Incidence of Healthcare-Associated Influenza-Like Illness After a Primary Care Encounter Among Young Children.

Year of Publication


Date Published

2018 Mar 22

ISSN Number



<p><strong>Background: </strong>Despite potential respiratory virus transmission in pediatric clinics, little is known about the risk of healthcare-associated viral infections attributable to outpatient encounters. We evaluated whether exposure to a pediatric clinic visit was associated with subsequent influenza-like illness (ILI).</p>

<p><strong>Methods: </strong>Using electronic health record data, we conducted a retrospective cohort study of all children aged &lt;6 years who presented to a provider in a 29-clinic pediatric primary care network for a non-ILI-related encounter over 2 respiratory virus seasons (September 1, 2012, to April 30, 2014). We defined a risk period for potential healthcare-associated (HA) ILI of 1 to 8 days after a non-ILI clinic visit and identified all cases of ILI to compare the incidences of ILI visits 1 to 8 days after a non-ILI encounter and those of visits &gt;8 days after a non-ILI encounter.</p>

<p><strong>Results: </strong>Among 149987 children &lt;6 years of age (mean age, 2.5 years) with ≥1 non-ILI visit during the study period, 531928 total encounters and 13951 (2.9%) ILI encounters were identified; 1941 (13.9%) occurred within the HA-ILI risk window. The incidence rate ratios (IRRs) for ILI 1 to 8 days after compared with ILI &gt;8 days after a non-ILI visit during season 1 were 1.36 (95% confidence interval, 1.22-1.52) among children ≥2 years of age and 1.01 (95% confidence interval, 0.93-1.09) among children &lt;2 years of age. Estimates remained consistent during season 2 and with a risk window of 3, 4, or 9 days.</p>

<p><strong>Conclusions: </strong>Pediatric clinic visits during a respiratory virus season were significantly associated with an increased incidence of subsequent ILI among children aged 2 to 6 years but not among those aged &lt;2 years. These findings support the hypothesis that respiratory virus transmission in a pediatric clinic can result in HA ILI in young children.</p>



Alternate Title

J Pediatric Infect Dis Soc




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