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Estimating the usual prevalence and incidence of acute illness in the community: implications for pandemic influenza and bioterrorism preparedness.

BACKGROUND
Early clinical signs of influenza caused by a pandemic strain will presumably not differ significantly from those caused by other respiratory viruses. Similarly, early signs of diseases that may result from bioterrorism are frequently non-specific and resemble those of influenza-like illness. Since the time window for effective intervention is narrow, treatment may need to be initiated prior to a definitive diagnosis. Consequently, planning of medications, manpower and facilities should also account for those who would be treated for an unrelated acute illness.


OBJECTIVES
To estimate usual patterns of acute illness in the community as a baseline for integration into pandemic influenza and bioterrorism preparedness plans.


METHODS
Between 2000 and 2003 we conducted 13 telephone surveys to estimate the usual incidence and prevalence of symptoms of acute illness in the community.


RESULTS
On average, 910 households were included in each of the surveys, representing about 3000 people. The compliance rates for full interviews ranged from 72.3% to 86.0%. In winter, on average, about 2% of the Israeli population (individuals) suffered each day from fever of > or = 38 degrees C, and about 0.8% during the other months. The prevalence of cough was higher, 9.2% in winter and 3% during summer. Daily incidence of fever ranged from about 0.4% per day in winter to about 0.2% in the fall. The prevalence and incidence of both fever and cough were highest for infants followed by children aged 1-5 years.


CONCLUSIONS
These background morbidity estimates can be used for planning the overall treatment requirements, in addition to actual cases resulting from pandemic influenza or a bioterrorist incident.