates of influenza-like illness activity. However, such systems differ in designs between countries and contexts, making it necessary to identify their characteristics to better understand how they fit traditional surveillance systems. Consequently, we aimed to investigate the performance of participatory surveillance systems for ILI worldwide. Methods We systematically searched four databases for relevant articles on influenza participatory surveillance systems for ILI. We extracted data from the included, eligible studies and assessed their quality using the Joanna Briggs Critical Appraisal Tools. We then synthesised the findings using narrative synthesis. Results We included 39 out of 3797 retrieved articles for analysis. We identified 26 participatory surveillance systems, most of which sought to capture the burden and trends of influenza-like illness and acute respiratory infections among cohorts with risk factors for influenza-like illness. Of all the surveillance system attributes assessed, 52% reported on correlation with other surveillance systems, 27% on representativeness, and 21% on acceptability. Among studies that reported these attributes, all systems were rated highly in terms of simplicity, flexibility, sensitivity, utility, and timeliness. Most systems (87.5%) were also well accepted by users, though participation rates varied widely. However, despite their potential for greater reach and accessibility, most systems (90%) fared poorly in terms of representativeness of the population. Stability was a concern for some systems (60%), as was completeness (50%). Conclusions The analysis of participatory surveillance system attributes showed their potential in providing timely and reliable influenza data, especially in combination with traditional hospital- and laboratory led-surveillance systems. Further research is needed to design future systems with greater uptake and utility.
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Affiliation(s)
- Nadege Atkins
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
- Joint first authorship
| | - Mandara Harikar
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
- Joint first authorship
| | - Kirsten Duggan
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Agnieszka Zawiejska
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Vaishali Vardhan
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Laura Vokey
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Marshall Dozier
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Emma F de los Godos
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
- Equal contribution
| | - Emilie Mcswiggan
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Ruth Mcquillan
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
- Equal contribution
| | - Evropi Theodoratou
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
- Equal contribution
| | - Ting Shi
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- Equal contribution
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Eum Y, Yoo EH. Using GPS-enabled mobile phones to evaluate the associations between human mobility changes and the onset of influenza illness. Spat Spatiotemporal Epidemiol 2022; 40:100458. [PMID: 35120680 PMCID: PMC8818086 DOI: 10.1016/j.sste.2021.100458] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/19/2021] [Accepted: 10/18/2021] [Indexed: 02/03/2023]
Abstract
Due to the challenges in data collection, there are few studies examining how individuals' routine mobility patterns change when they experience influenza-like symptoms (ILS). In the present study, we aimed to assess the association between changes in routine mobility and ILS using mobile phone-based GPS traces and self-reported surveys from 1,155 participants over the 2016-2017 influenza season. We used a set of mobility metrics to capture individuals' routine mobility patterns and matched their weekly ILS survey responses. For a statistical analysis, we used a time-stratified case-crossover analysis and conducted a stratified analysis to examine if such associations are moderated by demographic and socioeconomic factors, such as age, gender, occupational status, neighborhood poverty and education levels, and work type. We found that statistically significant associations existed between reduced routine mobility patterns and the experience of ILS. Results also indicated that the association between reduced mobility and ILS was significant only for female and for participants with high socioeconomic status. Our findings offered an improved understanding of ILS-associated mobility changes at the individual level and suggest the potential of individual mobility data for influenza surveillance.
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Affiliation(s)
- Youngseob Eum
- Department of Geography, State University of New York at Buffalo, Buffalo, NY, USA.
| | - Eun-Hye Yoo
- Department of Geography, State University of New York at Buffalo, Buffalo, NY, USA.
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Osoro EM, Lidechi S, Marwanga D, Nyaundi J, Mwatondo A, Muturi M, Ng'ang'a Z, Njenga K. Seroprevalence of influenza A virus in pigs and low risk of acute respiratory illness among pig workers in Kenya. Environ Health Prev Med 2019; 24:53. [PMID: 31421676 PMCID: PMC6698327 DOI: 10.1186/s12199-019-0808-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 08/02/2019] [Indexed: 01/27/2023] Open
Abstract
Background Influenza A viruses pose a significant risk to human health because of their wide host range and ability to reassort into novel viruses that can cause serious disease and pandemics. Since transmission of these viruses between humans and pigs can be associated with occupational and environmental exposures, we investigated the association between occupational exposure to pigs, occurrence of acute respiratory illness (ARI), and influenza A virus infection. Methods The study was conducted in Kiambu County, the county with the highest level of intensive small-scale pig farming in Kenya. Up to 3 participants (> 2 years old) per household from pig-keeping and non-pig-keeping households were randomly recruited and followed up in 2013 (Sept-Dec) and 2014 (Apr-Aug). Oropharyngeal (OP) and nasopharyngeal (NP) swabs were collected from participants with ARI at the time of study visit. For the animal study, nasal and oropharyngeal swabs, and serum samples were collected from pigs and poultry present in enrolled households. The human and animal swab samples were tested for viral nucleic acid by RT-PCR and sera by ELISA for antibodies. A Poisson generalized linear mixed-effects model was developed to assess the association between pig exposure and occurrence of ARI. Results Of 1137 human participants enrolled, 625 (55%) completed follow-up visits including 172 (27.5%) pig workers and 453 (72.5%) non-pig workers. Of 130 human NP/OP swabs tested, four (3.1%) were positive for influenza A virus, one pig worker, and three among non-pig workers. Whereas none of the 4462 swabs collected from pig and poultry tested positive for influenza A virus by RT-PCR, 265 of 4273 (6.2%) of the sera tested positive for virus antibodies by ELISA, including 11.6% (230/1990) of the pigs and 1.5% (35/2,283) of poultry. The cumulative incidence of ARI was 16.9% among pig workers and 26.9% among the non-pig workers. The adjusted risk ratio for the association between being a pig worker and experiencing an episode of ARI was 0.56 (95% CI [0.33, 0.93]), after adjusting for potential confounders. Conclusions Our findings demonstrate moderate seropositivity for influenza A virus among pigs, suggesting the circulation of swine influenza virus and a potential for interspecies transmission.
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Affiliation(s)
- Eric Mogaka Osoro
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
| | | | | | | | | | - Mathew Muturi
- Ministry of Agriculture and Irrigation, Nairobi, Kenya
| | - Zipporah Ng'ang'a
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
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Meng H, Liao Q, Suen LKP, O'Donoghue M, Wong CM, Yang L. Healthcare seeking behavior of patients with influenza like illness: comparison of the summer and winter influenza epidemics. BMC Infect Dis 2016; 16:499. [PMID: 27646778 PMCID: PMC5029067 DOI: 10.1186/s12879-016-1821-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 09/08/2016] [Indexed: 11/16/2022] Open
Abstract
Background Influenza often causes winter and summer epidemics in subtropical regions, but few studies have investigated the difference in healthcare seeking behavior of patients with influenza-like illness (ILI) between these two epidemics. Methods Household telephone surveys were conducted using random digit dialing in Hong Kong during July-August 2014 and March-April 2015. One adult from each household was interviewed for ILI symptoms and associated healthcare seeking behaviour of themselves and one child in the household (if any), during the preceding 30 days. Healthcare seeking behavior of respondents with self-reported ILI was compared between summer and winter influenza. Logistic regression was used to explore the factors associated with healthcare seeking behavior. Results Among 516 and 539 adult respondents in the summer and winter surveys, 22.6 and 38.0 % reported ILI symptoms, and 40.9 and 46.8 % of them sought medical care, respectively. There was no significant difference in healthcare seeking behavior between the summer and winter epidemics, except a higher proportion of self-medication in summer in the adult respondents. Among 155 and 182 children reported by the adults in both surveys, the proportion of self-reported ILI was 32.9 and 40.1 % in the summer and winter surveys, respectively. Of these children, 47.1 and 56.2 % were brought for medical consultation in summer and winter, respectively. Women, adults with diabetes and those with symptoms of cough, shortness of breath, and runny nose were more likely to seek medical consultations for ILI symptoms. The factors associated with seeking medical consultations in children with ILI symptoms included being female, age under 10 years, and with symptoms of sore throat or vomiting. Those older than 60 years were less likely to self-medicate, whereas regular smokers and those with symptom of sore throat were more likely to do so. Conclusion Healthcare seeking behavior of the general public was not significantly different between these two epidemics. However ILI was associated with increased healthcare utilization in both winter and summer epidemics in Hong Kong. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1821-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Huaiqing Meng
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong Special Administrative Region (HKSAR), China
| | - Qiuyan Liao
- School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region (HKSAR), China
| | - Lorna Kwai Ping Suen
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong Special Administrative Region (HKSAR), China
| | - Margaret O'Donoghue
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong Special Administrative Region (HKSAR), China
| | - Chit Ming Wong
- School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region (HKSAR), China
| | - Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong Special Administrative Region (HKSAR), China.
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