High-Risk Adults Often Do Not Seek Early Treatment for Flu Symptoms

Marcia Frellick

April 17, 2014

Adults with underlying health conditions are more likely to report influenza-like illnesses (ILIs), but most do not seek care promptly and may be missing the chance to benefit from early antiviral treatment, researchers have found. The study results were published online April 13 in the Journal of Infectious Diseases.

The Advisory Committee on Immunization Practices (ACIP) recommends early treatment of influenza with antiviral medications for people at high risk for influenza complications. That includes people aged 65 years or older, those with chronic pulmonary or cardiovascular conditions, and those with diabetes.

Matthew Biggerstaff, MPH, from the Epidemiology and Prevention Branch, Influenza Division, National Center for Immunization and Respiratory Disease at the Centers for Disease Control and Prevention, Atlanta, Georgia, and colleagues wanted to see whether ACIP guidelines were being followed in the 2010 to 2011 influenza season.

They analyzed adult responses in the Behavioral Risk Factor Surveillance System in 31 states and the District of Columbia and pediatric responses in 25 states and the District of Columbia for January through April 2011, by examining demographics and underlying health conditions, pregnancy, and access to care.

They found that among 75,088 adult and 15,649 child respondents, 8.9% and 33.9%, respectively, said they had had ILI. ILI was more frequent among adults who had:

  • chronic obstruction pulmonary disease (26%),

  • heart disease (19%),

  • asthma (16%),

  • kidney disease (16%),

  • diabetes (12%), or

  • obesity (11%).

Only 45% of adults and 57% of children who reported ILI sought health care. Of those adults, 35% sought care for ILI within 2 days of onset, when antiviral medications are most effective, and 47% within 3 to 7 days. Prompt requests for healthcare were associated with increased receipt of antiviral medications in this survey.

Those without a job or insurance or who were unable to work were much more likely either to delay or go without care, which may increase their risk for severe outcomes from influenza.

The authors conclude: "Our findings highlight the need to educate patients at high risk for influenza complications to seek care early, to educate physicians about the benefits of influenza antiviral treatment among high risk patients, and to better understand the social, medical and economic barriers that may prevent use of influenza antiviral treatment that is consistent with ACIP recommendations during a seasonal influenza epidemic."

The authors have disclosed no relevant financial relationships.

J Infect Dis. Published online April 13, 2014. Full text

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