Shirai Chika, Fujiyama Riyo, Uchino Eiko, Irie Fujiko, Takatoriges Toshio, Iso Hiroyasu
Public Health Center of Kobe City.
Nihon Koshu Eisei Zasshi. 2012 Sep;59(9):684-92.
To make recommendations on the revision of the Pandemic Influenza National Action Plan and Guidelines, we reviewed the data from the flu call center and medical institutions in Kobe city and compared them with data from Ibaraki prefecture.
The overall duration of study from May 2009 to December 2009 was divided into 4 periods; we analyzed details of the calls received by the call center and examined the correlation between them and cases who were seen at medical institutions in Kobe. We used a mathematical model to approximate the cumulative growth curve of the number of calls received by the call center and the number of cases attending fever clinics in Kobe. We compared the above data with data from Ibaraki because the total number of confirmed cases of pandemic (H1N1) 2009 influenza was similar: Kobe identified the first confirmed case of the influenza in Japan, while Ibaraki reported their first case 1 month later.
Following the report of the initial domestic case, the Kobe call center received 30,067 calls in a month. A "delayed sigmoid curve" fitted well for both the rise in the number of calls at the call center and of cases attending the fever clinics. "Feeling sick despite no overseas travel history" was the most common reason for call. More than 2,000 calls/day were received, and the responses to such calls were instructions to consult a general medical institution (40%), instructions to refer to a fever clinic (8%), guidance on home care or how to manage underlying disorders, and listening to callers' anxieties and complaints. The numbers of calls decreased towards the end ofJuly; the number of calls increased again when outbreaks were reported in schools and a death due to influenza was confirmed. After November, on an average, 500 calls/day were received; most were complaints regarding vaccination. Unlike Kobe, Ibaraki did not experience a surge in the number of calls to the call center or consultations to fever clinics within a short period of time.
The outbreak of pandemic (H1N1) 2009 influenza showed different call patterns and medical consultations in different regions. The time of disease outbreak and the availability of medical resources differ among regions; hence, each municipality should act practically and flexibly according to the situation in their locality.
为修订《大流行性流感国家行动计划和指南》提供建议，我们回顾了神户市流感咨询中心和医疗机构的数据，并将其与茨城县的数据进行比较。
2009年5月至2009年12月的研究总时长分为4个阶段；我们分析了咨询中心接到的电话详情，并研究了这些电话与神户市医疗机构所诊治病例之间的相关性。我们使用数学模型来拟合咨询中心接到的电话数量以及神户市发热门诊就诊病例数量的累积增长曲线。我们将上述数据与茨城县的数据进行比较，因为2009年甲型H1N1流感确诊病例总数相近：神户市确诊了日本首例该流感病例，而茨城县1个月后才报告首例病例。
在国内首例病例报告后，神户市咨询中心一个月内接到30067个电话。“延迟S形曲线”很好地拟合了咨询中心电话数量的增加以及发热门诊就诊病例数量的增加。“虽无海外旅行史但感觉不适”是打电话的最常见原因。每天接到2000多个电话，对这些电话的回复包括指示咨询综合医疗机构（40%）、指示前往发热门诊（8%）、关于家庭护理或如何处理基础疾病的指导，以及倾听来电者的焦虑和抱怨。7月底电话数量减少；在学校报告疫情和确诊一例流感死亡病例后，电话数量再次增加。11月之后，平均每天接到500个电话；大多数是关于疫苗接种的投诉。与神户不同，茨城县咨询中心的电话数量或发热门诊的咨询量在短时间内没有激增。
2009年甲型H1N1流感疫情在不同地区呈现出不同的电话模式和医疗咨询情况。不同地区疾病爆发时间和医疗资源可用性不同；因此，每个自治市应根据当地情况切实灵活应对。
