{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T13:37:57Z","timestamp":1780148277532,"version":"3.54.0"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,17]],"date-time":"2022-09-17T00:00:00Z","timestamp":1663372800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute ear, nose and throat (ENT) infections were the commonest referrals from accident and emergency to ENT services. The referral rate changed dramatically with season, year, national outbreaks and during the COVID pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Retrospective longitudinal study of the epidemiology of seven acute ENT infections in secondary care over 10\u2009years. A mixed city and rural population of over 650\u2009000 in central England was studied. The risk factors for each wave of infection during the surge of infection were sought. A statistical analysis of their significance was undertaken. This included analysis and correlation of group A\u2010beta haemolytic streptococcus (GABHS) in hospital and community. Seasonal variations, hospital admissions and the impact of the COVID were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 16\u2009883 reported cases of the seven index ENT infections during the 10\u2010year period. Great seasonal and year\u2010to\u2010year variations were recorded. There was an incremental rise in 2018. Spring had the highest season of acute ENT infections. An outbreak of GABHS was noted in the community in 2014. The mean duration of hospital admission was 1.5\u2009days. There was no statistical ethnic or gender predominance. A dramatically lower number of acute ENT infections were recorded during the COVID\u201019 pandemic, and this continued after lifting of lockdown restrictions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A resurgence in scarlet fever directly and indirectly contributed to an incremental rise in acute ENT infections in the following years. Both hospital and community B\u2010haemolytic cultures have declined during the COVID\u201019 pandemic due to a reduction in infections as opposed to reduced case ascertainment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.13978","type":"journal-article","created":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T00:24:17Z","timestamp":1662510257000},"page":"10-16","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Ten\u2010year prevalence of acute hospital\n                    <scp>ENT<\/scp>\n                    infections and the impact of\n                    <scp>COVID<\/scp>\n                    : A large population study"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2799-0465","authenticated-orcid":false,"given":"Bassem","family":"Mettias","sequence":"first","affiliation":[{"name":"Leicester Royal Infirmary  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9108-6126","authenticated-orcid":false,"given":"David","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Leicester Royal Infirmary  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0376-2716","authenticated-orcid":false,"given":"Peter","family":"Rea","sequence":"additional","affiliation":[{"name":"Leicester Royal Infirmary  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-019-05331-w"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-008-0619-y"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13233"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30693-X"},{"key":"e_1_2_12_6_1","unstructured":"Geographies of diversity in Leicestershire[cited 2013 Sep 30].http:\/\/hummedia.manchester.ac.uk\/institutes\/code\/briefings\/localdynamicsofdiversity\/geographies-of-diversity-in-leicestershire.pdf."},{"issue":"2","key":"e_1_2_12_7_1","first-page":"87","article-title":"Epidemiology of ENT emergencies","volume":"10","author":"Lammens F","year":"2014","journal-title":"B\u2010ENT"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.2010.00361.x"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30917-8"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268813002744"},{"key":"e_1_2_12_11_1","unstructured":"Toolkit for managing carbapenemase\u2010producing Enterobacteriaceae in non\u2010acute and community settings 2015[cited 2020 Mar 3].https:\/\/www.gov.uk\/government\/publications\/carbapenemase-producing-enterobacteriaceae-non-acute-and-community-toolkit."},{"key":"e_1_2_12_12_1","unstructured":"Otitis media \u2013 acute changes (last revised January 2021).https:\/\/cks.nice.org.uk\/topics\/otitis-media-acute\/how-up-to-date-is-this-topic\/changes\/."},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215120002741"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13869"}],"container-title":["Clinical 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