Measuring the disease burden of seasonal influenza in Germany 2015-2020 using the incidence-based disability-adjusted life years (DALYs)

BackgroundSeasonal influenza can lead to severe complications and death, resulting in high disease burden each year. The European Centre for Disease Prevention and Control introduced the Burden of Communicable diseases in Europe (BCoDE) project, quantifying the disease burden of infectious diseases in disability-adjusted life years (DALY). DALYs for influenza exceed those of Tuberculosis, HIV, and Invasive pneumococcal disease. As data on disease burden are limited, this study aims to calculate the seasonal influenza burden for Germany between 2015 and 2020.MethodsThe BCoDE-toolkit developed by the European Centre for Disease Prevention and Control was used, calculating country-specific DALYs. Information on incidence, population data, and underestimation were taken from the Robert Koch-Institute and the Federal Statistical Office of Germany. Outcome trees were created based on information from a rapid review and previous publications. Baseline, lower-bound and upper-bound scenarios were developed to assess the disease burden under varying conditions.ResultsEstimates range from 127,100 DALYs (153 DALYs per 100,000 population) and 1,171,115 DALYs (1,414 DALYs per 100,000 population) depending on the scenario and year examined. The main contributors to the disease burden are sequelae, primarily pneumonia, encephalitis, and myocarditis. The highest burden estimates are observable for infants, children under the age of five and the elderly.ConclusionsUsing a composite health measure like DALY can offer valuable insight into a disease's impact on population health. Our results indicate a high disease burden due to seasonal influenza in Germany, indicating further research into complication rates, underestimation, and intervention programs for vulnerable populations, e.g., vaccination in infants, children under age of five and elderly population.