OUTBREAK OF ESCHERICHIA-COLI O157-H7 HEMORRHAGIC COLITIS AND HEMOLYTIC-UREMIC SYNDROME - EFFECT ON USE OF A PEDIATRIC EMERGENCY DEPARTMENT

Study objective: To evaluate the effect of an outbreak of Escherichia coli 0157:H7 colitis, and media coverage of the outbreak, on use of an emergency department. Design: Review of pediatric ED use and charges for gastrointestinal illness during the epidemic and during a control period. Setting: Pediatric ED in Seattle, Washington. Participants: Al l children seen in the ED with a gastrointestinal illness during the e pidemic period (January and February 1993) and during a control period (January and February 1992). Results: During the epidemic, 31 patient s with E coli 0157:H7 infection had 45 visits to the ED. The number of visits for gastro intestinal illness not caused by E coli 0157:H7 was 103% higher in the epidemic period than in the control period (653 in 1992, 1,327 in 1993). The number of visits was closely associated wit h the number of newspaper stories about E coli 0157:H7 illness (correl ation coefficient, .88; P = .002). The increased number of E!valuation s for gastrointestinal illness not caused by E coli 0157:H7 infection during the epidemic period was associated with an additional $101,193 in charges per month compared with the control period. There were no i mportant differences in the E!valuation of gastrointestinal illness be tween 1992 and 1993 except for an increase in the proportion of patien ts with stool cultures (13.1% versus 26.4%, P<.001). Conclusion: For e very visit by a patient with E coli 0157:H7 infection, there were 15 a dditional visits (above the baseline from the control period) by patie nts with other gastrointestinal illness. The true cast of this epidemi c included not only the evaluation of patients with disease but also t he evaluation of those who presented because they were worried they ha d the disease. The intensity of media coverage of a disaster may corre late with the number of visits to the ED, and understanding of this fa ct may help in disaster planning.