PhotoRoutine children's visits to the doctor for check-ups and vaccinations -- so-called well-child visits -- are important but a study finds they're also the source of hundreds of thousands of flu-like infections each year.

"Well child visits are critically important. However, our results demonstrate that healthcare professionals should devote more attention to reducing the risk of spreading infections in waiting rooms and clinics," said Phil Polgreen, MD, MPH, lead author of the study. Polgreen noted that infection control guidelines already exist.

"To increase patient safety in outpatient settings, more attention should be paid to these guidelines by healthcare professionals, patients, and their families," he said. 

In the study, researchers from the University of Iowa used data from the Agency for Healthcare Research and Quality's (AHRQ) Medical Expenditure Panel Survey to examine the healthcare trends of 84,595 families collected from 1996-2008. 

They found an increased risk of flu-like illnesses in children and family members within two weeks of the visits. This risk translates to more than 700,000 potentially avoidable illnesses each year, costing more than $490 million annually. The study was published in the March issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.

The authors found that well-child visits for children younger than six years old increased the probability of a flu-like illness in these children or their families during the subsequent two weeks by 3.2 percentage points.

In a commentary accompanying the study, Lisa Saiman, MD, notes, "The true cost of flu-like illnesses are much higher since only a fraction result in ambulatory visits and many more cases are likely to result in missed work or school days. Furthermore, these flu-like illness visits are associated with inappropriate antimicrobial use."

The authors stress the importance of infection prevention and control in ambulatory settings, suggesting pediatric clinics follow recommended guidelines that include improving environmental cleaning, cough etiquette, and hand hygiene compliance.

"Even with interventions, such as the restricted use of communal toys or separate sick and well-child waiting areas, if hand-hygiene compliance is poor, and potentially infectious patients are not wearing masks, preventable infections will continue to occur," said Polgreen.


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