Representations of influenza and influenza-like illness in the community - a qualitative study

Abstract

BackgroundThere is little information regarding lay-people's representations of influenza and influenza-like illness in their day-to-day lives. An insight into these views may aid our understanding of community attitudes regarding official recommendations for its prevention.MethodsThis was a qualitative research. Semi-structured face-to-face interviews were conducted with 40 French participants from the community, and from five different locations. Questions elicited the participants' representations of onset of flu and influenza-like illness, as well as their views on what can/should be done to deal with symptoms and their personal experience with flu and flu-like symptoms.ResultsThematic content analyses allowed us to identify five main themes: the presence of a clear continuum between influenza-like illness and flu; a description of flu as a very contagious disease; flu as being benign, except in "frail people", which the respondents never considered themselves to be; interruption of daily activities, which could be considered pathognomonic for influenza for most subjects; self-medication as the main current practice, and requests for healthcare mainly to confirm an auto-diagnosis.ConclusionsThere was a large homogeneity in the representation of flu. There was also a gap between people's representations (i.e., a continuum from having a "cold" to having "influenza") and scientific knowledge (i.e., a distinction between "true" influenza and influenza-like illnesses based on the existence of a confirmatory virological diagnosis). This gap raises issues for current campaigns for flu prevention, as these may not be congruent with the representation of flu being responsible for interrupting daily activities while also being seen as a non-severe disease, as well as the perception that flu is only a risk to "frail people" though no participants considered themselves to be "frail".

Laypersons’ perception of common cold and influenza prevention—a qualitative study in Austria, Belgium and Croatia

“…The phenomenon of perceived influenza susceptibility, described by our participants as belonging to a risk group, could be in accordance with the category 'frail people' defined by Cedraschi et al, [31]. Interestingly, most participants from both studies did not consider themselves within this category [31]. Similar to our findings, that personal belief of being healthy as well as belief that alternative protective lifestyle (eating healthily and exercising) could confer immunity was emphasized by Rubinstein et al, as a barrier for vaccination [23].…”

“…The phenomenon of perceived influenza susceptibility, described by our participants as belonging to a risk group, could be in accordance with the category 'frail people' defined by Cedraschi et al, [31]. Interestingly, most participants from both studies did not consider themselves within this category [31].…”

‘Fuzzy’ virus: indeterminate influenza biology, diagnosis and surveillance in the risk ontologies of the general public in time of pandemics

“…Moreover, influenza is rarely diagnosed by a laboratory test since testing on a large scale places extreme burden upon the health system and testing is often restricted to cases of severe illness and death (Briand, Mounts, & Chamberland, 2011, p. 251). In addition, the general, temporary nature of influenza infection creates an expectation of recovery among most individuals (Cedraschi, Saya, Klein, Bordet, & Carrat, 2013).…”

“…Influenza serves as an example of the ebb and flow of preoccupation with risk. Seasonal influenza generally passes unremarked in public life (Cedraschi et al, 2013), yet the threat of a virulent new pandemic strain, such as H5N1 or H1N1, inspires governments and media to take up the discourse of risk (Nerlich & Halliday, 2007). This recourse to risk discourse was evident in 2009 (Mesch, Schwirian, & Kolobov, 2013), until it became clear that the pandemic turned out to be eventually mild for most of those affected by it.…”

Spatial and temporal patterns in the spread of influenza A and B viruses in the United States during the 2016-17 influenza season

“…It is also important to appreciate what is apparent in the classifying term 'influenza-like illness' that not all cases of ILI are influenza. The percentage of ILI cases that correspond to actual cases of influenza ranges from 0% when there is no influenza in circulation (as is the case in the summer) to between 60% and 70% when there is much influenza in circulation (such as in the winter) (Cedraschi et al, 2013).…”