European Journal of Internal Medicine
Volume 19, Issue 7 , Pages 494-498, November 2008

Increased complaints of fever in the emergency room can identify influenza epidemics

  • Z. Shimoni

      Affiliations

    • Internal Medicine B, Laniado Hospital, Natanyia, Israel
  • ,
  • M. Niven

      Affiliations

    • Internal Medicine B, Laniado Hospital, Natanyia, Israel
  • ,
  • N. Kama

      Affiliations

    • Internal Medicine B, Laniado Hospital, Natanyia, Israel
  • ,
  • N. Dusseldorp

      Affiliations

    • Computer Department, Laniado Hospital, Natanyia, Israel
  • ,
  • P. Froom

      Affiliations

    • Department of Epidemiology and Preventive Medicine, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
    • Corresponding Author InformationCorresponding author. Department of Epidemiology and Preventive Medicine, Sackler Medical School, Tel Aviv University, Ramat Aviv, Israel.

Received 25 January 2007; received in revised form 23 April 2007; accepted 23 April 2007. published online 20 March 2008.

Abstract 

Background

In developing countries, it may be easier to use the reasons why patients come to the emergency room (ER) instead of sentinel practices to identify influenza epidemics.

Methods

We studied the reasons why adult patients present to the ER in order to attempt to predict increased hospital activity as a result of influenza. The daily frequency of presenting symptoms during the 30 days of maximal influenza activity was compared to the other days of the study period (335 days).

Results

During the influenza period, more patients presented with fever, syncope or near syncope, cough, asthma attack, and paralysis than on the days outside of this period. On 50% of the days, eight or more patients presented with fever, an 8.36 (95% CI=4.6–15.19) higher frequency than during the rest of the year. During the subsequent year, days with excess presentations by patients with a principal complaint of fever predicted increased hospital activity due to influenza with no false-positive periods.

Conclusions

We conclude that an increase in the number of patients presenting to the ER complaining of fever can identify increased hospital influenza activity.

Keywords: Complaints, Emergency room, Influenza, Epidemic

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PII: S0953-6205(08)00039-3

doi:10.1016/j.ejim.2007.04.028

European Journal of Internal Medicine
Volume 19, Issue 7 , Pages 494-498, November 2008