Table 1 Details of the 19 missed opportunities that presented to healthcare
Cases 1–13: self reported prior presentation to health care with seroconversion symptoms
CaseEthnicity, sexuality, genderSymptomsDiagnosis patient recalls being givenHealthcare provider
1White MSMFever, sore throat, swollen glands, arthralgiaTonsillitisGP
2White heterosexual femaleFever, sore throat, diarrhoea, headacheTonsillitisA&E
3White heterosexual femaleRash, sore throat, swollen glands, weight lossGlandular feverGP
4White MSMFever, rash, flu-like symptomsViral infectionGP
5White MSMFever, abdominal pain, flu-like symptomsLow plateletsGP
6White MSMFever, sore throat, malaise, weight loss, headachesBacterial infectionGP
7White MSMFever, sore throatBacterial infectionGP
8White MSMFever, sore throat, flu-like symptomsBacterial infectionGP
9White MSMRash, sore throat, flu-like symptomsBacterial infectionGP
10White MSMFever, rash, flu-like symptomsNot specifiedGP
11White MSMFever, rash, sore throat, lymphadenopathy, mouth soresNot specifiedGP
12White MSMFlu-like symptomsNot specifiedGP
13White MSMFever, sore throat, diarrhoea,Not specifiedA&E
Cases 14–19: laboratory evidence of prior presentation to health care with seroconversion symptoms
CaseEthnicity, sexuality, genderClinical information on blood formLaboratory tests requestedHealthcare provider
14White MSMRash, streptococcalASOT titreGP
15White MSMHistory malaise, cough, swollen glandsFBC, U&E, LFTs, CMV+ EBV serology, monospotGP
16White MSMFever returning from KenyaFBC, U&E, LFTs, blood filmGP
17White MSMDiarrhoea, malaiseFBC, U&E, LFTs, ESR, stool cultureGP
18White bisexual maleSore throat 3 weeksFBC, U&E, LFTs, monospot testA&E
Infectious mononucleosisThroat culture
19White MSMHIVFourth generation HIV testGUM clinic
  • A&E, accident and emergency; ASOT, antistreptolysin-O-test; CMV, cytomegalovirus; EBV, Epstein-Barr virus; ESR, erythrocyte sedimentation rate; FBC, full blood count; GP, general practitioner; GUM, genitourinary medicine; LFT, liver function tests; MSM, men who have sex with men; U&E, urea and electrocytes