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Relationship between Clinical Screening Tools, Syndromic Surveillance, and Influenza-Positive Patients

Description

In 2003, with the advent of SARS, the Ontario Ministry of Health and Long-Term Care (MOHLTC) released a document mandating the use of a clinical screening tool to detect patients at high risk for having a febrile respiratory illness (FRI), defined as a temperature of > 38ºC and a new or worsening cough or shortness of breath (1). The FRI screening tool is available in all Ontario Emergency Departments (ED), and is utilized in 86% of them (2). Any patient who meets all of the criteria is designated FRI positive, treated with droplet precautions and is instructed to wear a mask and undergo frequent hand-washing (1). The FRI screening tool was created as a response to the SARS outbreaks, and while it is used to identify any FRI, its sensitivity has not been documented. We attempt to determine the utility of FRI as a defining element of clinical influenza.

Objective

 (1) To determine if patients who are found to be positive for influenza or parainfluenza by culture or antigen detection are all detected by the Ontario Ministry of Health and Long-Term Care's Febrile Respiratory Illness (FRI) screening tool, and thereby treated with appropriate respiratory precautions to prevent spread. (2) To determine if syndromic surveillance or another clinical predictor would be a more effective screening tool than FRI.

Submitted by elamb on