Environmental Health and Preventive Medicine

, Volume 17, Issue 1, pp 69–72

Increased emergency department chief complaints of fever identified the influenza (H1N1) pandemic before outpatient symptom surveillance

  • Zvi Shimoni
  • Joseph Rodrig
  • Natan Dusseldorp
  • Mark Niven
  • Paul Froom
Short Communication

DOI: 10.1007/s12199-011-0213-2

Cite this article as:
Shimoni, Z., Rodrig, J., Dusseldorp, N. et al. Environ Health Prev Med (2012) 17: 69. doi:10.1007/s12199-011-0213-2



To determine whether a sentinel clinic network or an emergency department (ED) was more timely in identifying the 2009 influenza A (H1N1) pandemic.


All reasons for presenting to the adult regional medical ED were coded online by admission secretaries, without the aid of medical personnel. Increased influenza activity defined by weekly chief complaints of fever was compared with activity defined by the Israel Center for Disease Control (viral surveillance as well as a large sentinel clinic network).


Influenza activity during the pandemic increased in the ED 2 weeks before outpatient sentinel clinics. During the pandemic, maximal ED activity was much higher than in previous seasons. Maximal activity during the past 5 years correlated with the timeliness of the chief complaint of fever in identifying the onset of epidemics.


Chief complaint of fever in the ED can be a sensitive marker of increased influenza activity and might replace the use of sentinel clinics.


Emergency departmentFeverClustersInfluenzaEpidemics

Copyright information

© The Japanese Society for Hygiene 2011

Authors and Affiliations

  • Zvi Shimoni
    • 1
  • Joseph Rodrig
    • 2
  • Natan Dusseldorp
    • 3
  • Mark Niven
    • 1
  • Paul Froom
    • 4
    • 5
  1. 1.Department of Internal Medicine BLaniado HospitalNetanyaIsrael
  2. 2.Emergency DepartmentLaniado HospitalNetanyaIsrael
  3. 3.Computer Support DepartmentLaniado HospitalNetanyaIsrael
  4. 4.Department of Epidemiology and Preventive Medicine, School of Public HealthTel Aviv UniversityRamat AvivIsrael
  5. 5.Maagan MichaelDN MenasheIsrael