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To examine and compare the medical burden of measles, influenza and COVID-19 outbreaks in the city of Bnei Brak, Israel.The study was conducted during 2018-2021. The numbers of hospitalisations for these infections and their complications were recorded. Hospitalisation rates were determined by using the number of children residing in Bnei Brak and hospitalised with these infections during the study period as the numerators. The denominators were the estimated paediatric cases of measles, influenza and COVID-19 in Bnei Brak and were calculated under both pragmatic and conservative assumptions.A total of 247, 65 and 32 children were hospitalised with influenza, COVID-19 and measles respectively. Complication rates were higher following measles than after influenza and SARS-CoV-2 infections. Hospitalisation rates were 10% for measles, 0.6%-1.2% for influenza and 0.15% - 0.25% for COVID-19 infections. Relative risks (RR) with 95% confidence intervals (CI) for hospitalisation following measles compared with COVID-19 ranged from 42 (26.3-67.3) to 70.1 (43.8-112.1), while the relative risks for influenza hospitalisation ranged from 2.5 (1.83-3.41) to 8.2 (6.0-11.2), compared with COVID-19 infection.Hospitalisation rates and direct medical burdens of measles and influenza were significantly higher than those of COVID-19 infection in children.

OBJECTIVE: We compared neonatal immunity after vaccination against SARS-CoV-2 during pregnancy to that achieved after maternal infection. STUDY DESIGN: We tested cord blood from women infected with SARS-CoV-2 during pregnancy (group 1, n = 29), women who were vaccinated during pregnancy (group 2, n = 29) and from women not infected and not vaccinated (Group 3, n = 21) for titers of antibodies to both SARS-CoV-2 spike and 'N' proteins. RESULTS: Seventy-nine women were included: Antibodies against SARS-CoV-2 spike protein were detected in all samples from Group 1 and 2. Antibodies to the 'N' protein were detected in 25/29 samples in Group 1. None of the samples from Group 3 had antibodies to either protein. Mean titers of SARS-CoV-2 antibodies were significantly higher in Group 2 than in Group 1 (p < 0.05). CONCLUSIONS: Neonates born to mothers vaccinated during pregnancy have higher antibody titers and may therefore have more prolonged protection than those born to women infected during pregnancy.

Across the world, children and adolescents are exposed daily to toxic levels of violent behaviors, including domestic and family violence. Violence increasingly has permeated and profoundly affected the lives of children, who are the most vulnerable members of society.1 Pediatric societies in Europe and North America have raised great concern over the effect that abusive experiences will have on present and future generations.1, 2, 3, 4 The global spread of coronavirus disease 2019 (COVID-19) during the past year has dramatically worsened the situation, contributing to a further increase in violence and aggression within households. Reports of domestic abuse and family violence have increased around the world with social isolation and quarantine measures, and national health and social care systems worldwide have faced serious challenges posed by the rising rates of domestic and family abuse.5 Children are typically the primary victims of family violence2; however, children who live in homes in which partner abuse occurs are described as secondary victims.6 Minors increasingly are witnessing various forms of unprecedented emotional and physical domestic abuse, often resulting in femicide, and exposed to the emotional, behavioral, physical, social, and cognitive effects.2 There are documented gendered patterns in violence perpetration and victimization.7 This commentary, authored by the working group on social pediatrics of the European Paediatric Association/Union of National European Paediatric Societies and Associations, discusses children witnessing family violence and domestic abuse, including femicide as the most extreme and irreversible expression of domestic violence involving parents or household members. Our aim is to raise awareness regarding this phenomenon, which is rapidly expanding during the COVID-19 pandemic, and on the serious long-term effects on the well-being of children.

Objective There is limited data regarding the safety of vaginal delivery in women infected with COVID-19. Our goal was to assess the safety of vaginal delivery in women infected with COVID-19 and the risk of neonatal infection. Study design This was a single medical center cohort study. Data were collected about the outcome of twenty-one women with laboratory-confirmed COVID-19 infection who delivered between March 23, 2020, and May 8, 2020. Results Twenty-one gravidas were diagnosed with COVID-19 infection. None required admission to the intensive care unit (ICU) and there were no fatalities. Seventeen delivered vaginally and four by caesareans. Apgar scores of all neonates were 9 at 1 minute and 10 at 5 minutes. One neonate was diagnosed with COVID-19 infection 24 hours after birth. Conclusions Vaginal delivery in women infected with COVID-19 is not associated with a significant risk of neonatal infection.

Background Estimating real-world vaccine effectiveness is challenging as a variety of population factors can impact vaccine effectiveness. We aimed to assess the population-level reduction in cumulative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases, hospitalizations, and mortality due to the BNT162b2 mRNA coronavirus disease 2019 (COVID-19) vaccination campaign in Israel during January–February 2021. Methods A susceptible-infected-recovered/removed (SIR) model and a Dynamic Survival Analysis (DSA) statistical approach were used. Daily counts of individuals who tested positive and of vaccine doses administered, obtained from the Israeli Ministry of Health, were used to calibrate the model. The model was parameterized using values derived from a previous phase of the pandemic during which similar lockdown and other preventive measures were implemented in order to take into account the effect of these prevention measures on COVID-19 spread. Results Our model predicted for the total population a reduction of 648 585 SARS-CoV-2 cases (75% confidence interval [CI], 25 877–1 396 963) during the first 2 months of the vaccination campaign. The number of averted hospitalizations for moderate to severe conditions was 16 101 (75% CI, 2010–33 035), and reduction of death was estimated at 5123 (75% CI, 388–10 815) fatalities. Among children aged 0–19 years, we estimated a reduction of 163 436 (75% CI, 0–433 233) SARS-CoV-2 cases, which we consider to be an indirect effect of the vaccine. Conclusions Our results suggest that the rapid vaccination campaign prevented hundreds of thousands of new cases as well as thousands of hospitalizations and fatalities and has probably averted a major health care crisis.

The article describes and discusses several key elements of the paediatric healthcare system in Israel, including paediatric training, family and community paediatrics, hospital-based paediatric services, preventive care services, and special programs such as the "Drop of Milk" (Tipat Halav) program. Although child care in Israel has gained several notable achievements, such as a low infant mortality rate, there are several significant challenges for the coming years. These include training of enough paediatricians and periodic updating of training programs to fulfil needs and provide an adequate preventive care from fetal life through infancy, childhood, and adulthood. In addition, paediatricians in Israel should continue to be involved in national public health programs to reduce health inequities among mothers and children and reduce health disparities among certain geographic areas and various populations. Graduates of paediatric residency are expected to be able to address the new technologies, the requirements for personal medicine and on-line medicine, and to be able to deal with both pure "medical" issues, and public health, lifestyle, and environmental issues.

SARS-CoV-2 vaccines proved their effectiveness to prevent severe illness and hospitalization in adults and adolescents. EPA-UNEPSA, ECPCP, and their member European pediatric societies urge national authorities to work intently toward the authorization of safe SARS-CoV-2 vaccine programs. The vaccination in children younger than age 12 years will allow a large number of children to attend school, spend time with friends, travel with their families, and enjoy their communities safely.

More than a year and a half after the first clinical manifestations of coronavirus disease 2019 (COVID-19) were reported in Wuhan, China,1 , 2 the magnitude of the pandemic across the globe and its related clinical and social effects3 remain unclear.4 The pandemic has affected lives and sparked concerns about everything from health to job security. In high–Gross Domestic Product (GDP) countries, despite trillions in coronavirus aid released by governments, many families still struggle to pay for basic necessities like food and rent, and these difficulties worsened during the pandemic.5 , 6 The general social uncertainty caused by the pandemic seems to have also affected family resilience, weakening the ability of individuals to confront challenges, survive difficulties, and thrive in adversities as a group.7 , 8 To reduce community spread of the virus, many countries adopted unprecedented confining measures, including the restriction of populations in their homes and reduction of interpersonal contacts. Confinement, quarantine measures for suspected COVID-19 cases, and social distancing were prolonged, and their effectiveness was debated at social, scientific, and political levels.9 However, although their prevention value in limiting viral spread is generally recognized,6 it is also widely accepted that social isolation measures have upended family lives.4 In particular, they have affected family functioning and parenting, which are significantly associated with the physical and psychosocial functioning of children and adolescents.10 This commentary, authored by the Working Group on Social Pediatrics of the European Paediatric Association/Union of National European Paediatric Societies and Associations, briefly discusses the effects of the confinement measures taken to combat the COVID-19 pandemic on family functioning. Our aim is to raise the awareness of pediatricians, social work professionals, and policy makers, as knowledge of the effects of social restrictions on family functioning may contribute to the efforts of national health systems to be effectively prepared to handle the social effects of future public health crises. Adopting a more mindful and coordinated approach may help overcome divergences across countries, particularly in terms of complex sociopolitical realities.

The Bacillus Calmette–Guérin (BCG) vaccine affords indirect protection against COVID-19, which is presumably due to priming of the innate immune system. It was hypothesized that the live attenuated Varicella Zoster (LAVZ) vaccine, recommended for the elderly population, would also protect against COVID-19 infection. A retrospective population-based cross-sectional study was conducted using the Leumit Health Services (LHS) database. LAVZ-vaccinated patients were matched with controls based on a propensity score model using 1:9 nearest-neighbor matching. Matching was based on age, gender, and the presence of some chronic disorders, which were selected according to their association with COVID-19 infection. Multivariate logistic regression analyses, adjusted for sex, age, smoking status, comorbidities, and chronic medications associated with COVID-19 risk, were used to estimate the association between LAVZ vaccination and COVID-19 RT-PCR results. Subjects (625) vaccinated with LAVZ and RT-PCR-tested for COVID-19 were identified. After 1:9 matching of subjects who received the LAVZ vaccine, 6250 subjects were included in the study. Multivariate logistic regression analysis demonstrated a significant and independent negative association between having received the LAVZ vaccine and the likelihood of COVID-19 infection (adjusted OR = 0.47 (95% CI 0.33–0.69, p < 0.001)). This association was further strengthened after separate analysis based on the time of LAVZ vaccination before COVID-19 RT-PCR testing. Individuals aged ≥50 years vaccinated with LAVZ had a decreased likelihood of being tested positive for COVID-19.

This paper presents the largest cohort to date of infants under 1 year of age treated with mebendazole. We evaluated the occurrence of mebendazole-associated clinical and laboratory toxicity as safety data in this age group are currently lacking.

BackgroundChild abuse and neglect, or maltreatment, is a serious public health problem, which may cause long-term effects on children’s health and wellbeing and expose them to further adulthood vulnerabilities. Studies on child maltreatment performed in Europe are scarce, and the number of participants enrolled relatively small. The aim of this multi-national European pilot study, was to evaluate the level of understanding and perception of the concepts of child abuse and neglect by European paediatricians working in different medical settings, and the attitude toward these forms of maltreatment in their practice.MethodsThe study was performed by a cross-sectional, descriptive, online survey, made available online to European paediatricians members of 50 national paediatric, who belonged to four different medical settings: hospital, family care, university centres and private practice.The questionnaire, designed as a multiple choice questions survey, with a single answer option consisted of 22 questions/statements. Frequency analyses were applied. Most of the data were described using univariate analysis and Chi-squared tests were used to compare the respondents and answers and a significance level ofp ≤ 0.05 applied.ResultsFindings show that European paediatricians consider the training on child maltreatment currently provided by medical school curricula and paediatric residency courses to be largely insufficient and continuing education courses were considered of great importance to cover educational gaps. Physical violence was recognized by paediatricians mostly during occasional visits with a significant correlation between detecting abuse during an occasional visit and being a primary care paediatrician. Results also showed a reluctance by paediatricians to report cases of maltreatment to the competent judicial authorities.ConclusionsData of this study may provide useful contribution to the current limited knowledge about the familiarity of European paediatricians with child maltreatment and their skills to recognize, manage and contrast abusive childhood experiences in their practice. Finally, they could provide local legislators and health authorities with information useful to further improve public health approaches and rules able to effectively address shared risk and protective factors, which could prevent child abuse and neglect from ever occurring.

We examined the dynamics of coronavirus 2019 (COVID-19) transmission within families. Our investigation demonstrated significantly lower rates of COVID-19 positivity in children compared with adults residing in the same household. Children of 5-17 years of age were 61% and children of 0-4 years of age were 47% less likely to have positive polymerase chain reaction results compared with adults residing in the same household.

Background Passive immunization against RSV (Respiratory Syncytial Virus) is given in most western countries (including Israel) to infants of high risk groups such as premature babies, and infants with Congenital Heart Disease or Congenital Lung Disease. However, immunoprophylaxis costs are extremely high ($2800–$4200 per infant). Using cost-utility analysis criteria, we evaluate whether it is justified to expand, continue or restrict nationwide immunoprophylaxis using palivizumab of high risk infants against RSV. Methods Epidemiological, demographic, health service utilisation and economic data were integrated from primary (National Hospitalization Data, etc.) and secondary data sources (ie: from published articles) into a spread-sheet to calculate the cost per averted disability-adjusted life year (DALY) of vaccinating various infant risk groups. Costs of intervention included antibody plus administration costs. Treatment savings and DALYs averted were estimated from applying vaccine efficacy data to relative risks of being hospitalised and treated for RSV, including possible long-term sequelae like asthma and wheezing. Results For all the groups RSV immunoprophylaxis is clearly not cost effective as its cost per averted DALY exceeds the $105,986 guideline representing thrice the per capita Gross Domestic Product. Vaccine price would have to fall by 48.1% in order to justify vaccinating Congenital Heart Disease or Congenital Lung Disease risk groups respectively on pure cost-effectiveness grounds. For premature babies of

This cohort study examines COVID-19 incidence rates in youths aged 0 to 19 before and after reopening schools in Israel.

Background Most pediatric coronavirus disease 2019 (COVID-19) is mild. We assessed nationally severe COVID-19, including pediatric inflammatory multisystem syndrome (PIMS), in hospitalized children. Methods An ongoing, prospective, national surveillance was conducted from March 2020 through March 2021, at 20 hospitals treating children, We assessed pediatric COVID-19 in 20/26 Israeli hospitals. Overall, 568 cases (82% mild disease, 8% moderate/severe disease, and 10% PIMS), representing

Background Benefits of school reopening must be weighed against the morbidity and mortality risks and the impact of enhancing spread of coronavirus disease 2019 (COVID-19). We investigated the effects of school reopening and easing of social-distancing restrictions on dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in Israel between March and July 2020. Methods We examined the nationwide age-wise weekly incidence, prevalence, SARS-CoV-2 polymerase chain reaction tests, their positivity, COVID-19 hospitalizations, and associated mortality. Temporal differences in these parameters following school reopening, school ending, and following easing of restrictions such as permission of large-scale gatherings were examined. Results Incidence of SARS-CoV-2 infections gradually increased following school reopening in all age groups, with a significantly higher increase in adults than children. Higher rate ratios (RRs) of sample positivity rates 21–27 days following school reopening relative to positivity rates prior to openings were found for the age groups 40–59 (RR, 4.72; 95% CI, 3.26–6.83) and 20–39 (RR, 3.37 [2.51–4.53]) years, but not for children aged 0–9 (RR, 1.46 [.85–2.51]) and 10–19 (RR, .93 [.65–1.34]) years. No increase was observed in COVID-19–associated hospitalizations and deaths following school reopening. In contrast, permission of large-scale gatherings was accompanied by increases in incidence and positivity rates of samples for all age groups, and increased hospitalizations and mortality. Conclusions This analysis does not support a major role of school reopening in the resurgence of COVID-19 in Israel. Easing restrictions on large-scale gatherings was the major influence on this resurgence.

Millions of young children throughout the world are not reaching their full potential owing to poor economic conditions, causing a variety of social disadvantages, including inadequate nutrition, lack of early stimulation and education, and major exposure to communicable and noncommunicable diseases. The health and well-being of children is in decline. The Union of the European Societies of Pediatrics is actively engaged in raising the awareness of governments and legislators of the importance of planning for the worst but hoping for the best by investing in children. Investments in services useful for improving the physical, mental, and emotional development of children during their developmental years are critical for promoting and preserving their well-being throughout their lifetime. Providing individuals with the proper constructive conditions to build a balanced healthy physical and mental state will contribute not only to the quality of life of single individuals or of groups of people, but also to the welfare of nations.

Food safety and protection of consumer's health are a major concern for many governments. Policies aim to prevent, mitigate, or eliminate risks at different stages of the food chain, while maintaining, providing, and supplying high-quality food to meet consumer demands. Biological, chemical, or physical hazards may be introduced into the food supply at any time during harvesting, processing, transporting, preparing, storing, and serving food. Understanding the risks associated with each of these steps can significantly decrease the potential of foodborne illnesses. All can be avoided through an effective food safety management system.

The dynamics of intrafamilial spread of SARS-CoV-2 during January-February 2021 when variant B.1.1.7 predominated were compared with data from April to May 2020, when other circulating variants prevailed. Much higher intrafamilial transmission rates among all age groups, in particular in young children, and lower rates of sensory impairment were demonstrated during January-February 2021.

Among individuals who tested positive for coronavirus disease 2019, smell and taste sensations were significantly less impaired among children than among adults, in a stepwise manner. Sensory impairment was correlated with recent data of angiotensin-converting enzyme 2 expression in the corresponding age groups. This is the first report to compare sensory impairment in children and adults testing positive for coronavirus disease 2019.

Namazova-Baranova, Leyla/0000-0002-2209-7531 WOS:000580392100002 PubMed ID: 32963476 This opening article for the volume dedicated to the diversity of paediatric healthcare systems in Europe, discusses the topic of children facing natural, economic, and public health crises in Europe. The natural and economic adversities and public health crises, which have repeatedly stormed the globe during the past twenty years, have often unveiled a low degree of self-sufficiency and a high degree of unpreparedness by European countries. It is always the case that the most vulnerable take the brunt, and these adverse events have shown their effects and a negative direct impact particularly on the population aged 0-18 years, with important implications for families and communities. The article discusses a rational approach to properly confront future public health emergencies and crises in general. The authors stress the concept that such approaches should be built on past negative experiences, in order to explore, identify, and make clear which are the priorities governing the disaster management activities at all levels in this population group. The authors conclude that safeguarding the health of children could be effectively accomplished by developing adequate, shared emergency management strategies. Improving pediatric preparedness approaches with the use of emergency measures and ongoing collaboration will facilitate a better and more efficient response, able to effectively care for the needs of children in actual crises.

This cohort study compares the characteristics of infections from SARS-CoV-2 variants spreading during August to October 2020 vs the variants spreading during December 2020 to February 2021 among children in Israel.

Infection is probably not uncommon in those with heart defects, and diagnosis should be considered for patients with culture-negative endocarditis., Bartonella quintana endocarditis, a common cause of culture-negative endocarditis in adults, has rarely been reported in children. We describe 5 patients 7–16 years of age from Ethiopia with heart defects and endocarditis; 4 cases were caused by infection with B. quintana and 1 by Bartonella of undetermined species. All 5 patients were afebrile and oligosymptomatic, although 3 had heart failure. C-reactive protein was normal or slightly elevated, and erythrocyte sedimentation rate was high. The diagnosis was confirmed by echocardiographic demonstration of vegetations, the presence of high Bartonella IgG titers, and identification of B. quintana DNA in excised vegetations. Embolic events were diagnosed in 2 patients. Our data suggest that B. quintana is not an uncommon cause of native valve endocarditis in children in Ethiopia with heart defects and that possible B. quintana infection should be suspected and pursued among residents of and immigrants from East Africa, including Ethiopia, with culture-negative endocarditis.

Introduction Rates of community acquired methicillin resistant staphylococcus aureus (MRSA) in Israel is quite low and estimated at the range of 3% out of staphylococcus aureus isolates. This survey has been undertaken due to clinical impression of significant rise at the rates of MRSA isolates during the last few years in a closed community in Israel. Methods All community acquired staphylococcus aureus isoltes from children referred to Mayenei Hayeshuah Hospital in Bnei Brak Israel during the years 2015–2018 were analyzed. This hospital serves a closed Ultraorthodox Jewish community characterized by crowdedness. Results A total of 201 isolates were reviewed. Most isolates (163) were from skin and soft tissue specimens and the rest were from normally sterile fluids, urine and ear specimens. The rates of MRSA isolates out of all staphylococcal isolates were 14%. Most MRSA isolated were from the skin and soft tissue while none of the isolated from normally sterile fluid fluids grew out MRSA. During the study years there was a dramatic rise at the rates of MRSA from 4% in 2015 to 23% in 2018. Children with MRSA infections were younger than those with methicillin sensitive staphylococcus aureus (MSSA) infection (mean ages were 2.9 years and 5.9 years in MRSA vs. MSSA infected children respectively, p Clindamycin inducible resistance was detected in 44% of MSSA isolates and in 7% of MRSA isolates. Trimethoprim/sulfamethoxazole resistant was observed in 2% of MSSA and in 7% of MRSA isolates. Conclusions These findings demonstrates the ability of MRSA clones to spread rapidly especially in a closed and crowded community. Our findings also indicate that clindamycin is not an appropriate antibiotic for empiric treatment of staphylococcal infection unless administered with another anti staphylococcal agent. In addition, the increased rate of trimethoprim/sulfamethoxazole resistant is worrisome and should be closely monitored.

To monitor parental vaccine attitudes, a survey was conducted in 2008 and in 2016. In both years (90%-89%) reported full immunization of their children, and a stable majority (71%-66%) supported documentation of vaccination before entering kindergarten. However, a declining confidence in official recommendations from 87% to 72% (P < 0.0001) in 2008 and 2016, respectively, was documented, requiring effort to rebuild it.