The burden of seasonal respiratory infections on a national telehealth service in England

Abstract

Seasonal respiratory illnesses present a major burden on primary care services. We assessed the burden of respiratory illness on a national telehealth system in England and investigated the potential for providing early warning of respiratory infection. We compared weekly laboratory reports for respiratory pathogens with telehealth calls (NHS 111) between week 40 in 2013 and week 29 in 2015. Multiple linear regression was used to identify which pathogens had a significant association with respiratory calls. Children aged <5 and 5-14 years, and adults over 65 years were modelled separately as were time lags of up to 4 weeks between calls and laboratory specimen dates. Associations with respiratory pathogens explained over 83% of the variation in cold/flu, cough and difficulty breathing calls. Based on the first two seasons available, the greatest burden was associated with respiratory syncytial virus (RSV) and influenza, with associations found in all age bands. The most sensitive signal for influenza was calls for 'cold/flu', whilst for RSV it was calls for cough. The best-fitting models showed calls increasing a week before laboratory specimen dates. Daily surveillance of these calls can provide early warning of seasonal rises in influenza and RSV, contributing to the national respiratory surveillance programme.

Long-lasting cough in an adult German population: incidence, symptoms, and related pathogens

“…The importance of rhinovirus was also stressed by a European study pointing to the role of re-infections with another rhinovirus type [20]. Linking a laboratory database with telehealth service data in the UK, Morbey et al [21] showed that the greatest burden of ARI was associated with influenza and RSV, and that RSV patients most often complained about coughing.…”

Can syndromic surveillance help forecast winter hospital bed pressures in England?

“…The indicators used included: acute respiratory infections, bronchitis, pneumonia and ILI from the ED and GP systems; and cold/flu calls from NHS 111. Each indicator was chosen based upon previously gathered evidence of sensitivity to circulating winter pathogens [9][10][11]. Syndromic indicators are monitored as daily rates rather than counts because routine surveillance can be affected by daily fluctuations in coverage.…”

“…influenza-like illness; ILI) can help distinguish between different trends in individual pathogens, e.g. between influenza and RSV [9][10][11]. Therefore, syndromic surveillance may be able to provide early warning of hospital bed pressures caused by seasonal respiratory disease.…”

Sommergrippe: Mehr als ein Mythos!

“…Mod. nach [10] den Verlauf der respiratorischen Symptome aus NHS-111-Anrufen. Interessant ist, dass Symptome des Atemtrakts auch im Sommer sehr häu g genannt werden.…”