"Dr. Herz’s contribution to the medical literature has wide applicability to many clinical settings, including the medical office, emergency department, and inpatient hospital setting."
Michael A. Horberg, MD
Chair, TPMG/KPNC
Central Research Committee
Pediatrics
Greater Southern Alameda Area
Recognized for his groundbreaking work, reported in “Changing Epidemiology of Outpatient Bacteremia in 3-36 month-old Children After the Introduction of the Heptavalent-Conjugated Pneumococcal Vaccine.” (The Pediatric Infectious Disease Journal 2006; 25:293-300).
Dr. Herz’s idea for the research that led to this article came after a colleague asked him to speak to residents about how to use the “Rochester Criteria” (RC) for evaluating infants with fever. Dr. Herz had a hunch that the RC was no longer a useful tool because the bacteria it screened for in 1991 was less prevalent following the introduction of
the Pneumococcal Vaccine.
His findings demonstrated a dramatic reduction in the kind of bacteria found in populations of children who had received their vaccinations. However, he also found something of great interest - that while pneumococcal bacteremia had decreased, E. coli, Salmonella, and Staphyloccus had increased in relative importance. Dr. Herz reported: “The use of white blood cell counts alone to guide the empiric use of antibiotics is not indicated. New guidelines are needed to approach
the previously healthy febrile toddler in the outpatient setting.”