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Fevers Are Rarer in the Morning--Could We Be Missing Infectious Disease Cases by Screening for Fever Then?

Harding, C.; Pompei, F.; Bordonaro, S. F.; McGillicuddy, D. C.; Burmistrov, D.; Sanchez, L. D.

2020-08-13 infectious diseases
10.1101/2020.05.23.20093484 medRxiv
Show abstract

We retrospectively studied US emergency department visits (n=295,406), including nationally representative results. Patients were less likely to have detectable fevers during mornings, with especially large morning-evening differences during influenza outbreaks (national RR=0.56, 95%CI=0.47-0.66). This suggests morning screenings could miss otherwise-detectable cases. Twice-daily screenings could be a simple solution. However, similar COVID-19 research is needed. Article Summary LineFevers were about half as common in the morning as in the evening during influenza outbreaks, suggesting that mornings may be a bad time to perform once-daily fever screenings for infectious diseases, and that twice-daily screenings could be preferable.

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