Noelle-Angelique M Molinari1, Tanya Telfair LeBlanc2, William Stephens3. 1. Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 2. Applied Science and Evaluation Branch, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 3. Office of Public Health Informatics, Tarrant County Public Health, Tarrant County, Texas, USA.
Abstract
BACKGROUND: The first Ebola virus disease (EVD) case in the United States (US) was confirmed September 30, 2014 in a man 45 years old. This event created considerable media attention and there was fear of an EVD outbreak in the US. METHODS: This study examined whether emergency department (ED) visits changed in metropolitan Dallas-Fort Worth--, Texas (DFW) after this EVD case was confirmed. Using Texas Health Services Region 2/3 syndromic surveillance data and focusing on DFW, interrupted time series analyses were conducted using segmented regression models with autoregressive errors for overall ED visits and rates of several chief complaints, including fever with gastrointestinal distress (FGI). Date of fatal case confirmation was the "event." RESULTS: Results indicated the event was highly significant for ED visits overall (P<0.05) and for the rate of FGI visits (P<0.0001). An immediate increase in total ED visits of 1,023 visits per day (95% CI: 797.0, 1,252.8) was observed, equivalent to 11.8% (95% CI: 9.2%, 14.4%) increase ED visits overall. Visits and the rate of FGI visits in DFW increased significantly immediately after confirmation of the EVD case and remained elevated for several months even adjusting for seasonality both within symptom specific chief complaints as well as overall. CONCLUSIONS: These results have implications for ED surge capacity as well as for public health messaging in the wake of a public health emergency.
BACKGROUND: The first Ebola virus disease (EVD) case in the United States (US) was confirmed September 30, 2014 in a man 45 years old. This event created considerable media attention and there was fear of an EVD outbreak in the US. METHODS: This study examined whether emergency department (ED) visits changed in metropolitan Dallas-Fort Worth--, Texas (DFW) after this EVD case was confirmed. Using Texas Health Services Region 2/3 syndromic surveillance data and focusing on DFW, interrupted time series analyses were conducted using segmented regression models with autoregressive errors for overall ED visits and rates of several chief complaints, including fever with gastrointestinal distress (FGI). Date of fatal case confirmation was the "event." RESULTS: Results indicated the event was highly significant for ED visits overall (P<0.05) and for the rate of FGI visits (P<0.0001). An immediate increase in total ED visits of 1,023 visits per day (95% CI: 797.0, 1,252.8) was observed, equivalent to 11.8% (95% CI: 9.2%, 14.4%) increase ED visits overall. Visits and the rate of FGI visits in DFW increased significantly immediately after confirmation of the EVD case and remained elevated for several months even adjusting for seasonality both within symptom specific chief complaints as well as overall. CONCLUSIONS: These results have implications for ED surge capacity as well as for public health messaging in the wake of a public health emergency.
Entities:
Keywords:
Ebola Virus Disease; emergency department visits; statistical model
Authors: Hiroshi Gotanda; Joyce Fogel; Gregg Husk; Jeffrey M Levine; Monte Peterson; Kevin Baumlin; Joseph Habboushe Journal: Prehosp Disaster Med Date: 2015-09-15 Impact factor: 2.040
Authors: Racquel Jandoc; Andrea M Burden; Muhammad Mamdani; Linda E Lévesque; Suzanne M Cadarette Journal: J Clin Epidemiol Date: 2015-03-11 Impact factor: 6.437
Authors: Arvind Venkat; Shellie L Asher; Lisa Wolf; Joel M Geiderman; Catherine A Marco; Jolion McGreevy; Arthur R Derse; Edward J Otten; John E Jesus; Natalie P Kreitzer; Monica Escalante; Adam C Levine Journal: Acad Emerg Med Date: 2015-04-22 Impact factor: 3.451
Authors: David Sugerman; Kelly H Nadeau; Kathryn Lafond; Wendy Cameron; Karl Soetebier; Michael Jhung; Alexander Isakov; Ian Greenwald; Karen Neil; Stephanie Schrag; Alicia Fry Journal: Clin Infect Dis Date: 2011-01-01 Impact factor: 9.079
Authors: William Stephens; Grete E Wilt; Erica Adams Lehnert; NoelleAngelique M Molinari; Tanya Telfair LeBlanc Journal: Disaster Med Public Health Prep Date: 2020-02 Impact factor: 1.385