Epidemiology of rotavirus in young children

Rotaviruses are ubiquitous in nature, infecting virtually all young children by the second or third year of life resulting in the high burden of disease and morbidity in both developed and developing countries 7, 18 . However, it is clear that differences exist in the epidemiology and the distribution of rotavirus strains between developing countries and industrialized countries. Following a WHO recommendation for specific standardized studies in Africa and Asia on the epidemiology of rotavirus...

Investigations

Currently, there are two non-invasive tests that are becoming extremely reliable in detecting H. pylori infection. The more established one is the urea breath test and the other is the stool antigen test. Serology test is not recommended as diagnostic tool because of its poor sensitivity and test-to-test variability 33 . The urea breath test utilizes the essential enzyme urease, which is produced by H. pylori. Urease converts urea to ammonia and CO2. If the CO2 is labeled with a stable isotope,...

Epidemiology and clinical features of avian influenza in children

Avian influenza viruses have caused a spectrum of disease in humans, including typical influenza-like illness, conjunctivitis and severe respiratory disease. More recent outbreaks, and the H5N1 virus in particular, have been more severe and more frequently associated with fatal illness. In general, avian influenza virus infections in children have been no less severe than in adults. Mild respiratory disease was reported in 2 Dutch children due to reassortant human-avian influenza viruses in...

Extragastric manifestations of H pylori infection in children

With the increasing awareness among clinicians of H. pylori infection over the last decade, there have been a number of reports on the consequences of adverse effects from H. pylori infections outside the gastrointestinal tract (Tab. 1). Studies purporting the association between these manifestations of H. pylori infections are weak in terms of design and are not reviewed in this chapter. However, there are two manifestations that need to be mentioned the first is refractory iron-deficiency...

References

1 Miller MA, Hinman AR (2004) Economic analysis of vaccine policies. In SA Plotkin, WA Orenstein (eds) Vaccines, 4th edn. Elsevier Inc., Philadelphia, PA, 1463-1490 2 Bloom DE, Canning D, Weston M (2005) The value of vaccination. World Economics 6 15-39 3 Keja K, Chan C, Hayden G, Henderson RH (1988) Expanded programme on immunization. World Health Stat Q 41 59-63 4 Fenner F, Henderson DA, Arita I, Jezek A, Ladnyi ID (1988) Smallpox and its eradication. World Health Organization, Geneva 5...

Clinical presentation and outcome

The reported symptoms of avian influenza in children have ranged from typical influenza-like symptoms (e.g., fever, cough, sore throat, and muscle aches) to eye infections (conjunctivitis), pneumonia, acute respiratory distress, viral pneumonia, and other severe and life-threatening complications (Tab. 2). The majority of children have presented with fever and respiratory symptoms, although in the Vietnam cases, diarrhea was prominent. Notably, Table 2. Clinical features of H5N1 avian influenza...

Idiopathic thrombocytopenia and H pylori infection

In 1998, Akiyama and Onozawa 54 demonstrated that a PPI administration was associated with an increase in platelet count in patients with chronic idiopathic thrombocytopenia (ITP). Subsequently, a Lancet paper in a pilot study by Gasbarini et al. 55 described a significant increase in platelet count in 8 of 11 patients with H. pylori, which was successfully eradicated. Since then, there have been numerous case reports and case series reporting that eradication of H. pylori is accompanied by...

Schroten Lawrence

1 Sachs J, Malaney P (2002) The economic and social burden of malaria. Nature 415 680-685 2 WHO (1986) Severe and complicated malaria. Trans R Soc Trop Med Hyg 80 3-49 3 Marsh K, Snow RW (1997) Host-parasite interaction and morbidity in malaria endemic areas. Philos Trans R Soc Lond 352 1385-1394 4 Cannon PR (1941) Some pathological aspects of human malaria. In FR Moulton (ed) A symposium on human malaria. American Association for the Advancement of Science, Washington, 214-220 5 Meleney HE...

Carl Siegmund Franz Cred introducer of the antiseptic eye prophylaxis with silver nitrate

Carl Siegmund Franz Cred (23.12.1819-14.03.1892) (Fig. 1) 8, 12-15 was born in Berlin where he went to school and studied medicine, with the exception of one semester at the university of Heidelberg (Germany). The principle of nihil nocere - an attempt to keep necessary treatment approaches as mild and gentle as possible - was his general philosophy in medicine. After several years of postgraduate study in Austria, France, Belgium and Italy, he returned to Berlin in 1847 and was appointed...

Pathogenesis and host response

Experimental animal models of hMPV infection have been reported, including both primates and rodents. The first published experimental hMPV infection model in cynomolgus macaques (Macaca fascicularis) confirmed that hMPV is a primary pathogen of the respiratory tract in primates 45 . The hMPV-infected macaques showed mild clinical signs of rhinorrhea corresponding with a suppurative rhinitis at pathological examination. In addition, mild erosive and inflammatory changes in the mucosa and...

Neurological involvement in malaria

CM is a clinical syndrome characterised by coma (inability to localise a painful stimulus) at least 1 h after termination of a seizure or correction of hypoglycaemia, detection of asexual forms of P. falciparum malarial parasites on peripheral blood smears, and exclusion of other causes of encepha-lopathy 137 . Energy depletion and cerebral oedema A relatively consistent feature of acute CM in children is raised intracranial pressure (ICP). Studies in African children have demonstrated a raised...

Immunization is safe and one of the most effective disease prevention measures

Seven most often used controversial arguments are discussed Controversial argument 1 Most vaccines are not really indicated, because many of the so-called vaccine-preventable diseases already disappeared due to the improved socioeconomic conditions before vaccines were introduced. Improved socioeconomic conditions as well as the development of antibiotics have undoubtedly had a great impact on disease incidence, disease-related complications and death. However, the immediate and direct impact...

Demographics and epidemiology

Warts are a very common illness worldwide. In the United States, children are the most likely targets of the common wart viruses. Warts follow acne and atopic dermatitis in frequency of diagnosis in pediatric dermatology clinics 12, 13 . It is thought that 10-20 of children will at sometime be infected with warts 1, 3, 14 . The peak incidence of disease varies from study to study with some studies showing a peak age grouping of 8-9 years and others pointing to a peak age range between 12 and 18...

Pediatric populations at risk for invasive infections

The pediatric populations at risk can be defined by specific predisposing defects in host defenses and several additional, non-immunological factors. In general, deficiencies in the number or function of phagocytic cells are associated with invasive infections by opportunistic fungi, such as Candida spp., Aspergillus spp., zygomyces spp. and a large variety of other, less frequently encountered yeasts and molds. In contrast, deficiencies or imbalances of T lymphocyte function are linked to...

Challenges to rotavirus vaccine development

What challenges can ostensibly remain for rotavirus vaccines, at the time that two safe and efficacious rotavirus vaccines are licensed internationally and on the verge of being introduced in multiple countries in the Americas and in Europe Certainly, these vaccines will reduce the tremendous costs associated with rotavirus-associated illness and hospitalizations. Nevertheless, for rotavirus vaccines to reach their full potential and impact significantly on reducing childhood mortality, the...

Host side effects of note

Diabetics with palmoplantar warts may experience greater injury or prolonged ulceration post treatment related to diabetic neuropathy. On the other side, diabetics with untreated plantar warts may develop ulcerations from the chronic pressure of the wart. While treatment should be given for all diabetics' warts, aggressive therapy is contraindicated in diabetics with neuropathic disease. In the pediatric age group, older adolescents with an infantile onset of insulin-dependent diabetes mellitus...

Red cell abnormalities and malaria

Only the erythrocytic form of malaria is associated with disease, so valuable information about which African children are likely to have more, or less, severe malaria has inevitably been obtained from examining the inborn RBC abnormalities that endemic malaria has selected across the tropics. The coinciding geographic distributions of malaria transmission and the thalassaemias prompted Haldane to put forward the 'malaria hypothesis', which proposed that common erythrocyte abnormalities are...

Recent advances in early diagnosis and preemptive therapy

Early diagnosis and rapid initiation of effective antifungal chemotherapy is paramount to the successful management of invasive mycoses. The microbiological diagnosis should be attempted if feasible in all cases of suspected invasive fungal infection, and the organism identified at the species level. Because of the lack of its predictive value in other settings, the performance of in vitro susceptibility testing is currently reserved to Candida species vs. fluconazole and flucytosine,...

Discussion of Creds activities and his four publications with the same title

In Cred 's case there was an urgent medical need for an effective prophylaxis against gonorrheal ophthalmia neonatorum. Cred realized that vaginal douches were almost ineffective in preventing ophthalmia neonatorum, and that a strong antiseptic agent for prophylactic application at the ocular infection site - the newborn's eye - was needed. Potential irritative side effects had to be tolerable at this sensitive organ. Further, he recognized the threat of re-contamination of the eye by vaginal...

Credes prophylaxis today

In recent times, especially after the discovery and development of potent antibiotics, the etiology of ophthalmia neonatorum has changed signifi cantly. Despite cases of ophthalmia neonatorum due to Neisseria gonorrhoeae infections, chlamydial eye infections in the newborn became more the primary focus compared to gonorrheal eye infections 40-45 . Silver nitrate and acetate show no sufficient activity in prophylaxis of chlamydial eye infections and exhibit irritative adverse effects of chemical...

Clinical presentation

The clinical course or natural history of the infection is quite variable and is likely to be dependent on host, environmental and bacterial factors. The majority of children and adults infected with this bacterium are asymptomatic. Most infected patients with H. pylori develop gastritis, particularly nodular gastritis in children 17, 18 . Those with antral predominant gastritis are more likely to develop duodenal ulcers and have a reduced risk of gastric cancer compare to those with corpus...

Prevention of Inflammatory eye disease in the newborn Information from the Maternity Clinic Leipzig by Crede [22

I am ( ) publishing the following information concerning the prevention of inflammatory eye disease in the newborn ( ) in this Archive because the disease is almost invariably caused by infection during delivery and is therefore directly related to a diseased condition of the female genitals. Responsibility for prevention of the disease must also lie solely with obstetricians and midwives. I shall confine my remarks exclusively to the practical question of prophylaxis. ( ) My request for...

Genital HPV infection

Almost all strains of genital HPV are oncogenic, whether of high potential (e.g., HPV 16, 18, 31, 33, 34) or low potential (e.g., HPV 6, 11), eventually potentially causing invasive disease such as cervical intraepithelial neoplasia, cervical cancers, genital cutaneous and mucosal squamous cell carcinomas (e.g., Bowen's disease) including penile carcinomas. Cervical cancer is the second or third leading cause of cancer deaths in epidemio-logical studies of adult women 1, 3, 5 . Pap smears are...

H pylori and gastroesophageal reflux disease

Currently there is no evidence that H. pylori eradication worsen gastroesophageal reflux disease (GERD) in adults 41 . Limited data are also available in children. However, there is a theoretical risk, even though the data are conflicting, that long-term proton pump inhibitor (PPI) treatment could increase the development of H. pylori-associated atrophic gastritis and increase the risk of gastric cancer 42, 43 . Some experts recommend testing and eradicating H. pylori if the child or adolescent...

Contraindications and false contraindications

Contraindications to immunization dictate circumstances when vaccines should not be given because the condition in an individual increases the risk for a serious adverse reaction following immunization. The majority of con traindications are temporary, and the vaccine can be given later. However, in many cases immunization is delayed or denied because of conditions falsely believed by the physician or the health worker to constitute a contraindication. The World Health Organization and the...

Clinical characteristics

The first description of hMPV in children with lower RTI has been reported by a Dutch group that identified the virus in respiratory secretions 1 . Clinical symptoms were similar to those caused by RSV, ranging from upper RTI, severe bronchiolitis and pneumonia during the winter season. All 28 children observed were < 5 years of age, and 46 were < 1 year old. Asymptomatic carriage seems to be rare in children no hMPV was detected in 400 infants without respiratory symptoms. The prevalence...

Immune dysfunction and malnutrition

Malnutrition in the neonatal period and early childhood can lead to severe immune deficiency and high mortality. Effects on the immune system are broad, involving all limbs of the immune system, with impaired T cell responses secondary to effects on thymic architecture and function being the most common. The link between malnutrition and infection is readily observable. For children living a rural environment in a developed country, one study reported that bacterial infections were discovered...

Host response

The human clearance of HPV is a complex and variable process, which consists of three arms (1) protective skin barrier, (2) innate immunity and (3) acquired immunity 1, 3, 19 . Table 2. Summary of the categorizations of warts Humoral vascular reaction cellular extravasation Infiltrating cytotoxic T cells natural killer cells, macrophages Simultaneous appearance of inflammatory cells (cytotoxic T cells) and anti-viral cytokines Same as plane warts, but at a slower pace due to depression of cell...

Diagnosis of warts

Diagnosis of warts is made by the classic physical examination features, including absence of normal dermatoglyphics of the skin and presence of pinpoint areas of bleeding when the lesion is pared. These latter features distinguish warts from calluses. Because of the verrucous appearance microscopically, warts are often rough to the touch, distinguishing them from other viral skin conditions, such as molluscum. Furthermore, mollusca have central punctae 1, 3 . If the diagnosis is questioned one...

Role of HPV in nonwart skin conditions

HPV can often be detected in common dermatoses, leading to speculation that HPV may play a role in the development of conditions such as psoriasis vulgaris. It has been postulated that EDV HPV types may play a role in the hyperproliferation of skin in psoriasis vulgaris. Anti-HPV 5 antibodies have been demonstrated in epidermal repair processes, including second degree burn and autoimmune skin diseases, including bullous disorders. Thus, it initially appeared that antibodies to the EDV HPVs...

Severe malaria in children compared to adults

The majority of the clinical cases of malaria occur in sub-Saharan Africa. Nevertheless, malaria also accounts for considerable morbidity and mortality in other continents particularly South East Asia 6 . In malaria-endemic regions (e.g. sub-Saharan Africa), where the resident population have continuous exposure to malarial parasites, most of the severe cases are seen in children 7 . In hypoendemic regions (e.g. South East Asia), where parasite exposure is more intermittent, cases of severe...

Introduction

In both industrialized and developing countries, child immunization has become one of the most important and cost-effective public health interventions 1, 2 . National immunization programs have prevented millions of deaths since WHO initiated the 'Expanded Program on Immunization (EPI)' in 1974 3 . Smallpox was eradicated in 1979 4 , poliomyelitis is on the verge of eradication 5 , and two thirds of developing countries have eliminated neonatal tetanus (NT).1 Global immunization coverage, as...

Indications for the immunization of selected risk groups

Many authors take the conservative position that the use of vaccines during pregnancy should generally be avoided at any stage of the pregnancy, since definitive studies on the level of risk have not been carried out. Other authors take a more balanced position They consider that there is no convincing evidence that pregnancy should be an absolute contraindication to the use of standard vaccines. With regard to live vaccines, only smallpox vaccine has been shown to cause fetal malformation....

How might P falciparum cause this complex disease

Once the malarial parasite was identified as the cause of disease, it quickly became apparent that illness and death were linked with parasite invasion into bloodstream and subsequent parasite growth within (and release from) the erythrocytes. By the start of the 20th century, two major theories, capillary blockage and toxicity of the parasites themselves, had been proposed to explain morbidity and mortality. Thus, the study of malarial disease is not a settled story requiring regular updates,...

Childhood periodontal diseases

Periodontal diseases can be grouped broadly into gingivitis and periodonti-tis, and each can be further divided according to the disease characteristics (e.g., chronic, aggressive) and the contributing factors, including related systemic conditions and disorders 39 . On the basis of histopathology, gingivitis is characterized by inflammation confined to the gingiva, and peri-odontitis denotes destruction of periodontal tissues that involve the gingiva, the periodontal ligament, root cementum...

Gateways into the brain

Vascular Organ Lamina Terminalis

It is still unclear why many pathogens principally have the potential to initiate meningitis, but only a relatively small number of them account for the vast majority of cases. The crucial step for all microorganisms after invasion of the host is the attachment and subsequent penetration of the structures that separate the CNS from the periphery. For most pathogens, however, the exact port of entry into the brain remains unclear. Nonetheless, observations on cell culture and animal models as...

Hepatitis C

What Anti Hcv Means

Chronic hepatitis C occurs only infrequently in childhood. Based on our own research, the estimated rate is about 1 2000 children in Germany 13 . Many of these patients were found to have received blood or blood prod- Table 2. Advantages and disadvantages of antiviral medications for chronic hepatitis B Table 2. Advantages and disadvantages of antiviral medications for chronic hepatitis B Few if any complications In most patients HBV-DNA and GPT decrease during therapy Available in juice form...

Epidemiology and presentation of invasive fungal infections in pediatric patients

Epidemiology Fungi

Candida spp. colonize the vaginal tract of approximately 30 of pregnant women very rarely, they can become the cause of chorioamnionitis and intrauterine infection 29, 30 . Candida rapidly colonizes the mucocutaneous surfaces 31, 32 in healthy infants, this colonization may result in thrush and diaper dermatitis 31 . In hospitalized, ill neonates, however, Candida has evolved as important cause of life-threatening invasive infections, particularly in very low birth weight infants. Candida spp....

Defining wart types

Warts are usually defined by morphology, location and host immune response, which are not mutually exclusive 3, 19 . Definition by morphology (Tab. 1) Common warts (Fig. 1) Common warts are rough, verrucous plaques of the skin that usually measure 3-10 mm in diameter. HPV type 2 is the most common immunotype type 1 warts may be indistinguishable. These lesions are often located on the dorsal surface of the hands, but the knees and other areas of the body may also be affected. Common warts on...

Specific micronutrient deficiencies

Micronutrients have a major impact on immune response, through antioxidant activities and modulation of cytokine expression. Antioxidant enzymes, such as copper, zinc, and manganese superoxide dismutases, require trace metals for biological activity, and these enzyme reactions protect against oxidative damage caused by free radical formation during immune response and other biological reactions. Intracellular redox balance has a signaling role in immune cell development and function, and the...

Fattal Valevsk 2001 On Micronutrient

1 Cunningham-Rundles S, McNeeley DF, Moon A 2005 Mechanisms of nutrient modulation of the immune response. J Allergy Clin Immunol 115 1119-1128 quiz 1129 2 Ganji V, Hampl JS, Betts NM 2003 Race-, gender- and age-specific differences in dietary micronutrient intakes of US children. Int J Food Sci Nutr 54 485-490 3 Fattal-Valevski A, Kesler A, Sela BA, Nitzan-Kaluski D, Rotstein M, Mesterman R, Toledano-Alhadef H, Stolovitch C, Hoffmann C, Globus O et al 2005 Outbreak of life-threatening thiamine...

Impact of health and nutrition on school readiness

Common conditions of poor health and nutrition can affect education in a number of ways. First of all, health and nutrition has an impact on children's access to education, particularly where disease leads to serious physical or mental disabilities. However, this chapter addresses the impact of health and nutrition on children's ability to learn once they do enroll in school - their 'school readiness'. This impact on school readiness may have knock-on effects for children's educational...

Conditions with excessive numbers of warts

In most patients, immunosurveillance and innate immunity contain HPV infection. Excessive numbers of warts are seen in a variety of genetic and acquired conditions Tab. 4 , and may be associated with an increased local risk of cutaneous oncogenesis. Acquired immunosuppression Fig. 2 is exceedingly common, whether from transplantation, chemotherapy or acquired immunodeficiency syndrome. Of the acquired conditions, renal transplantation, because it often occurs in younger patients, is associated...

Malnutrition syndromes of childhood

Malnutrition syndromes of childhood are especially important for host defense since long-term effects may occur due to the continuing interaction of the immune system with potentially infectious pathogens. In addition, there are long-term implications for response to immunization and duration of protection. A general outline of how nutrients affect immune function is shown in Table 2. Low birth weight infants are classified as SGA small for gestational age , which can also occur in full-term...

Early childhood caries

Dental caries is one of the most prevalent diseases affecting people in industrialized countries. Caries of enamel surfaces enamel caries is particularly common in children ECC and young subjects up to the age of 20 years, while root surface caries is frequently observed in elder individuals with gingival recession exposing the vulnerable cementum to microbial colonization Fig. 1 3 . The ECC lesion invariably originates as small demineralized area on the external surface of erupted teeth, i.e.,...

Differential diagnosis

Warts can be mistaken for any other benign or malignant overgrowths tumors, and vice versa, benign and malignant overgrowths or tumors of the skin and mucosa may take on the appearance of warts. Thus, warts can be mistaken for a callus, a nevus, acrochordons, seborrheic keratoses, actinic keratoses, a squamous cell carcinoma or a melanoma when pigmented . On the other hand, cases of depigmented and verrucous melanomas and warty-appearing squamous cell carcinomas have been reported in the...

Ludwig Sigesmund Albert Neisser and insights into etiology and pathophysiology of gonorrhea at Creds time

Ludwig Sigesmund Albert Neisser 1855-1916 was a German physician and bacteriologist 25-32 . He was a school classmate of Paul Ehrlich 1854-1915 in Breslau - former Germany - and studied medicine mainly in Breslau thereafter. Consecutively, he started specializing in dermatology, although he primarily intended to specialize in internal medicine but could not get an appointment as assistant in Breslau. Apart from working on echinococcosis PhD thesis , leprosy and syphilis, he was the person who...

Pathophysiology of malnutrition

Malnutrition can be classified as either primary or secondary 1 . Primary malnutrition is caused by inadequate calorie and nutrient intake. In developed societies, calorie intake is usually presumed to be adequate. However, inadequate intake of micronutrients including vitamins A and E, calcium, iron and zinc are prevalent among children of 1-10 years of age and often unrecognized, especially in minority populations 2 . Primary malnutrition in infants can also occur through child neglect or...

Autism

At the end of the 1990s, concerns about the safety of the measles, mumps and rubella MMR and thimerosal-containing vaccines as possible causes of autism and other neuro-developmental disorders were raised. Various careful designed studies have been undertaken particularly in Denmark, Finland, Sweden, the United Kingdom and the United States to evaluate if there is any evidence for an association between MMR and thimero-sal-containing vaccines and neuro-developmental disorders, particularly...

List of contributors

R diger Adam, Pediatric Infectious Diseases, Department of General Pediatrics, University Children's Hospital, Moorenstrasse 5, 40225 D sseldorf, Germany e-mail adam med.uni-duesseldorf.de Ian A. Clark, School of Biochemistry and Molecular Biology, Australian National University, Canberra ACT 0200, Australia e-mail ian.clark anu.edu.au Susanna Cunningham-Rundles, Host Defenses Program, Department of Pediatrics, Weill Medical College of Cornell University, 1300 York Avenue, New York, NY 10021,...