HCGFAA is a 1000-bed tertiary care facility with a 30-bed infectious diseases unit. In response to high demand for emergency medical services among adult patients with acute respiratory complaints, infectious disease specialists implemented an ILI scoring system on April 25, 2009. This scoring system was adapted from a system developed by Hak et al in the United States for hospitalization decision-making among elderly patients with pneumonia or influenza during influenza epidemics [18] . In the emergency room (ER), a questionnaire was used to record patients' demographics, signs and symptoms, history of health care utilization, chronic medical conditions, laboratory, and radiology findings to calculate patients' ILI-scores ( Figure 1 ). Clinicians used an ILI-score $16 (high-risk), their judgment of patients' severity of illness and proximity to the hospital to decided whether to admit the patient and treat them with oseltamivir. Patients with intermediate ILI-scores (7) (8) (9) (10) (11) (12) (13) (14) (15) were discharged from the ER, treated with oseltamivir and followed daily by phone for 10 days. Those with low ILI-scores (#6) were discharged without antiviral treatment, and instructed to return if their symptoms worsened.