| Popis: |
Body temperatures are generally lower during mornings, but it is unclear how this affects practice during disease outbreaks. We retrospectively studied fever rates during seasonal influenza outbreaks and the 2009 H1N1 (swine flu) pandemic, analyzing Boston emergency department visits (2009– 2012; n=93,225) and a nationally representative sample of adult US emergency department visits (National Hospital Ambulatory Care Survey, 2002–2010; n=202,181). Outbreak periods were defined from regional and national ILINet thresholds set by the Centers for Disease Control and Prevention. During outbreak periods, temperatures were about half as likely to reach the fever range (≥100.4°F, ≥38.0°C) in the morning as in the evening (rate ratios for 6 AM–noon vs. 6 PM– midnight: Boston=0.43, 95% CI=0.29-0.61; national=0.56, 95% CI=0.47-0.66; national with multivariable adjustment for 12 case characteristics=0.59, 95% CI=0.50-0.70). Fever rates were also lowest during mornings for other common fever definitions and in supplementary analyses of a non-emergency-department, non-medical population of adults (National Health and Nutrition Examination Survey I). Our results suggest that mornings may be a bad time to perform once-daily fever screenings for infectious diseases, and that twice-daily screenings could be preferable as a simple solution. However, similar research is needed on COVID-19 to address the current pandemic. One Sentence Summary Fevers are about half as common in the morning as in the evening during influenza outbreaks, suggesting that mornings may be a bad time to perform once-daily fever screenings for infectious diseases, and that twice-daily screenings could be preferable. |
