Hospital discharge planning for preterm infants with a history of AOP should be carefully considered after discontinuing caffeine. This study showed that caffeine may not reach subtherapeutic levels until around 11-12 days.

OBJECTIVE:To determine whether predischarge event recording (PDER) can accurately identify preterm infants with resolving apnea of prematurity (AOP) at risk for postdischarge complications. DESIGN:PDER was performed on infants with resolving AOP on caffeine, ready for discharge. The outcome of infants with normal recordings was compared with that of infants with abnormal recordings. Follow-up data were obtained for outcome. RESULTS:Of the 106 infants, 74 had a normal PDER and 32 had an abnormal PDER (apneas lasting for Ͼ20 seconds and/or a heart rate of Ͻ80 beats per minute for Ͼ5 seconds). Birth weight, gestational age at birth, length of stay, discharge weight, and duration of caffeine treatment after discharge were no different between groups. None of the normal PDER infants (0 of 74) had postdischarge complications, whereas 4 of 32 infants with an abnormal PDER had complications (p Ͻ 0.05, power ϭ 0.7). The positive predictive value of a normal PDER and no postdischarge complications was 100%. The positive predictive value of an abnormal PDER and an adverse outcome was 12.5%. CONCLUSION:Normal PDER accurately identifies infants at low risk for an adverse outcome. Journal of Perinatology 2000; 2:92-95.Apnea of prematurity (AOP) is a common diagnosis in the premature infant, occurring in up to 85% of infants of Ͻ34 weeks' gestation.1 Timing of discharge for infants with AOP in a safe and expedient manner is a challenge faced by many neonatologists. Criteria for discharge of these infants may include an apnea-free interval, 2 usage of medications (methylxanthines), 3,4 gestational age (GA) at birth, or corrected age at discharge.Documented event recording has been used to evaluate the compliance of monitor usage at home 5,6 and to document efficacy of treatment;7,8 in addition, documented event recording has been shown to result in a shorter duration of home monitoring compared with a nonrecording monitor. 9 We use predischarge recordings as a tool for determining the need for home apnea monitoring at hospital discharge.Event-recording apnea monitors record cardiorespiratory waveforms with pulse oximetry; the user sets the parameters that define an event.5-13 For example, in-hospital "test" parameters in our institution record apneas lasting for Ͼ10 seconds and heart rates of Ͻ90 beats per minute. Smith and Hoy 14 reported a positive correlation between an abnormal predischarge event recording (PDER) performed for 1 week and continued apneas at home. We sought to determine whether a 24-hour PDER in preterm infants treated with caffeine could accurately identify infants who are at greater risk of an adverse outcome [15][16][17][18][19][20] (apparent life-threatening event [ALTE], rehospitalization, and death). METHODSThe medical records of all preterm infants followed by the Infant Apnea Program at University Medical Center and Hospital at Stony Brook during the period of January 1, 1996 to January 13, 1999 were reviewed retrospectively. Only those infants discharged with caffeine citrate were included. Informed...

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A better understanding of SARS-CoV-2 transmission from children and adolescents is crucial for informing public health mitigation strategies. We conducted a retrospective cohort study among household contacts of primary cases defined as children and adolescents aged 7-19 years with laboratory evidence of SARS-CoV-2 infection acquired during an overnight camp outbreak. Among household contacts, we defined secondary cases using the Council of State and Territorial Epidemiologists definition. Among 526 household contacts of 224 primary cases, 48 secondary cases were identified, corresponding to a secondary attack rate of 9% (95% confidence interval [CI], 7%-12%). Our findings show that children and adolescents can transmit SARS-CoV-2 to adult contacts and other children in a household setting.

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