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Subacute sclerosing panencephalitis (SSPE) is a progressive neurodegenerative disease of children and young adults that may occur as an uncommon complication 7-10 years after a measles infection. In measles - endemic countries like India, the incidence of this fatal disease is high and more number of new cases are detected in recent times. In this case series, we have presented three cases of SSPE between the 4 and 5 years age group, presented with abnormal movement and neuroregression and diagnosed by characteristic clinical features, raised anti-measles antibody titer in CSF, and typical Electroencephalography findings. All of them had a history of measles infection before the vaccination and very short latency period between measles infection and the development of SSPE. They were discharged in stable condition after the treatment with oral Isoprinosine and intrathecal Interferon alfa 2b. Early age of presentation, short latency period, and apparently good response to treatment for the time being prompted us to present these cases. [ABSTRACT FROM AUTHOR]

Background: Scrub typhus is a mite-born disease scrub. It commonly manifests as an acute febrile illness with multi-system involvement. It is regarded as a life-threatening disease in children, with serious complications usually occurring in the 2nd week of illness. Aims and Objectives: The aims of this study were to explore the clinical and laboratory profile of children with scrub typhus. Materials and Methods: All children admitted with scrub typhus over 1-year duration were enrolled in the study. The clinical, laboratory profile, and outcome were observed and analyzed. Results: A total of 47 children were diagnosed with scrub typhus, 17 (36.1%) children had clinical and laboratory evidence of meningitis. The most frequent presenting features were fever (100%), headache (82.4%), vomiting (82.4%), seizures (41.2%), and altered sensorium (70.6%). The mean duration of fever was 6.57 days, eight children (7%) had persistent fever for >14 days duration. Other complications reported were hepatitis 2 (4.3%), hepatosplenomegaly in 18 (38.3%) acute respiratory distress syndrome 2 (4.3%), and shock 31 (66%). The mean cerebrospinal fluid (CSF) protein, glucose, and cell count was 65.75±9.27 mg/dL, 45.00±7.23 mg/dL, and 65.94±52.72 cells/mm³ of CSF, respectively, with lymphocyte count of more than 96% in all cases. Most patients had lymphocytic pleocytosis and the mean lymphocyte percentage was 96.2%±4.5%. Out of all 47 patients, 45 (84.61%) patients recovered with appropriate antibiotics in both groups, while two (15.38%) patients expired in the group without meningitis. Conclusion: A high degree of suspicion and knowledge of the geographical distribution of Rickettsial diseases is crucial for its early diagnosis and favorable outcome. Scrub typhus should be considered in the differential diagnosis of aseptic meningitis. [ABSTRACT FROM AUTHOR]

Background: Febrile seizure occurs in 2-5% of neurologically healthy infants and children. The recurrence of febrile seizures is 30% after single episode, 50% after 2 or more episodes, and 50% when febrile seizures occur in infants. Their incidence of febrile seizures in India is 10-17% which is higher than in developed countries (2-7%). Aims and Objectives: The purpose of this study was to evaluate iron deficiency (ID) as a risk factor for febrile convulsion and the association of ID anemia with febrile convulsions. Materials and Methods: This was an observational case-control study conducted in tertiary care center in central India between December 2019 and June 2021. All patients with febrile seizures taken as cases and control from similar age group with febrile illness. Body temperature of children in both the groups was measured and recorded. The blood tests of complete blood count, serum iron, and TIBC were performed. Results: In the present study, mean age was 2.33 years in case and mean age was 2.204 years in control. The mean hemoglobin levels were 8.25±1 g/dL in the febrile seizure case group and 9.86±1.49 g/dL in the control group; and their statistical difference was significant. Serum ferritin values was significantly lower among cases group than the control group. The average of MCV, MCH, and MCHC for the case group was less than that of the control group. The present study also demonstrates an association between ID and febrile seizures. Thus, ID is one of the possible risk factors for febrile seizures. Conclusion: The present study showed that hemoglobin, MCV, serum ferritin, and serum iron levels are significantly lower in children suffering from febrile seizures, suggesting that a low iron status has an important role in children with febrile seizures. Thus, ID is predictor for febrile convulsion. [ABSTRACT FROM AUTHOR]

Background: Weather and the susceptibility of children to SARS-CoV-2 infection is still a debated question particularly in view of important decisions regarding opening schools. Therefore, we planned this cross-sectional analysis of antiSARS-CoV-2 Immunoglobulin-G (IgG) antibodies in children with known household exposure to SARS-CoV-2. This serosurveillance, to find the presence of IgG antibodies among children of probable household exposure of confirmed COVID-19 cases will help in the better understanding of the immune response after COVID-19 infection/exposure. Aims and Objectives: The aim of the study was to investigate the prevalence of anti-SARS-CoV-2 antibodies in children among the families who had confirm case/cases of COVID 19 during the second wave of the COVID-19 pandemic. This study is designed as a cross-sectional serosurveillance study in Kota, Rajasthan India. Materials and Methods: Population-based serosurveillance among children with probable household exposure to confirmed COVID-19 cases who was admitted in Govt. Medical College attached COVID 19 dedicated hospital was carried out during October 2021 to December 2021 using the COVID IgG Antibody Detection Enzyme-Linked Immunosorbent Assay kits. Seropositivity among children was measured and with various other factors to understand the immunity status among COVID-19 cases. Descriptive statistical analysis done. Results: 156/1285 eligible candidates (19.53%) having a total of 251 household contacts of <17 years age group agreed to participate in study while rest of them refused. Anti-SARSCoV-2 IgG antibodies were present in 127/251 household contacts (50.59%). Among them maximum 28.68% of seropositive were from age group 11–17 years age, symptoms were observed in 29.13% IgG positive contacts, maximum seropositivity was seen when only one family member was hospitalized, 63% seropositivity was seen when primary relative of child was hospitalized as compared to secondary. Maximum seroreactivity (55.9%) was seen when the Chest CT score of index case was high, that is, 14–25. max reactivity was observed 76/127 (59.84%) when hospital duration of index case is <1 week. 118/127 (92.91%) of seroreactive children were found when the index case was unvaccinated or partially vaccinated. Conclusion: Seropositivity of 50.59% suggests that all the cases may not have IgG antibodies. Among the seronegative cases, the antibodies either not developed, or are undetectable, or have disappeared during the post COVID period. Seropositivity based on gender difference is statistically not significant. Proportion of positivity shows an increasing trend with increasing age among pediatric household contacts. Complete COVID-19 vaccination is an effective tool to minimize the disease frequency/severity. Severe disease patients with high CT score transmits the infection to household contacts more efficiently. [ABSTRACT FROM AUTHOR]

Background: Japanese encephalitis (JE) is an important cause of viral encephalitis in children in South East Asian countries including India. Aims and Objective: We have done this study in an JE endemic district of India to know the demographic profile, clinical presentation, seasonal variation, outcome and about the vaccination status of the JE cases. Materials and Methods: This observational, cross sectional study was done for a period of one year in the Pediatric department of Burdwan Medical College, West Bengal in children up to the age of 12 year, presented with acute encephalitis syndrome (AES). Demographic data, clinical presentation and JE vaccination status were recorded and confirmed JE cases were detected by either serum or CSF JE IgM antibody. Outcome of the JE cases were noted as discharge, death or leave against medical advice (LAMA). Results: We have found confirmed JE in 18 children out of total 125 AES cases (14.4%). 61.1% of them were within 6 to 12 year age, mostly from low socioeconomic status and 100% case occurred during monsoon and post monsoon period. History, was of JE vaccination were present in only 11.1% case of JE. Most common presenting symptoms were high fever (100%), convulsion (94.4%) and altered sensorium (72.2%). 77.8% JE case were discharged and 11.1% expired. Conclusion: We must consider JE whenever a child from any endemic district comes with AES and we should try to bring every child under the JE vaccination coverage in the endemic regions globally to reduce the burden of this preventable encephalitis. [ABSTRACT FROM AUTHOR]