Increased Risk of Flu-Like Illnesses After Well-Child Visits

Philip M. Polgreen, MD, MPH. Associate Professor of Internal Medicine - Infectious Diseases University of Iowa Carver College of Interview with:
Philip M. Polgreen, MD, MPH.
Associate Professor of Internal Medicine – Infectious Diseases
University of Iowa Carver College of Medicine What are the main findings of the study?

Dr. Polgreen: In this paper, to determine if well-child visits are associated with increased risk for subsequent influenza-like-illness visits, we used a large database that tracks healthcare expenditures of families over time. Controlling for other factors such as the presence of other children, insurance and demographics, we found that well-child visits were a risk factor for subsequent influenza-like-illness within the next two weeks for a patient or for a family member. The estimated probability of a subsequent influenza-like illness visit was increased by 3.2 percentage points for those with well-child visit. We estimated that this additional risk translates to over 700,000 cases of influenza-like-illness per year in the United States. Total costs (lost wages, medical costs, etc.) for these infections could amount to $500 million annually. What should clinicians and patients take away from your report?

Dr. Polgreen: Well child visits are critical for monitoring and promoting child health. However, our results demonstrate that more attention should be devoted to reducing the risk of spreading respiratory infections in waiting rooms and clinics, especially during respiratory virus season. Infection control guidelines currently exist that are designed to reduce the risk of outpatient disease transmission, such as separate waiting rooms for ill and healthy children and the prompt isolation of patients who are visibly ill. and the use of masks along with environmental cleaning and proper hand hygiene. However, to increase patient safety in outpatient settings, more attention should be paid to these guidelines by healthcare professionals, patients and their families. What recommendations do you have for future research as a result of this study?

Dr. Polgreen: A great deal of energy and expense has been devoted to understanding and controlling infections in the inpatient setting, but the infection control community needs to focus more energy on controlling infections in outpatient settings as well.

  • First, more research should focus on monitoring adherence to infection control guidelines in outpatient clinics. Although there are precautions that can be taken to reduce infection transmission in clinics, we do not know to what extent these precautions are routinely used, especially in busy clinics. If hand-hygiene compliance is poor, and potentially infectious patients are not wearing masks, preventable infections will continue to occur.
  • Second, more work needs to be done to discover how to make the existing guidelines as easy to follow as possible.
  • Third, future work needs to focus on interventions in clinical settings to further estimate and quantify risks and to develop new interventions and approaches to decrease these risks.


Are Well-child Visits a Risk Factor for Subsequent Influenza-Like-Illness Visits

Reference: Jacob E. Simmering, Linnea A. Polgreen, Joseph E. Cavanaugh, Philip M. Polgreen. Are Well-child Visits a Risk Factor for Subsequent Influenza-Like-Illness Visits? Infection Control and Hospital Epidemiology 35:3 (March 2014).

Last Updated on February 14, 2014 by Marie Benz MD FAAD