{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T06:32:08Z","timestamp":1767162728262,"version":"build-2238731810"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2018,3,22]],"date-time":"2018-03-22T00:00:00Z","timestamp":1521676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Agency of Healthcare Research and Quality Mentored Clinical Scientist Research Career Development Award program","award":["1K08HS020939"],"award-info":[{"award-number":["1K08HS020939"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u2013ILI-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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 149987 children &lt;6 years of age (mean age, 2.5 years) with \u22651 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\u20131.52) among children \u22652 years of age and 1.01 (95% confidence interval, 0.93\u20131.09) among children &lt;2 years of age. Estimates remained consistent during season 2 and with a risk window of 3, 4, or 9 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jpids\/piy023","type":"journal-article","created":{"date-parts":[[2018,2,7]],"date-time":"2018-02-07T23:12:16Z","timestamp":1518045136000},"page":"191-196","source":"Crossref","is-referenced-by-count":12,"title":["Incidence of Healthcare-Associated Influenza-Like Illness After a Primary Care Encounter Among Young Children"],"prefix":"10.1093","volume":"8","author":[{"given":"Kristen","family":"Feemster","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Children\u2019s Hospital of Philadelphia, Pennsylvania"},{"name":"Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Russell","family":"Localio","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Grundmeier","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia"},{"name":"Department of Biomedical and Health Informatics, Children\u2019s Hospital of Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua P","family":"Metlay","sequence":"additional","affiliation":[{"name":"Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan E","family":"Coffin","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Children\u2019s Hospital of Philadelphia, Pennsylvania"},{"name":"Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2018,3,22]]},"reference":[{"key":"2019101003054411700_CIT0001","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1097\/00006454-198910000-00002","article-title":"Epidemiologic study of 4684 hospital-acquired infections in pediatric patients","volume":"8","author":"Ford-Jones","year":"1989","journal-title":"Pediatr Infect Dis J"},{"key":"2019101003054411700_CIT0002","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/S1473-3099(07)70310-9","article-title":"Infection control in paediatrics","volume":"8","author":"Posfay-Barbe","year":"2008","journal-title":"Lancet Infect Dis"},{"key":"2019101003054411700_CIT0003","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1542\/peds.55.5.673","article-title":"Nosocomial influenza infection as a cause of intercurrent fevers in infants","volume":"55","author":"Hall","year":"1975","journal-title":"Pediatrics"},{"key":"2019101003054411700_CIT0004","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1056\/NEJM197512252932604","article-title":"Nosocomial respiratory syncytial virus infections","volume":"293","author":"Hall","year":"1975","journal-title":"N Engl J Med"},{"key":"2019101003054411700_CIT0005","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1017\/S0195941700052371","article-title":"Nosocomial viral infections: I. 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