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At present, there is scarce evidence about the burden associated with the isolation of COVID-19 patients. We aimed to assess the differences between COVID-19 and other influenza-like illnesses (ILIs) in disease burden brought by isolation. We conducted an online survey of 302 respondents who had COVID-19 or other ILIs and compared the burden of isolation due to sickness with one-to-one propensity score matching. The primary outcomes are the duration and productivity losses associated with isolation, the secondary outcome is the health-related quality of life (HRQoL) valuation on the day of the survey. Acute symptoms of outpatient COVID-19 and other ILIs lasted 17 (interquartile range (IQR) 9-32) and 7 (IQR 4-10) days, respectively. The length of isolation due to COVID-19 was 18 (IQR 10-33) days and that due to other ILIs was 7 (IQR 4-11) days, respectively. The monetary productivity loss of isolation due to COVID-19 was 1424.3 (IQR 825.6-2545.5) USD and that due to other ILIs was 606.1 (IQR 297.0-1090.9) USD, respectively. HRQoL at the time of the survey was lower in the COVID-19 group than in the 'other ILIs' group (0.89 and 0.96, P = 0.001). COVID-19 infection imposes a substantial disease burden, even in patients with non-severe disease. This burden is larger for COVID-19 than other ILIs, mainly because the required isolation period is longer.

Acute gastroenteritis (AGE) remains a common condition in both low- and high-income countries. In Belgium, however, there is currently a lack of information on the societal health and economic impact of AGE. We conducted a retrospective study using mortality and cause-of-death data, hospital data, primary care data, health interview survey data and other published data. We estimated the burden of illness during a 5-year period (2010-2014) in Belgium in terms of deaths, patients admitted to hospitals, patients consulting their general practitioner (GP) and cases occurring in the community. We further quantified the health impact in terms of disability-adjusted life years (DALYs) and the economic impact in terms of cost-of-illness estimates. We estimated 343 deaths, 27 707 hospitalised patients, 464 222 GP consultations and 10 058 741 episodes occurring in the community (0.91 cases/person) on average per year. AGE was associated with 11 855 DALYs per year (107 DALY per 100 000 persons). The economic burden was estimated to represent direct costs of €112 million, indirect costs of €927 million (90% of the total costs) and an average total cost of €103 per case and €94 per person. AGE results in a substantial health and economic impact in Belgium, justifying continued mitigation efforts.

The WAIFW matrix (Who Acquires Infection From Whom) is a central parameter in modelling the spread of infectious diseases. The calculation of the basic reproductive number (R0) depends on the assumptions made about the transmission within and between age groups through the structure of the WAIFW matrix and different structures might lead to different estimates for R0 and hence different estimates for the minimal immunization coverage needed for the elimination of the infection in the population. In this paper, we estimate R0 for varicella in Belgium. The force of infection is estimated from seroprevalence data using fractional polynomials and we show how the estimate of R0 is heavily influenced by the structure of the WAIFW matrix.

The objective of this study was to model the age-time-dependent incidence of hepatitis B while estimating the impact of vaccination. While stochastic models/time-series have been used before to model hepatitis B cases in the absence of knowledge on the number of susceptibles, this paper proposed using a method that fits into the generalized additive model framework. Generalized additive models with penalized regression splines are used to exploit the underlying continuity of both age and time in a flexible non-parametric way. Based on a unique case notification dataset, we have shown that the implemented immunization programme in Bulgaria resulted in a significant decrease in incidence for infants in their first year of life with 82% (79-84%). Moreover, we have shown that conditional on an assumed baseline susceptibility percentage, a smooth force-of-infection profile can be obtained from which two local maxima were observed at ages 9 and 24 years.