Looking Back, Looking Forward
In celebration of the 20th anniversary of Red Book Online, we reflect on the first edition of the Red Book published in 1938—a mere 8 pages covering a mix of 18 topics including the common cold, pertussis, and variola.
I. The Common Cold
The Common Cold was the first section:
A. Test: None
B. Active Immunity: No active immune principle of any proven value has been described.
C. Passive Immunity: None
Today, 85 years later, we now know what causes the common cold and can even test for many of these pathogens at point-of-care.
The 2021 Red Book emphasizes that rhinoviruses are the most frequent cause of the common cold, accounting for 2/3 of cases. Other viruses associated with the common cold include human bocavirus, adenoviruses, and human coronaviruses 229E, OC43, NL63, and HKU1. SARS-CoV-2 can present with common cold symptoms, particularly in young children. And remember the common cold is not a bacterial infection, although Bordetella pertussis infection is an important exception that often manifests with cold symptoms during its catarrhal phase.
Unfortunately, we may know what causes the common cold, but we still can't do much about it. There aren't vaccines for children to protect against the many viral causes except SARS-CoV-2, and effective treatments are mostly limited to supportive care.
VI. Epidemic Parotitis
Chapter 6 was “Epidemic Parotitis”, a disease for which there was no diagnostic test available, and the only treatment was convalescent serum, without convincing evidence of its therapeutic effect.
How things change over time. The current Red Book recognizes “Epidemic Parotitis” as Mumps, caused by an RNA virus of the paramyxoviridae family. This virus remains the only known epidemic cause of parotitis. With the widespread recommendation of a two-dose MMR vaccine in 1989, mumps infection rates in the US fell to extremely low levels. Today, there remain sporadic outbreaks with more than 3,000 cases per year.
Many young health care providers have never seen a case of mumps. As a result, vigilance and a high index of suspicion are necessary to prevent the next outbreak. Regardless of vaccination status, anyone with parotitis, orchitis, or oophoritis without another identifiable cause , should be evaluated for mumps by PCR testing. If the test is negative, but there is more than one case of mumps in the community, further testing may be advisable.
The Red Book’s description of “Epidemic Parotitis” has grown from 7 lines of text to 6 pages delineating etiology, epidemiology, diagnostics, and prevention by vaccination. Red Book Online brings the collective knowledge of many ID experts and remains your trusted source for all contemporary information about pediatric infectious diseases.
"Twenty years of Red Book Online is a remarkable accomplishment! RBO has grown and matured across these past two decades to be a versatile, accessible, parallel way to get Red Book content when and where a practitioner needs it."— David W. Kimberlin, MD, FAAP | Editor, Red Book
