GP phone logs may give warning of flu pandemic

PUBLIC health specialists have unearthed a possible early-warning system for the onset of a flu pandemic by examining the logs of patient telephone calls to GP out-of-hours (OOH) services.

Using a computer software package, health surveillance experts combed the call records for mentions of influenza-like illness (ILI) and discovered that the number of calls to OOH services peaked a week ahead of a national peak of the pandemic. This advance surge occurred in five out of six flu seasons analysed (2003-2008) and led those who carried out the research to conclude that the data extracted from the OOH telephone records had “the potential to be utilised as an early alert system for seasonal and pandemic influenza”.

The researchers, including Dr Elaine Brabazon, Health Service Executive (HSE) surveillance scientist, and Dr Declan Bedford, public health doctor, also felt the method they had used “could be applied to other important areas of public health surveillance” at a relatively low cost.

In addition, the researchers discovered that anecdotally, it appeared an increase in calls from younger age groups may result in an increase in the numbers attending hospitals’ emergency departments and that this information could be used to forewarn hospitals to stock up on certain essentials.

“Advance notice of such increases in the community, particularly during a pandemic, can give hospitals valuable time to prepare separate waiting areas, obtain adequate stocks of antiviral drugs and diagnostic swabs, and ensure an action plan for rapid admission to isolation of suspected cases is in place,” they said.

They also believe the method they used to extract information could be used widely without any additional costs or workload other than the IT requirement, as the data they studied is collected routinely.

The study, published in the recent edition of online medical journal, Eurosurveillance, examined patient contact records with two out-of-hours (OOH) services – North East Doctor on Call and Midlands Doctor on Call. The study’s authors said that by analysing where the calls came from, there was potential to identify local influenza outbreaks and their points of origin. They said analysis of this type has already been employed with influenza military emergency and primary care surveillance data in the US and fever and vomiting calls to NHS Direct in Britain to generate a ‘moving picture’ or tracking of cases through location and time.

During an average week, the OOH service is in operation for over two thirds of the week (118 of 168 hours) and patients with acute illnesses who need urgent attention may contact the OOH service rather than their GP. Ireland’s OOH service covers 70% of the population.

The Health Service Executive has confirmed that its winter influenza vaccination programme will include vaccination against H1N1 or swine flu which claimed 24 lives between August 2009 and March 2010.