Are well-child visits a risk factor for subsequent influenza-like illness visits?

Infect Control Hosp Epidemiol. 2014 Mar;35(3):251-6. doi: 10.1086/675281.


Objective: To determine whether well-child visits are a risk factor for subsequent influenza-like illness (ILI) visits within a child's family.

Design: Retrospective cohort.

Methods: Using data from the Medical Expenditure Panel Survey from the years 1996-2008, we identified 84,595 families. For each family, we determined those weeks in which a well-child visit or an ILI visit occurred. We identified 23,776 well-child-visit weeks and 97,250 ILI-visit weeks. We fitted a logistic regression model, where the binary dependent variable indicated an ILI clinic visit in a particular week. Independent variables included binary indicators to denote a well-child visit in the concurrent week or one of the previous 2 weeks, the occurrence of the ILI visit during the influenza season, and the presence of children in the family in each of the age groups 0-3, 4-7, and 8-17 years. Socioeconomic variables were also included. We also estimated the overall cost of well-child-exam-related ILI using data from 2008.

Results: We found that an ILI office visit by a family member was positively associated with a well-child visit in the same or one of the previous 2 weeks (odds ratio, 1.54). This additional risk translates to potentially 778,974 excess cases of ILI per year in the United States, with a cost of $500 million annually.

Conclusions: Our results should encourage ambulatory clinics to strictly enforce infection control recommendations. In addition, clinics could consider time-shifting of well-child visits so as not to coincide with the peak of the influenza season.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cross Infection / epidemiology
  • Cross Infection / etiology*
  • Humans
  • Infant
  • Infant, Newborn
  • Influenza, Human / epidemiology
  • Influenza, Human / etiology*
  • Logistic Models
  • Office Visits / statistics & numerical data*
  • Risk Factors
  • Socioeconomic Factors
  • United States / epidemiology