Impact of Middle East respiratory syndrome outbreak on the use of emergency medical resources in febrile patients

Jeong, Hyunho; Jeong, Sikyoung; Oh, Juseok; Woo, Seon Hee; So, Byung Hak; Wee, Jeong Hee; Kim, Ji Hoon; Im, Ji Yong; Choi, Seung Pill; Park, Kyoungnam; Cho, Byul Nim Hee; Hong, Sungyoup

This study showed a significant change on emergency resource use by febrile patients after the outbreak of highly transmissible respiratory infectious diseases. The overall volume of ED visits and the proportion of febrile patients using the services increased after the MERS outbreak and the change was more prominent in children under age 5 years. In pediatric patients, crude ED visits increased and the age of patients was significantly higher. Systolic and diastolic blood pressure measurements were higher in both patient groups after the outbreak. Body temperature was lower after the outbreak. Furthermore, illness duration before ED arrival was longer than before the MERS-CoV outbreak. Length of ED stay for febrile patients was increased after the outbreak of the respiratory contagious illness. The MERS outbreak in Korea was characterized by in-hospital transmission, particularly in overcrowded emergency rooms in patients with chronic diseases, like cancer. 4 Patients with fever or febrile symptoms account for only a small proportion of the total number of ED visits. However, some of these patients have acute respiratory infections and respiratory distress accounts for a large proportion of the morbidity and mortality in complex emergencies. Air droplets from patients with highly transmittable respiratory illness can turn emergency rooms into vectors for transmis- Crowding of EDs has been reported for several decades. Many researchers and societies have developed measures to prevent ED crowding and to provide proper care for emergency patients. Interventions are categorized into input, throughput, and output controls. 9 Input factors include the number of patients and clinical condition severity of patients, such as the risk of infection. 10 We demonstrated a worse ED patient input following the MERS outbreak and specifically, the crude volume of emergency visits was increased and the change was more obvious in children.