Febrile Illness in Adolescents and Adults

Authors: John Crump, Paul Newton, Sarah Baird, Yoel Lubell

Fever, one of the most common symptoms reported by patients seeking health care, presents a challenge to treatment since it may be caused by bacterial, fungal, parasitic, and viral infections as well as noninfectious conditions. The diagnostic tests, vaccines, and medicines necessary to reduce the burden of fevers are often of poor quality, especially in countries with insufficient regulation. Febrile illnesses are key drivers of health expenditures and productivity losses. More studies are required to assess the cost-effectiveness of surveillance of bloodstream infections for sepsis. Five elements need to be addressed for cost-effectiveness analyses: (1) inclusion of the intervention’s implications for all febrile patients; (2) inclusion of factors affecting the intervention’s performance in real-life settings; (3) framing of the evaluations within etiological contexts and exploration of the implications of heterogeneity; (4) extension of the analyses to include implications for ongoing pathogen transmission; and (5) accounting for the intervention’s impact on development of antimicrobial resistance.