Title Page
Red Book: 2009 Report of the Committee on Infectious Diseases
by Committee on Infectious Diseases, American Academy of Pediatrics, Author
Larry K. Pickering, MD, FAAP, Editor
Associate Editors
Copyright © 2009, by the American Academy of Pediatrics. All rights reserved.
Notices and Disclaimers
Committee on Infectious Diseases
Collaborators
Dedication
Preface
Introduction
Unbound™ mobile platform
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Associate Editors
Carol J. Baker , MD, FAAP
David W. Kimberlin , MD, FAAP
Sarah S. Long , MD, FAAP
Notices and Disclaimers
Red Book: 2009 Report of the Committee on Infectious Diseases (the "Content") is a publication of American Academy of Pediatrics and copyright © 2009, The American Academy of Pediatrics
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Committee on Infectious Diseases 2007-2009
Robert S. Baltimore, MD
Henry H. Bernstein, DO
Joseph A. Bocchini, Jr, MD
John S. Bradley, MD
Michael T. Brady, MD
Carrie L. Byington, MD
Penelope H. Dennehy, MD
Robert W. Frenck, Jr, MD
Mary P. Glode, MD
Harry L. Keyserling, MD
David W. Kimberlin, MD Red Book Associate Editor
Julia A. McMillan, MD
Walter A. Orenstein, MD
Lorry G. Rubin, MD
Ex-officio
Larry K. Pickering, MD, Red Book Editor
Carol J. Baker, MD, Red Book Associate Editor
Sarah S. Long, MD, Red Book Associate Editor
Liaisons
Beth P. Bell, MD, MPH Centers for Disease Control and Prevention
Robert Bortolussi, MD Canadian Paediatric Society
Richard D. Clover, MD American Academy of Family Physicians
Joanne Embree, MD Canadian Paediatric Society
Marc A. Fischer, MD Centers for Disease Controland Prevention
Richard L. Gorman, MD National Institutes of Health
Lucia Lee, MD Food and Drug Administration
R. Douglas Pratt, MD Food and Drug Administration
Jennifer S. Read, MD, MS, National Institute of Child Health MPH, DTM&H and Human Development
Anne Schuchat, MD Centers for Disease Controland Prevention
Benjamin Schwartz, MD National Vaccine Program Office
Jeffrey R. Starke, MD American Thoracic Society
Consultants
Edgar O. Ledbetter, MD
H. Cody Meissner, MD
AAP Liaisons
Margaret C. Fisher, MD; Section on Infectious Diseases
Jack Swanson, MD; Practice Action Group
Collaborators
Mark Abdy, DVM, PhD, US Department of Health and Human Services, Washington, DC
Emily S. Abernathy, MS, Centers for Disease Control and Prevention, Atlanta, GA
Mark Abzug, MD, University of Colorado School of Medicine, Children's Hospital,Denver, CO
Jennifer Adjemian, PhD, Centers for Disease Control and Prevention, Atlanta, GA
James P. Alexander, Jr, MD, MA, MEd, Centers for Disease Control and Prevention,Atlanta, GA
John J. Alexander, MD, MPH, Food and Drug Administration, Washington, DC
Manual R. Amieva, MD, Stanford University School of Medicine, Stanford, CA
Krow Ampofo, MD, University of Utah, Salt Lake City, UT
Alicia D. Anderson, Centers for Disease Control and Prevention, Atlanta, GA
Larry J. Anderson, MD, Centers for Disease Control and Prevention, Atlanta, GA
Warren A. Andiman, MD, Yale School of Medicine, New Haven, CT
Nelson Arboleda, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
John C. Arnold, MD, Rady Children's Hospital, San Diego, CA
Stephen S. Arnon, MD, California Department of Public Health, Richmond, CA
David M. Asher, MD, Food and Drug Administration, Kensington, MD
Shai Ashkenazi, MD, Schneider Children's Medical Center of Israel, Petah-Tikva, Israel
Chintamani D. Atreva, PhD, Food and Drug Administration, Rockville, MD
Kassa Avalew, MD, Food and Drug Administration, Silver Spring, MD
James Baggs, Centers for Disease Control and Prevention, Atlanta, GA
Robert Ball, MD, MPH, ScM, Food and Drug Administration, Rockville, MD
Robert Baltimore, MD, Yale University School of Medicine, New Haven, CT
Albert E. Barskev, IV, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Ezra J. Barzilay, MD, Centers for Disease Control and Prevention, Atlanta, GA
Margaret C. Bash, MD, MPH, Food and Drug Administration, Rockville, MD
Brigid Batten, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Melisse S. Baylor, MD, Food and Drug Administration, Rockville, MD
Michael Beach, Centers for Disease Control and Prevention, Atlanta, GA
Judy Beeler, MD, Food and Drug Administration, Rockville, MD
Ermias D. Belay, MD, Centers for Disease Control and Prevention, Atlanta, GA
Ozlem Belen, MD, MPH, Food and Drug Administration, Silver Spring, MD
Yodit Belew, MD, Food and Drug Administration, Silver Spring, MD
Beth P. Bell, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Elise M. Beltramini, MD, MPH, Centers for Disease Control and Prevention,Atlanta, GA
Jeffrey Bender, MD, University of Utah, Salt Lake City, UT
Latanya T. Benjamin, MD, University of Miami Miller School of Medicine, CooperCity, FL
Stuart M. Berman, MD, ScM, Centers for Disease Control and Prevention, Atlanta, GA
Caryn Bern, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Henry H. Bernstein, MD, Dartmouth Hitchcock Medical Center, Lebanon, NH
Stephanie R. Bialek, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Robin M. Biswas, MD, Food and Drug Administration, Rockville, MD
Margaret Blythe, MD, Indiana University School of Medicine, Indianapolis, IN
Elizabeth A. Bolvard, RN, MPH, Centers for Disease Control and Prevention,Atlanta, GA
Suresh B. Boppana, MD, University of Alabama at Birmingham, Birmingham, AL
Robert Bortolussi, MD, Dalhousie University, Halifax, Nova Scotia
Anna B. Bowen, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Kenneth M. Boyer, MD, University Medical Center, Chicago, IL
John S. Bradley, MD, Children's Hospital of San Diego, San Diego, CA
Michael T. Brady, MD, Children's Hospital Columbus, Ohio State University,Columbus, OH
Mary E. Brandt, PhD, Centers for Disease Control and Prevention, Atlanta, GA
M. Miles Braun, MD, MPH, Food and Drug Administration, Rockville, MD
Joseph S. Bresee, Centers for Disease Control and Prevention, Atlanta, GA
Karen R. Broder, Centers for Disease Control and Prevention, Decatur, GA
Gary W. Brunette, MD, MS, Centers for Disease Control and Prevention, Duluth, GA
Jane L. Burns, MD, University of Washington, Seattle, WA
Jay Butler, Centers for Disease Control and Prevention, Atlanta, GA
Carrie L. Byington, MD, University of Utah, Salt Lake City, UT
Angela Calugar, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
D. William Cameron, MD, The Ottawa Hospital, Ottawa, Ontario, Canada
Michael J. Cannon, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Michael Cappello, MD, Yale Child Health Research Center, New Haven, CT
Corey Casper, MD, MPH, University of Washington, Seattle, WA
Tom M. Chiller, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Lance Chilton, MD, University of New Mexico School of Medicine, Albuquerque, NM
Thomas Clark, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Thomas G. Cleary, MD, University of Texas Medical School, Houston, TX
Adam L. Cohen, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Amanda C. Cohn, MD, Centers for Disease Control and Prevention, Atlanta, GA
Felicia L. Collins, MD, MPH, Food and Drug Administration, Silver Spring, MD
Charles K. Cooper, MD, Food and Drug Administration, Silver Spring, MD
Julie Ann Crewalk, MD, Food and Drug Administration, Silver Spring, MD
James E. Crowe, Jr, MD, Vanderbilt University School of Medicine, Nashville, TN
Kimberly M. Cushing, MPH, Centers for Disease Control and Prevention,Greenland, NH
Therese A. Cvetkovich, MD, Food and Drug Administration, Rockville, MD
Ron Dagan, MD, Soroka University Medical Center, Beer-Sheva, Israel
Inger Damon, MD, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Gregory A. Dasch, PhD, Centers for Disease Control and Prevention, Atlanta, GA
S. Deblina Datta, Centers for Disease Control and Prevention, Atlanta, GA
Jon R. Daugherty, PhD, Food and Drug Administration, Rockville, MD
Alma C. Davidson, MD, Food and Drug Administration, Silver Spring, MD
Rajeshwar Dayal, MD, DNB, DCH, S N Medical College, Rajamandi, Agra, India
Michael S. Deming, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Gail J. Demmler, MD, Baylor College of Medicine, Texas Children's Hospital,Houston, TX
Penelope Dennehy, MD, Rhode Island Hospital, Providence, RI
Meredith Deutschler, MD, Centers for Disease Control and Prevention, Atlanta, GA
Pamela S. Diaz, MD, Centers for Disease Control and Prevention, Atlanta, GA
Kenneth L. Dominguez, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Eileen F. Dunne, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Mark L. Eberhard, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Morven S. Edwards, MD, Baylor College of Medicine, Houston, TX
Lawrence F. Eichenfield, MD, University of California San Diego School of Medicine, San Diego, CA
Joanne Embree, MD, University of Manitoba, Winnipeg, Manitoba, Canada
Dean Erdman, DrPH, Centers for Disease Control and Prevention, Atlanta, GA
Marina Eremeeva, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Geoffrey Evans, MD, National Vaccine Injury Compensation Program, Department of Health and Human Services, Rockville, MD
Karen M. Farizo, MD, Food and Drug Administration, Rockville, MD
Mahmood Farshid, PhD, Food and Drug Administration, Rockville, MD
Stephen M. Feinstone, MD, Food and Drug Administration, Bethesda, MD
Theresa M. Finn, PhD, Food and Drug Administration, Rockville, MD
Anthony E. Fiore, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Gayle E. Fischer, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Marc Fischer, MD, MPH, Centers for Disease Control and Prevention, Fort Collins, CO
Margaret Fisher, MD, Monmouth Medical Center, Long Branch, NJ
Collette Fitzgerald, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Patricia M. Flynn, MD, MS, St. Jude's Children's Research Hospital, Memphis, TN
Leanne M. Fox, MD, MPH, DTM, Centers for Disease Control and Prevention, Atlanta, GA
Robert W. Frenck, Jr, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
Cindy R. Friedman, MD, Centers for Disease Control and Prevention, Atlanta, GA
Julianne Gee, Centers for Disease Control and Prevention, Atlanta, GA
Michael A. Gerber, MD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
Anne A. Gershon, MD, Columbia University Medical Center, New York, NY
Jane Gidudu, Centers for Disease Control and Prevention, Atlanta, GA
Francis Gigliotti, MD, University of Rochester School of Medicine, Rochester, NY
Janet Gilsdorf, MD, Women's Hospital, University of Michigan Medical Center, Ann Arbor, MI
Steve Gitterman, Food and Drug Administration, Silver Spring, MD
Laurence B. Givner, MD, Wake Forest University School of Medicine, Winston-Salem, NC
M. Kathleen Glynn, DVM, MPVM, Centers for Disease Control and Prevention, Atlanta, GA
Bess G. Gold, MD, Children's Hospitals and Clinics of Minnesota, St. Louis Park, MN
Rachel Gorwitz, Centers for Disease Control and Prevention, Atlanta, GA
Patricia M. Griffin, MD, Centers for Disease Control and Prevention, Atlanta, GA
Kevin S. Griffith, MD, MPH, Centers for Disease Control and Prevention, Fort Collins, CO
Charles Grose, MD, Children's Hospital, University of Iowa, Iowa City, IA
Marion F. Gruber, PhD, Food and Drug Administration, Rockville, MD
Marta A. Guerra, DVM, MPH, PhD, Centers for Disease Control and Prevention,Atlanta, GA
Penina Haber, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Jeffrey C. Hageman, MHS, Centers for Disease Control and Prevention, Atlanta, GA
Scott A. Halperin, MD, Dalhousie University, Halifax, Nova Scotia
Neal A. Halsey, MD, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
Theresa Anne Harrington, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Julie R. Harris, PhD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Edward B. Hayes, MD, Centers for Disease Control and Prevention, Fort Collins, CO
Thomas W. Hennessey, MD, MPH, Centers for Disease Control and Prevention, Anchorage, AK
Barbara L. Herwaldt, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Beth F. Hibbs, RN, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Sheila Hickey, MD, University of New Mexico School of Medicine, Albuquerque, NM
Lauri Hicks, Centers for Disease Control and Prevention, Atlanta, GA
Michelle Hlavsa, Centers for Disease Control and Prevention, Atlanta, GA
Scott D. Holmberg, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Karen Hoover, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Peter J. Hotez, MD, PhD, George Washington University and Sabin Vaccine Institute, Washington, DC
Wan-Ting Huang, Centers for Disease Control and Prevention, Atlanta, GA
Joseph P. Icenogle, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Menfo A. Imoisili, MD, MPH, Food and Drug Administration, Ellicott City, MD
John K. Iskander, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Martha Iwamoto, Centers for Disease Control and Prevention, Atlanta, GA
Hector Izurieta, MD, MPH, Food and Drug Administration, Rockville, MD
Richard F. Jacobs, MD, Arkansas Children's Hospital, Little Rock, AR
John A. Jereb, MD, Centers for Disease Control and Prevention, Atlanta, GA
John A. Jernigan, MD, MS, Centers for Disease Control and Prevention, Atlanta, GA
Robert E. Johnson, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Jeffrey L. Jones, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
M. Patricia Joyce, MD, Centers for Disease Control and Prevention, Atlanta, GA
Aisha Jumaan, Centers for Disease Control and Prevention, Atlanta, GA
Alexander J. Kallen, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Nino Khetsuriani, MD, PhD, Centers for Disease Control and Prevention, Decatur, GA
Tina Khoie, MD, Food and Drug Administration, Rockville, MD
Peter W. Kim, MD, MS, Food and Drug Administration, Silver Spring, MD
Paul Kitsutani, MD, MPH, Food and Drug Administration, Rockville, MD
Martin B. Kleiman, MD, Indiana University, Indianapolis, IN
Emilia Helen A. Koumans, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Phyllis E. Kozarsky, MD, Centers for Disease Control and Prevention, Atlanta, GA
Philip R. Krause, MD, Food and Drug Administration, Bethesda, MD
John W. Krebs, MS, Centers for Disease Control and Prevention, Atlanta, GA
Andrew T. Kroger, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Matt Kuehnert, Centers for Disease Control and Prevention, Atlanta, GA
John A. Leake, MD, MPH, Children's Hospital–San Diego, San Diego, CA
Lucia H. Lee, MD, Food and Drug Administration, Rockville, MD
Nicole M. A. Le Saux, MD, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
Rebecca E. Levorson, MD, Food and Drug Administration, Silver Spring, MD
Linda L. Lewis, MD, Food and Drug Administration, Silver Spring, MD
Jay M. Lieberman, MD, University of California Irvine, Irvine, CA
Sue Lim, MD, Food and Drug Administration, Silver Spring, MD
Brandi Limbago, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Mark N. Lobato, MD, Centers for Disease Control and Prevention, Hartford, CT
Cherie M. Long, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Shari L. Lydy, BS, MS, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Michael F. Lynch, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Noni E. MacDonald, MD, MSc, Dalhousie University, Halifax, Nova Scotia
Shelley Sylvester Magill, MD, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Yvonne Aida Maldonado, MD, Stanford University School of Medicine, Stanford, CA
Susan E. Manning, MD, MPH, Massachusetts Department of Public Health, Boston, MA
Nina Marano, Centers for Disease Control and Prevention, Atlanta, GA
Mona Marin, MD, Centers for Disease Control and Prevention, Atlanta, GA
Stacene R. Maroushek, MD, PhD, Hennepin County Medical Center, Minneapolis, MN
Robert Massung, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Els Mathieu, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Lisa Mathis, MD, Food and Drug Administration, Silver Spring, MD
Anne E. McCarthy, MD, MSc, FRCPC, DTM&H, Ottawa Hospital General Campus, Ottawa, Ontario, Canada
George H. McCracken, Jr, MD, University of Texas Southwestern Medical Center at Dallas, Dallas, TX
L. Clifford McDonald, MD, Centers for Disease Control and Prevention, Atlanta, GA
Julia A. McMillan, MD, Johns Hopkins Hospital, Baltimore, MD
Meredith L. McMorrow, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Jennifer H. McQuiston, DVM, MS, Centers for Disease Control and Prevention, Atlanta, GA
Paul S. Mead, MD, MPH, Centers for Disease Control and Prevention, Fort Collins, CO
Felicita M. Medalla, MD, MS, Centers for Disease Control and Prevention, Atlanta, GA
H. Cody Meissner, MD, New England Medical Center, Boston, MA
David Menschik, MD, Food and Drug Administration, Rockville, MD
Joette M. Meyer, PharmD, Food and Drug Administration, Silver Spring, MD
Nancy B. Miller, MD, Food and Drug Administration, Rockville, MD
Elaine R. Miller, RN, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Eric D. Mintz, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Roque Miramontes, PA-C, MPH, Centers for Disease Control and Prevention, Atlanta, GA
John F. Modlin, MD, Dartmouth Hitchcock Medical Center, Lebanon, NH
Lynne M. Mofenson, MD, Eunice Kennedy Shriver National Institute of Child Health
and Human Development, National Institutes of Health, Rockville, MD
Nasim Moledina, MD, Food and Drug Administration, Silver Spring, MD
Susan P. Montgomery, DVM, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Anne C. Moore, MD, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Gina T. Mootrey, DO, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Riyadh D. Muhammad, MD, MPH, Centers for Disease Control and Prevention, Stockbridge, GA
Kenneth L. Muldrew, MD, MPH, Yale University School of Medicine, New Haven, CT
Jean Mulinde, MD, Food and Drug Administration, Silver Spring, MD
Dennis L. Murray, MD, Medical College of Georgia Children's Medical Center, Augusta, GA
Sumathi Nambiar, MD, Food and Drug Administration, Silver Spring, MD
Santosh Nanda, DVM, PhD, Food and Drug Administration, Bethesda, MD
Roger S. Nasci, PhD, Centers for Disease Control and Prevention, Fort Collins, CO
James P. Nataro, MD, PhD, MBA, University of Maryland School of Medicine, Baltimore, MD
Steven R. Nesheim, MD, Centers for Disease Control and Prevention, Atlanta, GA
Kathleen Neuzil, MD, MPH, University of Washington School of Medicine, Seattle, WA
Jane W. Newburger, MD, MPH, Children's Hospital Boston, Harvard Medical School, Boston, MA
Lori M. Newman, MD, Centers for Disease Control and Prevention, Atlanta, GA
William L. Nicholson, BS, MS, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Ryan T. Novak, PhD, Centers for Disease Control and Prevention, Atlanta, GA
J. Pekka Nuorti, MD, DSc, Centers for Disease Control and Prevention, Atlanta, GA
M. Steven Oberste, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Masahiro Ohashi, MD, Food and Drug Administration, Bethesda, MD
Rosalyn E. O'Loughlin, MSc, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Ciarra E. O'Reilly, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Walter A. Orenstein, MD, Emory University School of Medicine, Emory Vaccine Center, Atlanta, GA
Miguel O'Ryan, MD, University of Chile, Santiago, Chile
Elizabeth M. O'Shaughnessy, MD, Food and Drug Administration, Silver Spring, MD
Gary D. Overturf, MD, TriCore Reference Laboratories, Albuquerque, NM
Christopher D. Paddock, MD, Centers for Disease Control and Prevention, Atlanta, GA
Elijah Paintsil, MD, Yale University School of Medicine, New Haven, CT
Debra L. Palazzi, MD, Baylor College of Medicine, Houston, TX
Mark A. Pallansch, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Adelisa L. Panlilio, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Umesh D. Parashar, MBBS, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Monica E. Parise, MD, Centers for Disease Control and Prevention, Atlanta, GA
Ben J. Park, MD, Centers for Disease Control and Prevention, Atlanta, GA
Amy A. Parker, MSN, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Robert Pass, MD, University of Alabama at Birmingham, Department of Pediatrics, Birmingham, AL
Mary E. Patrick, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Andrew T. Pavia, MD, University of Utah, Salt Lake City, UT
Joseph F. Perz, MA, DrPH, Centers for Disease Control and Prevention, Atlanta, GA
Nicki T. Pesik, MD, Centers for Disease Control and Prevention, Decatur, GA
Georges Peter, MD, Brown University, Brookline, MA
Thomas A. Peterman, MD, MSc, Centers for Disease Control and Prevention, Atlanta, GA
John R. Peters, MD, Food and Drug Administration, Silver Spring, MD
Larry K. Pickering, MD, Centers for Disease Control and Prevention, Atlanta, GA
Andreas Pikis, MD, Food and Drug Administration, Silver Spring, MD
Andrew J. Pollard, MD, PhD, University of Oxford, Children's Hospital, Oxford, United Kingdom
R. Douglas Pratt, MD, Food and Drug Administration, Rockville, MD
Charles G. Prober, MD, Stanford University, Stanford, CA
Octavio Ramilo, MD, University of Texas Southwestern Medical Center, Dallas, TX
Gopa Raychaudhuri, PhD, Food and Drug Administration, National Institutes of Allergy and Infectious Diseases, Bethesda, MD
Jennifer S. Read, MD, MS, MPH, DTM&H, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
Stephen Redd, Centers for Disease Control and Prevention, Atlanta, GA
Susan E. Reef, MD, Centers for Disease Control and Prevention, Atlanta, GA
Frank O. Richards, Jr, MD, Centers for Disease Control and Prevention, Atlanta, GA
Tony Richardson, MS, MPH, CPHA, Centers for Disease Control and Prevention, Atlanta, GA
Pierre E. Rollin, MD, Centers for Disease Control and Prevention, Atlanta, GA
Jennifer B. Rosen, MD, Centers for Disease Control and Prevention, Atlanta, GA
Steven Rosenthal, MD, MPH, Food and Drug Administration, Rockville, MD
Jennifer Ross, PhD, Food and Drug Administration, Rockville, MD
Lawrence A. Ross, MD, Keck School of Medicine at the University of Southern California, Los Angeles, CA
Sandra W. Roush, MT, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Sharon L. Roy, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Lorry G. Rubin, MD, Schneider Children's Hospital, New Hyde Park, NY
Charles E. Rupprecht, VMD, MS, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Hari C. Sachs, MD, Food and Drug Administration, Silver Spring, MD
Leonard Sacks, MD, Food and Drug Administration, Silver Spring, MD
Pablo J. Sanchez, MD, Utah Southwestern Medical Center, Dallas, TX
Jason B. Sauberan, University of California San Diego, San Diego, CA
Mark H. Sawyer, MD, University of California San Diego School of Medicine, San Diego, CA
Elaine J. Scallan, MA, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Urs B. Schaad, MD, University Children's Hospital, Basel, Switzerland
Peter M. Schantz, Centers for Disease Control and Prevention, Atlanta, GA
Lawrence B. Schonberger, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Stephanie Schrag, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Lewis Schrager, MD, Food and Drug Administration, Rockville, MD
Gordon E. Schutze, MD, Texas Children's Hospital, Houston, TX
Ann T. Schwartz, MD, Food and Drug Administration, Rockville, MD
Dorothy Scott, MD, Food and Drug Administration, Bethesda, MD
James J. Seivar, MD, Centers for Disease Control and Prevention, Atlanta, GA
Jane F. Seward, MBBS, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Sean V. Shadomv, DVM, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Andi L. Shane, MD, MPH, Emory University School of Medicine, Atlanta, GA
Alan Shapiro, MD, PhD, Food and Drug Administration, Silver Spring, MD
Eugene D. Shapiro, MD, Yale Department of Pediatrics, New Haven, CT
Stanford T. Shulman, MD, Children's Memorial Hospital, Chicago, IL
Toby A. Silverman, MD, Food and Drug Administration, Rockville, MD
Mary E. Singer, MD, PhD, Food and Drug Administration, Silver Spring, MD
Barbara A. Slade, MD, Centers for Disease Control and Prevention, Atlanta, GA
Laurence Slutsker, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Theresa L. Smith, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Thomas D. Smith, MD, Food and Drug Administration, Silver Spring, MD
Alfred F. Sorbello, DO, MPH, Food and Drug Administration, Silver Spring, MD
Mark J. Sotir, PhD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Ariun Srinivasan, MD, Centers for Disease Control and Prevention, Atlanta, GA
Mary Allen Staat, MD, MPH, Children's Hospital Medical Center, Cincinnati, OH
J. Erin Staples, MD, PhD, Centers for Disease Control and Prevention, Fort Collins, CO
Jeffrey R. Starke, MD, Baylor College of Medicine, Texas Children's Hospital, Houston, TX
William J. Steinbach, MD, Duke University, Durham, NC
E. Richard Stiehm, MD, University of California Los Angeles Medical Center, Los Angeles, CA
Shannon K. Stokley, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Nancy Strockbine, Centers for Disease Control and Prevention, Atlanta, GA
David L. Swerdlow, MD, Centers for Disease Control and Prevention, Atlanta, GA
Shuang Tang, PhD, Food and Drug Administration, Bethesda, MD
Amy M. Taylor, MD, MHS, Food and Drug Administration, Silver Spring, MD
Tracy N. Thomas, MPH, MSc, Centers for Disease Control and Prevention, Atlanta, GA
Susan D. Thompson, MD, Food and Drug Administration, Silver Spring, MD
Evasu Habtu Teshale, MD, Centers for Disease Control and Prevention, Atlanta, GA
Rosemary Tiernan, MD, MPH, Food and Drug Administration, Rockville, MD
Maureen R. Tierney, MD, MSc, Food and Drug Administration, Potomac, MD
Tejpratap S. P. Tiwari, MD, Centers for Disease Control and Prevention, Atlanta, GA
James K. Todd, MD, The Children's Hospital, Denver, CO
Joseph G. Toerner, MD, MPH, Food and Drug Administration, Rockville, MD
Christine Uhlenhaut, PhD, Food and Drug Administration, Bethesda, MD
Elizabeth R. Unger, PhD, MD, Centers for Disease Control and Prevention, Atlanta, GA
Gary A. Urquhart, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Julienne Vaillancourt, BS, Pharm, MPH, Food and Drug Administration, Rockville, MD
Chris A. Van Beneden, MD, MPH, Centers for Disease Control and Prevention,Atlanta, GA
Jennifer R. Verani, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Govinda S. Visvesvara, PhD, Centers for Disease Control and Prevention, Atlanta, GA
Ellen R. Wald, MD, University of Wisconsin School of Medicine and Public Health, Madison, WI
Gregory S. Wallace, MD, MS, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Richard J. Wallace, MD, University of Texas Health Center, Tyler, TX
Nicholas D. Walter, MD, MSc, Centers for Disease Control and Prevention, Atlanta, GA
Elaine Wang, MD, Replidyne Inc, Milford, CT
Diane W. Wara, MD, University of California San Francisco, San Francisco, CA
Annemarie Wasley, Centers for Disease Control and Prevention, Atlanta, GA
John C. Watson, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Donna L. Weaver, RN, MN, Centers for Disease Control and Prevention, Atlanta, GA
Stanley Wei, Centers for Disease Control and Prevention, Atlanta, GA
Cindy M. Weinbaum, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Michele S. Weinberg, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Leonard B. Weiner, MD, SUNY Upstate Medical University, Syracuse, NY
Eric S. Weintraub, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Richard J. Whitley, MD, The University of Alabama at Birmingham, Children's Hospital, Birmingham, AL
Cynthia G. Whitney, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA
Marc-Alain Widdowson, MD, Centers for Disease Control and Prevention, Atlanta, GA
Ian Williams, Centers for Disease Control and Prevention, Atlanta, GA
John V. Williams, MD, Vanderbilt University Medical Center, Nashville, TN
Emily Woo, MD, MPH, Food and Drug Administration, Rockville, MD
Kimberly Workowski, MD, Centers for Disease Control and Prevention, Atlanta, GA
Alexandra Worobec, MD, US Food and Drug Administration, Rockville, MD
Jennifer Wright, Centers for Disease Control and Prevention, Atlanta, GA
Henry M. Wu, MD, Centers for Disease Control and Prevention, Atlanta, GA
Yuliya I. Yasinskava, MD, Food and Drug Administration, Silver Spring, MD
Zhiping Ye, MD, Food and Drug Administration, Bethesda, MD
Eileen L. Yee, MD, Centers for Disease Control and Prevention, Atlanta, GA
Emily C. Zielinski-Gutierrez, MPH, DrPH, Centers for Disease Control and Prevention, Fort Collins, CO
Dedication
This edition of the Red Book is dedicated to Ralph D. Feigin, MD, FAAP. Although Ralph never served on the AAP Committee on Infectious Diseases, there are very few chapters in this book that were not influenced by his considerable body of work or that of his trainees. In fact, a true listing of his accomplishments in pediatrics and pediatric infectious diseases would likely require a book this size. Ralph planned on being a general pediatrician, but entered the field of infectious diseases almost by accident. As a medical student, he learned how to measure amino acids in human blood, a relatively new science at the time. When he entered the military in 1965, he was assigned to the US Army Research Institute of Infectious Diseases at Fort Detrick, Maryland, where he performed ground-breaking work on the circadian periodicity of amino acid metabolism during infection. Thus, a great career was launched. A few of his subsequent contributions to the understanding of infectious diseases and their management in children include:
- Defining many of the metabolic changes that occur during the incubation period and early phases of clinical infectious diseases
- Using animal models to document that the time of day when a viral or bacterial infection occurs may have a marked effect on morbidity and mortality
- Providing one of the first descriptions of the effectiveness of clindamycin for methicillin-susceptible Staphylococcus aureus infections
- Defining the stability of antimicrobial agents in parenteral solutions, which still serves as the basis for most manufacturers' recommendations for intravenous use
- Contributing to epidemiologic studies showing that a single dose of measles vaccine would not be an effective strategy to eradicate measles and documenting the development of atypical measles syndrome in previously immunized children
- Defining the pharmacokinetics of cefazolin in children
- Reporting detailed epidemiologic studies of the occurrence of leptospirosis in urban populations and documenting transmission from healthy immunized dogs to humans
- Performing detailed sequential long-term (5–20 years) prospective evaluations of children with bacterial meningitis to determine how epidemiology and pathogenesis related to clinical manifestations and sequelae
- Delineating the role of the syndrome of inappropriate antidiuretic hormone secretion in children with bacterial meningitis
- Contributing to defining adherence of Haemophilus influenzae to epithelial cells as a necessary requirement for colonization and/or invasion
Impressive as these accomplishments are, they only scratch the surface of Ralph's contribution to pediatrics. He served as President of the Society for Pediatric Research, the American Pediatric Society, and the Association of Medical School Pediatric Department Chairs. He authored or coauthored 15 books, including 6 editions of the Textbook of Pediatric Infectious Diseases, and was coeditor of Oski's Pediatrics: Principles and Practice. He served as the Associate Editor of Pediatrics and Editor for the Pediatric Division of Up-To-Date, Inc. Beginning in 1974, he served as a consultant to the Surgeon General of the US Army on defense of the United States against biologic warfare. He was a vocal advocate for the need to consider the special needs of children in disaster planning, including events of biological terrorism. He also served as a member of the Board of Governors and the Finance Committee for the Clinical Center of the National Institutes of Health, again advocating for promotion and funding of pediatric research. Ralph's many accomplishments were recognized in 2007 with his receipt of the John Howland Award, the penultimate award in pediatrics.
Anyone who knew Ralph understands that his greatest professional passion was teaching. The fabled "Feigin rounds" were a truly unique experience in the art of differential diagnosis. He won the "Outstanding Teacher Award" from the medical students so often that he had to be retired from competition. When Ralph was asked how he built the pediatrics program at Baylor College of Medicine into the largest one in the United States, he emphatically stated that it started with the residency program. In his 31 years as a department chairman, Ralph helped train more than 1000 residents, and his department trained more than 900 fellows. His graduates are members of the faculty at 109 US medical schools and include 55 division heads and 5 department chairs or deans of medical schools. As recognition of his prowess, he received the Lifetime Educational Achievement Award from the American Academy of Pediatrics.
Although his professional accomplishments speak volumes, they reflect only one part of the man himself. Ralph was noted for his boundless energy and limitless optimism. He was one of the rare leaders who turned his personal vision of excellence into reality, but maintained his sense of proportion and humanity. He was kind, gentle, and compassionate in the best tradition of pediatricians. He was generous with his wisdom and his time, with his door always open to friends and colleagues, residents, and students. He also was devoted to his family. With his wife Judy (the "other Dr. Feigin"), he raised 2 daughters and a son and has 6 grandchildren, all of whom live in Houston.
It is difficult to think of anyone who has contributed more to pediatrics and the study of infectious diseases in the last 4 decades than Ralph Feigin. He was a brilliant clinician, accomplished researcher, creative administrator, unparalleled teacher, devoted family man, and revered mentor. He has forever changed the study of pediatric infectious diseases. This edition of the Red Book is dedicated to Ralph to thank him on behalf of all the children and pediatricians whose lives he has touched.
Preface
The Red Book is a unique source of information on immunizations and infectious diseases for practitioners. The practice of pediatric infectious diseases is changing rapidly. With the limited time available to the practitioner, the ability to quickly obtain up-to-date information about new vaccines and vaccine recommendations, emerging infectious diseases, new diagnostic modalities, and treatment recommendations is essential. The Committee on Infectious Diseases of the American Academy of Pediatrics (AAP) and the editors of the Red Book are dedicated to providing the most current and accurate information available in the concise, practical format for which the Red Book is known.
The value of the Red Book is further enhanced by the Red Book Online (www.aapredbook.org ), where statements and recommendations from the AAP and other important information that becomes available during the 3 years between editions of Red Book are provided. Another important resource is the visual library of Red Book Online, which has been updated and expanded to include more images of infectious diseases, examples of classic radiologic and other findings, and recent epidemiology of infectious diseases.
The Committee on Infectious Diseases relies on information and advice from many experts, as evidenced by the lengthy list of contributors to Red Book . We especially are indebted to the many contributors from other AAP committees, the Centers for Disease Control and Prevention, the Food and Drug Administration, the National Institutes of Health, the Canadian Paediatric Society, the World Health Organization, and many other organizations and individuals who have made this edition possible. In addition, suggestions made by individual AAP members to improve the presentation of information on specific issues and on topic selection have been incorporated into this edition.
Most important to the success of this edition is the dedication and work of the editors, whose commitment to excellence is unparalleled. Under the able leadership of Larry K. Pickering, MD, editor, with associate editors Carol J. Baker, MD, David W. Kimberlin, MD, and Sarah S. Long, MD, this new edition was made possible. We also are indebted to Edgar O. Ledbetter, MD, for his invaluable and untiring efforts to gather and organize the slide materials that make up the visual library of Red Book Online and are part of the electronic versions of the Red Book .
As noted in previous editions of the Red Book , some omissions and errors are inevitable in a book of this type. We ask that AAP members continue to assist the committee actively by suggesting specific ways to improve the quality of future editions.
Joseph A. Bocchini, Jr, MD, FAAP
Chairperson, Committee on Infectious Diseases
Introduction
The Committee on Infectious Diseases (COID) of the American Academy of Pediatrics (AAP) is responsible for developing and revising guidelines for the AAP for control of infectious diseases in children. At intervals of approximately 3 years, the committee issues the Red Book: Report of the Committee on Infectious Diseases , which contains a composite summary of current AAP recommendations concerning infectious diseases in and immunizations for infants, children, and adolescents. These recommendations represent a consensus of opinions developed by members of the committee in conjunction with liaison representatives from the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the National Institutes of Health, the National Vaccine Program Of.ce, the Canadian Paediatric Society, the American Thoracic Society, Red Book consultants, and numerous collaborators. This edition is based on information available as of January 2009.
Unanswered scienti.c questions, the complexity of medical practice and technology, continuous new information, and inevitable differences of opinion among experts result in inherent limitations of the Red Book . In the context of these limitations, the committee endeavors to provide current, relevant, science-based recommendations for prevention and management of infectious diseases in infants, children, and adolescents. In some cases, other committees and experts may differ in their interpretation of data and resulting recommendations. In some instances, no single recommendation can be made because several options for management are equally acceptable.
In making recommendations in the Red Book , the committee acknowledges these differences in viewpoints by use of the phrases "most experts recommend..." and "some experts recommend..." Both phrases indicate valid recommendations, but the first signifies more support among experts, and the second, less support. Hence "some experts recommend..." indicates a minority view that is based on data and/or experience and is sufficiently valid to warrant consideration.
Inevitably in clinical practice, questions arise that cannot be answered on the basis of currently available data. In such cases, the committee attempt to provide guidelines and information that, in conjunction with clinical judgment, will facilitate well-reasoned decisions. We appreciate questions, different perspectives, and alternative recommendations that we have received, and encourage any suggestions or correspondence that will improve future editions of the Red Book . Through this process, the committee seeks to provide a practical and authoritative guide for physicians and other health care professionals in their care of infants, children, and adolescents.
To aid physicians and other health care professionals in assimilating current changes in recommendations in the Red Book , a list of major changes has been compiled (see Summary of Major Changes, p xxix). However, this listing only begins to cover changes that have occurred in each chapter and section. Health care professionals should consult individual chapters and sections of the book for current guidelines. In addition, new information inevitably begins to outdate some recommendations in the Red Book , and necessitates that health care professionals remain informed of new developments and resulting changes in recommendations. Between editions, the AAP publishes new recommendations from the committee in Pediatrics , in AAP News , and on the Red Book Online Web site (www.aapredbook.org ). In this edition, we continue to provide Web site addresses throughout the text to enable rapid access to new information. The Red Book Online Web site provides access to important Red Book errata that may have occurred. On Red Book Online, you can enroll for e-mail alerts to be noti.ed automatically when new errata have been announced.
When using antimicrobial agents, physicians should review the package inserts (product labels) prepared by manufacturers, particularly for information concerning contraindications and adverse events. No attempt has been made in the Red Book to provide this information, because it is available readily in the Physicians' Desk Reference , online (www.pdr.net ), and in package inserts (product labels). As in previous editions, recommended dosage schedules for antimicrobial agents are given (see Section 4, Antimicrobial Agents and Related Therapy). Recommendations in the Red Book for drug dosages may differ from those of the manufacturer in the package insert. Physicians also should be familiar with information in the package insert for vaccines and immune globulins as well as recommendations of other committees (see Sources of Vaccine Information).
This book could not have been prepared without the dedicated professional competence of many people. Edgar O. Ledbetter, MD, H. Cody Meissner, MD, and Jon R. Almquist, MD, served as Red Book reviewers appointed by the AAP Board of Directors. Dr Ledbetter also led the charge in gathering and organizing the new slide materials for the electronic part of the Red Book . The AAP staff has been outstanding in its committed work and contributions, particularly Alison Siwek and Hope Hurley, managers, who served as the administrative directors for the committee and coordinated preparation of the Red Book ; Jennifer Pane, senior medical copy editor, who improved every aspect of the Red Book ; Darlene Mattefs, department assistant; Barbara Drelicharz, division assistant;Peg Mulcahy, graphic designer; and Jeff Mahony, Mark Ruthman, and Mark Grimes, Department of Marketing, who make the Red Book Online and other Red Book products possible. Special appreciation is given to Stephanie Renna, assistant to the editor, for her work, patience, and support. Marc Fischer, MD, of the CDC, and R. Douglas Pratt, MD, and Lisa Lee, MD, of the FDA, devoted time and effort in providing input from their organizations. I am especially indebted to the associate editors Carol J. Baker, MD, Sarah S. Long, MD, and David W. Kimberlin, MD, for their expertise, tireless work, good humor, and immense contributions in their editorial and committee work. Georges Peter, MD, continues to provide constant support and advice and has left his imprint on all future editions of the Red Book . Members of the committee contributed countless hours and deserve appropriate recognition for their patience, dedication, revisions, and reviews. As a committee, we particularly appreciate the guidance and dedication of the current committee chairperson, Joseph A. Bocchini, MD, whose knowledge, dedication, insight, and leadership are re.ected in the quality and productivity of the committee's work. I thank Mimi for always being there and for her patience, understanding, and neverending support.
There are many other contributors whose professional work and commitment have been essential in the committee's preparation of the Red Book . Of special note is the person to whom this edition of the Red Book is dedicated, Ralph D. Feigin, MD, who was an exceptional leader, a constant inspiration, and a good friend. His death leaves a void in all of our lives.
Larry K. Pickering MD, FAAP
