Red Book Editor David W. Kimberlin, M.D., FAAP, likens the creation of the infectious disease guide to a symphony, with hundreds of experts each playing parts that come together in harmony.
After three years of preparation, their efforts are ready for showtime. The 33rd edition of the Red Book is out, with updates to every chapter that provide the latest clinical guidance on more than 200 childhood infectious diseases.
The 2024 Red Book includes a significantly revised chapter on discussing vaccines with patients and parents; new chapters on COVID-19 and mpox; expanded tables, figures and algorithms; and an expanded listing of codes for commonly administered pediatric vaccines, toxoids and immune globulins.
AAP members can request one complimentary print copy of the 2024 Red Book as a member benefit by visiting https://www.aap.org/getredbook. Nonmembers can order a copy at https://bit.ly/4adBBOq.
Dr. Kimberlin recently spoke with AAP News about highlights of the new edition and how it came together over the past three years. The following interview has been edited for length and clarity.
Q: How would you describe the process of updating the Red Book?
A: The process is an elaborate one. It’s a dance that starts literally the moment the prior edition comes out and includes absolutely phenomenal people. The Committee on Infectious Diseases (COID), members, the liaisons, the subject matter experts, the CDC (Centers for Disease Control and Prevention), FDA (Food and Drug Administration), NIH (National Institutes of Health), AAP committees, sections and the AAP staff and board. Everybody coming together to create this book is an inspiring thing.
The reason people are so dedicated to the Red Book long preceded any of our tenures in these positions. It’s on the shoulders of the giants that came before us that we get to contribute to and hopefully advance the product even further. We didn’t invent this. We inherited this, and hopefully we’re good stewards of it.
Q: What are you most excited about in this year’s update?
A: It’s not the pandemic anymore, thank goodness! We can think about broader issues than just the one virus that consumed us in recent years. I think that as we have moved through the pandemic, the value of the Red Book has become even more apparent. The pandemic illustrated how disruptive an infectious disease can be.
Q: One new chapter is on COVID-19. Do you expect to add chapters for new emerging diseases in the future?
A: Everyone expected the next pandemic would be an influenza pandemic. We did not anticipate a coronavirus pandemic.
There’s a lot more people on this planet now. We’ve got climate change, we have encroachment in habitats that humans were previously not in and that puts them closer to where the viruses may be, which is in animals, and they can make that zoonotic jump into people. I don’t know when that will happen, but it will happen.
There’s absolutely no way you could imagine a world that never has another pandemic. I’m hoping it will be a long time, but then you look at H5N1 influenza. We’ve had our eye on that one since the 1990s. Thankfully, it hasn’t made the jump, but if it does, it could be bad.
Q: When pediatricians open their Red Book, what is the first chapter they should brush up on?
A: I think the first thing they ought to do is turn to the dedication and read about Sarah Long (longtime associate editor of Red Book and former COID member). She truly has changed history. Her impact on child health is immeasurable.
In terms of the chapters, we have taken what was new in the 2021 edition, the systems-based treatment table, and moved it to the front of the Red Book. We did that because it was well-received in the 2021 edition but was buried back in section 4. It’s been expanded a little compared with 2021, but mostly, it’s been organized in such a way we think is going to be easier to use.
I also think that pediatricians should look at the measles chapter, even if they’re not seeing measles cases right now. It includes a new table that shows what to do when a child has been exposed to measles.
We really doubled down with this edition to try to get the information more rapidly in front of users (with an algorithm, figure or table) so they don’t have to dig for it within paragraphs but rather see it right there and say, ‘OK, here’s what I have to do.’
Q: What do you hope the Red Book provides for pediatricians?
A: Undoubtedly, the primary driver of this book is to improve the lives of the children we all have the privilege of taking care of. I hope that pediatricians will find this edition, as they have with prior editions, helps them in their efforts to accomplish this goal.
Q: What do you hope pediatricians take away from the chapter on vaccine communication, which was rewritten to coincide with the 2024 AAP clinical report on this topic?
A: It’s a way that a busy pediatrician can find that information quickly. So much of what parents have questions about these days is the safety of vaccines. Pediatricians need to be savvy about these incredibly detailed safety networks that look to confirm we don’t have a safety signal or problem with a vaccine. So that’s all been moved into that chapter. It allowed us to re-envision what should be communicated and consolidate it in one place for easy access and reference for the pediatrician.
Q: What other updates will pediatricians find?
A: In terms of what general pediatricians and nurse practitioners will be dealing with, there are some changes to the congenital CMV (cytomegalovirus) chapter. More states are mandating testing for congenital CMV either universal or in a targeted fashion when babies fail their newborn hearing screen. So more of the country is going to have a requirement to test for congenital CMV, and we’ve positioned ourselves to be ahead of that curve.
Same with hepatitis C. There’s some pretty big changes for babies born to women with hepatitis C and the ways we can test for that and how rapidly we can rule it out as compared with the older approach where you had to wait until they were a year and a half to fully rule it out.
We have a lot with HIV. It was also in the 2021 edition, but we have a couple of algorithms that reflect what to do when a baby is born to a mom with HIV, and it’s an easier way to see it. It’s been modified to reflect the most recent drug recommendations to manage those babies.
Q: How do you use Red Book Online to keep information current between print editions?
Red Book Online is a tremendous resource to get information out to a pediatrician or a nurse practitioner quickly. There’s a lot on Red Book Online about emerging infections and (drug) shortages.
The Red Book content of Red Book Online is a duplication of what’s in the print edition albeit with a powerful online platform that allows for searching in a way the book doesn’t allow. There’s a functionality with Red Book Online that the book doesn’t have, and there’s a functionality the print edition has that Red Book Online doesn’t have. They complement each other very well.
Q: What else should readers know?
A: If the reader thinks something needs to be better, please send that to us. We obviously can’t do every single thing everybody says, but we do take feedback very seriously.
