Comparing the impact of two concurrent infectious disease outbreaks on The Netherlands population, 2009, using disability-adjusted life years

Epidemiol Infect. 2014 Nov;142(11):2412-21. doi: 10.1017/S0950268813003531. Epub 2014 Jan 24.

Abstract

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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Communicable Disease Control
  • Databases, Factual
  • Disabled Persons / statistics & numerical data*
  • Disease Outbreaks
  • Female
  • Humans
  • Influenza A Virus, H1N1 Subtype / isolation & purification*
  • Influenza, Human / epidemiology*
  • Influenza, Human / virology
  • Male
  • Netherlands / epidemiology
  • Prevalence
  • Q Fever / diagnosis
  • Q Fever / epidemiology*
  • Quality-Adjusted Life Years*
  • Retrospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Survival Rate