Peaks in online inquiries into pharyngitis-related symptoms correspond with annual incidence rates

Outdoor Temperature as an Independent Risk Factor for Acute Pharyngitis Incidence: A Preliminary Study

Objective: Acute pharyngitis is common worldwide. Meteorological changes contribute to respiratory infections. This study aims to explore the correlation between acute pharyngitis and meteorological parameters. Methods: We collected the monthly acute pharyngitis cases in our hospital and the meteorological data, including temperature, relative humidity, and air quality index (AQI) of Shanghai, China, from January, 2015, to December, 2017. Pearson correlation and multivariable regression analysis were used to explore the association between meteorological parameters and the monthly hospital visits. Results: A total of 8287 patients were included in this study, and the monthly number of hospital visits was 230.2 ± 39.0. The best air quality index was 46.4 and the worst was 113.2. Temperature ranged from 5.2°C to 32.0°C, and relative humidity ranged from 59.4% to 83.1%. The monthly hospital visits of acute pharyngitis were negatively correlated with temperature (r = -.558, 95% CI -.746, -.274) and relative humidity (r = -.480, 95% CI -.695, -.137). A decrease of 1°C could cause an increase in hospital visits by 1.9. No significant correlation was found were found between acute pharyngitis cases and AQI (P = .051, 95% CI -.005, .590). Multivariable linear regression analysis showed the temperature was the independent risk factor of acute pharyngitis (coefficient = -1.906, P = .022). Conclusion: Low temperature might cause an increased incidence of acute pharyngitis.

Presentation Rates for Acute Pharyngitis in the Emergency Room Are Influenced by Extreme Weather Events

OBJECTIVE

Extreme weather events are becoming more prevalent with the increasing pace of climate change. These events negatively impact human health and put considerable strain on health care resources, including emergency departments. Within otolaryngology, acute pharyngitis is a common reason for emergency room visits (ERV). Therefore, we aimed to investigate the impact of extreme meteorological conditions on ERV rates related to acute pharyngitis.

STUDY DESIGN

Retrospective time-series study.

SETTING

ERVs related to acute pharyngitis (n = 1511) were identified at a tertiary care hospital in Vienna, Austria, between 2015 and 2018.

METHODS

The effects of single-day and prolonged (3-day) extreme weather events on ERVs were analyzed using a distributed lag nonlinear model. Relative risk (RR) and cumulative relative risk (cRR) were calculated over a lag period of 14 days. RR refers to the risk for pharyngitis-related ERV at extreme conditions (1st, 5th, 95th, or 99th percentile) compared to the risk at median conditions.

RESULTS

Same-day RR (lag0) was elevated more than 3-fold after prolonged extremely low mean temperatures (P = .028). Furthermore, same-day RR after single-day and prolonged extremely high relative humidity was elevated by 51% (P = .024) and 46% (P = .036), respectively. Significant delayed effects on cRR were observed for extreme mean temperatures, relative humidity, and mean wind speeds within 8 days and for extreme atmospheric pressure within 14 days.

CONCLUSION

Extreme weather events impact ERV rates for acute pharyngitis. Extremely low temperatures, high relative humidity, high atmospheric pressure, and low and high wind speeds were risk-promoting factors.

Fluctuations in emergency department visits related to acute otitis media are associated with extreme meteorological conditions

Background

Climate change has been associated with a higher frequency of extreme weather events, resulting in an overall increase in morbidity and mortality. Acute otitis media (AOM) is one of the most common otolaryngological infections and accounts for 1.5% of emergency department visits. This study aimed to identify associations between extreme weather events and the immediate and delayed risks for AOM-related emergency department visits (EV).

Methods

A total of 1,465 AOM-related EVs were identified in the Vienna General Hospital between 2015 and 2018. A distributed lag non-linear model was applied to evaluate the relationship between extreme weather conditions and the total number of AOM-related EVs per day. The relative risk (RR) and cumulative RR (cRR) of single-day events and extended weather events over three days were analyzed over a lag period of 14 days.

Results

AOM-related EVs showed a pronounced seasonality, with the highest occurrence during winter. Single-day weather events affected AOM-related EVs only at high relative humidity. Prolonged extreme weather conditions over three days, however, significantly increased the cRR for AOM-related EVs to 3.15 [1.26-7.88; p = 0.014] and 2.14 [1.14-4.04; p = 0.018] at mean temperatures of -4°C (1^st-percentile - p₁) and 0°C (p₅) on the same day. Relative humidity of 37% (p₁) decreased RR to 0.94 [0.88-0.99; p = 0.032] on day 7, while extremely high humidity of 89% (p₉₉) led to an increased cRR of 1.43 [1.03-2.00; p = 0.034] on day 7. Heavy prolonged precipitation of 24mm (p₉₅) reduced cRR beginning day 4 up until day 14 to 0.52 [0.31-0.86; p = 0.012]. Prolonged low atmospheric pressure events of 985hPa (p₅) reduced the RR to 0.95 [0.91-1.00; p = 0.03], whereas extremely high atmospheric pressure events of 1013hPa (p₉₉) increased the RR to 1.11 [1.03-1.20; p = 0.008]. Extremely low wind speeds significantly diminished the RR of AOM-related EVs.

Conclusions

While single-day extreme weather events had little impact on the occurrence of AOM-related EVs, extended periods of extreme temperatures, relative humidity, precipitation, wind speeds and atmospheric pressure significantly impacted the RR for AOM-related EVs. These findings could help improve healthcare resource allocation in similar climates and aid in educating patients about the role of environmental factors in AOM.

Biannual Differences in Interest Peaks for Web Inquiries Into Ear Pain and Ear Drops: Infodemiology Study

Background

The data retrieved with the online search engine, Google Trends, can summarize internet inquiries into specified search terms. This engine may be used for analyzing inquiry peaks for different medical conditions and symptoms.

Objective

The aim of this study was to analyze World Wide Web interest peaks for “ear pain,” “ear infection,” and “ear drops.”

Methods

We used Google Trends to assess the public online interest for search terms “ear pain,” “ear infection,” and “ear drops” in 5 English and non–English-speaking countries from both hemispheres based on time series data. We performed our analysis for the time frame between January 1, 2004, and December 31, 2019. First, we assessed whether our search terms were most relevant to the topics of ear pain, ear infection, and ear drops. We then tested the reliability of Google Trends time series data using the intraclass correlation coefficient. In a second step, we computed univariate time series plots to depict peaks in web-based interest. In the last step, we used the cosinor analysis to test the statistical significance of seasonal interest peaks.

Results

In the first part of the study, it was revealed that “ear infection,” “ear pain,” and “ear drops” were the most relevant search terms in the noted time frame. Next, the intraclass correlation analysis showed a moderate to excellent reliability for all 5 countries’ 3 primary search terms. The subsequent analysis revealed winter interest peaks for “ear infection” and “ear pain”. On the other hand, the World Wide Web search for “ear drops” peaked annually during the summer months. All peaks were statistically significant as revealed by the cosinor model (all P values <.001).

Conclusions

It can be concluded that individuals affected by otitis media or externa, possibly the majority, look for medical information online. Therefore, there is a need for accurate and easily accessible information on these conditions in the World Wide Web, particularly on differentiating signs and therapy options. Meeting this need may facilitate timely diagnosis, proper therapy, and eventual circumvention of potentially life-threatening complications.