Colds and influenza-like illnesses in university students: Impact on health, academic and work performance, and health care use

Kristin L. Nichol, Sarah D'Heilly, Edward Ehlinger

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92 Scopus citations


Background. Upper respiratory tract illnesses (URIs) are a major cause of morbidity among adults, with substantial direct and indirect costs to society, but their impact among university students has not been well described. We sought to assess the impact of URIs (colds and influenza-like illnesses [ILIs]) on the health, academic and work performance, and health care use of university students. Methods. This was a cohort study of college students at the University of Minnesota, Twin Cities campus (Minneapolis-St. Paul), who were recruited during October 2002 and followed up from November 2002 through April 2003. All 42,000 registered students were invited via e-mail to participate. Baseline information was obtained in October 2002. Monthly follow-up information about colds or ILIs was obtained for the period of November 2002 through April 2003. Data were collected by use of Internet-based questionnaires. Results. Of 4919 volunteers, 3249 completed all follow-up surveys. The mean age was 22.7 years; 68% of the volunteers were female. Ninety-one percent had ≥1 URI (83% had ≥1 cold, and 36.7% had ≥1 ILI). These URIs caused 6023 bed-days, 4263 missed school days, 3175 missed work days, and 45,219 days of illness. Of the cohort, 22.2% had ≥1 health care visit, and 15.8% used antibiotics to treat a URI; 27.8% did poorly on a test and 46.3% did poorly on a class assignment. ILIs versus colds had a much greater impact on all parameters (e.g., general health level was 55%-60% lower with ILI vs. no URI and 33%-39% lower for colds vs. no URI; P < .001 for each). Conclusion. Colds and ILIs were common and associated with substantial morbidity in university students. Enhanced efforts to prevent and control URIs, especially influenza vaccination, could improve the health and well-being of the 17 million college and university students in this country.

Original languageEnglish (US)
Pages (from-to)1263-1270
Number of pages8
JournalClinical Infectious Diseases
Issue number9
StatePublished - May 1 2005

Bibliographical note

Funding Information:
Financial support. This was an investigator-initiated study that was supported by unrestricted grants from Aventis Pasteur and MedImmune. The study sponsors reviewed the proposed study design before providing funding and had an opportunity to review the manuscript before it was submitted, but they did not otherwise participate in the design or conduct of the study; in the collection, management, analysis, or interpretation of the study data; or in the preparation or approval of the manuscript.

Funding Information:
Potential conflicts of interest. K.L.N. has previously received research funding from Aventis Pasteur. S.D. and E.E.: no conflicts.


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