title: Perception of the Risks of Ebola, Enterovirus-E68 and Influenza Among Emergency Department Patients.
abstract: BACKGROUND
  Emerging infectious diseases often create concern and fear among the public. Ebola virus disease (EVD) and enterovirus (EV-68) are uncommon viral illnesses compared to influenza. The objective of this study was to determine risk for these viral diseases and then determine how public perception of influenza severity and risk of infection relate to more publicized but less common emerging infectious diseases such as EVD and EV-68 among a sample of adults seeking care at an emergency department (ED) in the United States.
  
  
  METHODS
  We included consenting adults who sought care in two different urban EDs in Seattle, WA in November 2014. Excluded were those who were not fluent in English, in police custody, had decreased level of consciousness, a psychiatric emergency, or required active resuscitation. Patients were approached to participate in an anonymous survey performed on a tablet computer. Information sought included demographics, medical comorbidities, risk factors for EVD and EV-68, and perceptions of disease likelihood, severity and worry for developing EVD, EV-68 or influenza along with subjective estimates of the number of people who have died of each virus over the year in the United States.
  
  
  RESULTS
  A total of 262 (88.5% participation rate) patients participated in the survey. Overall, participants identified that they were more likely to get influenza compared to EVD (p<0.001) or EV-68 (p<0.001), but endorsed worry and concern about getting both EVD and EV-68 despite having little or no risk for these viral diseases. Nearly two-thirds (64%) of participants had at-least one risk factor for an influenza-related complication. Most participants (64%) believed they could get influenza in the next 12 months. Only 52% had received a seasonal influenza vaccine.
  
  
  CONCLUSIONS
  Perception of risk for EVD, EV-68 and influenza is discordant with actual risk as well as self-reported use of preventive care. Influenza is a serious public health problem and the ED is an important healthcare location to educate patients.
authors.affiliation: University of Washington, Department of Emergency Medicine, Seattle, Washington.
authors.forename: Lauren K
authors.initials: LK
authors.lastname: Whiteside
authors.affiliation: University of Washington, Department of Emergency Medicine, Seattle, Washington.
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Fernandez
authors.affiliation: University of Washington, Department of Emergency Medicine, Seattle, Washington.
authors.forename: Justin
authors.initials: J
authors.lastname: Bammer
authors.affiliation: Harborview Center for Prehospital Emergency Care, Department of Medicine, Seattle, Washington.
authors.forename: Graham
authors.initials: G
authors.lastname: Nichol
mesh_terms: D001007:Anxiety; D021821:Communicable Diseases, Emerging / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D004219:District of Columbia / Q000453:epidemiology; D029043:Ebolavirus; D004636:Emergency Service, Hospital; D004770:Enterovirus; D004769:Enterovirus Infections / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D017589:Immunization Programs; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011639:Public Opinion; D018570:Risk Assessment; D011795:Surveys and Questionnaires
chemical_list: D007252:Influenza Vaccines