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While children have experienced less severe coronavirus disease (COVID-19) after SARS-CoV-2 infection than adults, the cause of this remains unclear. The objective of this study was to describe the humoral immune response to COVID-19 in child vs. adult household contacts, and to identify predictors of the response over time. In this prospective cohort study, children with a positive SARS-CoV-2 polymerase chain reaction (PCR) test (index case) were recruited along with their adult household contacts. Serum IgG antibodies against SARS-CoV-2 S1/S2 spike proteins were compared between children and adults at 6 and 12 months after infection. A total of 91 participants (37 adults and 54 children) from 36 families were enrolled. Overall, 78 (85.7%) participants were seropositive for anti-S1/S2 IgG antibody at 6 months following infection; this was higher in children than in adults (92.6% vs. 75.7%) (p = 0.05). Significant predictors of a lack of SARS-CoV-2 seropositivity were age ≥ 25 vs. < 12 years (odds ratio [OR] = 0.23, p = 0.04), presence of comorbidities (vs. none, adjusted OR = 0.23, p = 0.03), and immunosuppression (vs. immunocompetent, adjusted OR = 0.17, p = 0.02). [ABSTRACT FROM AUTHOR]

Background: Direct comparisons of paediatric hospitalizations for acute coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C) can inform health system planning. We describe the absolute and relative hospital burden of acute paediatric COVID-19 and MIS-C in Canada. Methods: This national prospective study was conducted via the Canadian Paediatric Surveillance Program from March 2020-May 2021. Children younger than 18 years old and hospitalized for acute COVID-19 or MIS-C were included in the analysis. Outcomes included supplemental oxygen (low-flow oxygen or high-flow nasal cannula), ventilation (non-invasive or conventional mechanical), vasopressors, paediatric intensive care unit (PICU) admission, or death. Adjusted risk differences (aRD) and 95% confidence intervals (CI) were calculated to identify factors associated with each diagnosis. Results: Overall, we identified 330 children hospitalized for acute COVID-19 (including five deaths) and 208 hospitalized for MIS-C (including zero deaths); PICU admission was required for 49.5% of MIS-C hospitalizations versus 18.2% of acute COVID-19 hospitalizations (aRD 20.3; 95% CI, 9.9-30.8). Resource use differed by age, with children younger than one year hospitalized more often for acute COVID-19 (aRD 43.4% versus MIS-C; 95% CI, 37.7-49.1) and more children 5-11 years hospitalized for MIS-C (aRD 38.9% vs. acute COVID-19; 95% CI, 31.0-46.9). Conclusion: While there were more hospitalizations and deaths from acute paediatric COVID-19, MIS-C cases were more severe, requiring more intensive care and vasopressor support. Our findings suggest that both acute COVID-19 and MIS-C should be considered when assessing the overall burden of severe acute respiratory syndrome coronavirus 2 in hospitalized children. [ABSTRACT FROM AUTHOR]

Background Extensively drug-resistant (XDR) typhoid fever is a threat to travelers to Pakistan. We describe a multicontinental case series of travel-acquired XDR typhoid fever to demonstrate the global spread of the problem and encourage preventive interventions as well as appropriate empiric antimicrobial use. Methods Cases were extracted from the GeoSentinel database, microbiologic laboratory records of two large hospitals in Toronto, Canada, and by invitation to TropNet sites. All isolates were confirmed XDR Salmonella enterica serovar Typhi (Salmonella typhi), with resistance to ampicillin, ceftriaxone, ciprofloxacin and trimethoprim–sulfamethoxazole. Results Seventeen cases were identified in Canada (10), USA (2), Spain (2), Italy (1), Australia (1) and Norway (1). Patients under 18 years represented 71% (12/17) of cases, and all patients travelled to Pakistan to visit friends or relatives. Only one patient is known to have been vaccinated. Predominant symptoms were fever, abdominal pain, vomiting and diarrhoea. Antimicrobial therapy was started on Day 1 of presentation in 75% (12/16) of patients, and transition to a carbapenem or azithromycin occurred a median of 2 days after blood culture was drawn. Antimicrobial susceptibilities were consistent with the XDR S. typhi phenotype, and whole genome sequencing on three isolates confirmed their belonging to the XDR variant of the H58 clade. Conclusions XDR typhoid fever is a particular risk for travelers to Pakistan, and empiric use of a carbapenem or azithromycin should be considered. Pre-travel typhoid vaccination and counseling are necessary and urgent interventions, especially for visiting friends and relatives travelers. Ongoing sentinel surveillance of XDR typhoid fever is needed to understand changing epidemiology. [ABSTRACT FROM AUTHOR]

Background: There are limited data on outcomes of SARS-CoV-2 infection among infants (<1 year of age). In the absence of approved vaccines for infants, understanding characteristics associated with hospitalization and severe disease from COVID-19 in this age group will help inform clinical management and public health interventions. The objective of this study was to describe the clinical manifestations, disease severity, and characteristics associated with hospitalization among infants infected with the initial strains of SARS-CoV-2. Methods: This is a national, prospective study of infants with SARS-CoV-2 from April 8th 2020 to May 31st 2021 using the infrastructure of the Canadian Paediatric Surveillance Program. Infants <1 year of age with microbiologically confirmed SARS-CoV-2 infection from both inpatients and outpatients seen in clinics and emergency departments were included. Cases were classified as either: 1) Non-hospitalized patient with SARS-CoV-2 infection; 2) COVID-19-related hospitalization; or 3) non-COVID-19-related hospitalization (e.g., incidentally detected SARS-CoV-2). Case severity was defined as asymptomatic, outpatient care, mild (inpatient care), moderate or severe disease. Multivariable logistic regression was performed to identify characteristics associated with hospitalization. Results: A total of 531 cases were reported, including 332 (62.5%) non-hospitalized and 199 (37.5%) hospitalized infants. Among hospitalized infants, 141 of 199 infants (70.9%) were admitted because of COVID-19-related illness, and 58 (29.1%) were admitted for reasons other than acute COVID-19. Amongst all cases with SARS-CoV-2 infection, the most common presenting symptoms included fever (66.5%), coryza (47.1%), cough (37.3%) and decreased oral intake (25.0%). In our main analysis, infants with a comorbid condition had higher odds of hospitalization compared to infants with no comorbid conditions (aOR = 4.53, 2.06–9.97), and infants <1 month had higher odds of hospitalization then infants aged 1–3 months (aOR = 3.78, 1.97–7.26). In total, 20 infants (3.8%) met criteria for severe disease. Conclusions: We describe one of the largest cohorts of infants with SARS-CoV-2 infection. Overall, severe COVID-19 in this age group was found to be uncommon. Comorbid conditions and younger age were associated with COVID-19-related hospitalization amongst infants. [ABSTRACT FROM AUTHOR]

Introduction: Children are frequent international travelers and may acquire serious infectious diseases during travel. We undertook a retrospective 10-year review examining children admitted to hospital with infectious diseases associated with international travel at a Canadian tertiary care pediatric hospital. Methods: Retrospective chart review was performed on select travel-related infectious diseases in children ranging in age from birth to <18 years who were admitted at the Hospital for Sick Children in Toronto between January 1st, 2009 and December 31st, 2018. Cases were identified using ICD-10 discharge codes. Patient demographics, travel history, epidemiological data, disease, and prophylaxis history were documented. Results: A total of 154 children were hospitalized with a travel-related infection over a 10-year period. The most common diagnoses were typhoid or paratyphoid fever (n = 58, 38%), malaria (n = 57, 37%), and hepatitis A (n = 14, 8%). The median age of those infected was 8 years (IQR 3-12). There were 120 (78%) children who were Canadian born, 31 (20%) immigrants and 3 (2%) who were visiting Canada. Of those who lived in Canada, 112 (90%) travelled for the purpose of visiting friends and relatives (VFR), 6 (5%) for tourism and 2 (2%) for humanitarian work. India was typically known for the acquisition of infection for typhoid or paratyphoid fever, and Nigeria for malaria. Hepatitis A was most commonly acquired in Pakistan. Conclusion: Imported infectious diseases continue to be a significant issue in travelers returning from trips suggesting improved preventative pre-travel care. VFR children are a group that should, in particular, be targeted for appropriate pre-travel advice and care. [ABSTRACT FROM AUTHOR]

Sediment toxicity is usually assessed by conducting laboratory bioassays on thoroughly homogenized, field‐collected, sediment samples. Although it is generally held that these bioassays provide a conservative assessment of the potential for environmental impact, there are few studies comparing the results of laboratory sediment bioassays with actual measures of benthic community health in exposed field populations. To help inform an understanding of the relative efficacy of laboratory‐based bioassays in predicting potential impacts in exposed field populations, a laboratory‐to‐field comparison study was conducted. Laboratory bioassays included standard 10‐d acute toxicity tests measuring survival in 4 species of estuarine/marine amphipods (Eohaustorius estuarius, Ampelisca abdita, Rhepoxinius abronius, and Leptocheirus plumulosus) and 2 longer term, 28‐d sublethal tests with a marine polychaete, Neanthes arenaceodentata (survival and growth), and the amphipod L. plumulosus (survival, growth, and reproduction). A highly contaminated and toxic sediment was mixed with a cleaner sediment of similar grain size to produce a series of diluted contaminated sediment treatments (0, 6, 12, 25, and 50%). Sediment treatments were placed in containers and deployed in the field. At specified intervals (at time of deployment and 9 and 12 mo post deployment), containers were retrieved from the field and analyzed for sediment chemistry, infaunal community composition, and toxicity. Laboratory toxicity endpoints were compared with measures of benthic community health to evaluate the ability of the toxicity tests to accurately predict benthic impacts. The results of these comparisons indicate that the laboratory tests evaluated provide conservative estimates of potential benthic community impacts, with both acute and chronic tests detecting effects at lower treatment levels than were detected in exposed field populations using traditional measures of benthic community health. Environ Toxicol Chem 2019;38:1784–1802. Published 2019 Wiley Periodicals, Inc. on behalf of SETAC. This article is a US government work, and as such, is in the public domain in the United States of America. [ABSTRACT FROM AUTHOR]

The present study evaluated sorbent amendments for in situ remediation of sediments contaminated with two divalent metals. A literature review screening was performed to identify low-cost natural mineral-based metal sorbents and high-performance commercial sorbents that were carried forward into laboratory experiments. Aqueous phase metal sorptivity of the selected sorbents was evaluated because dissolved metals in sediment porewater constitute an important route of exposure to benthic organisms. Based on pH-edge sorption test results, natural sorbents were eliminated due to inferior performance. The potential as in situ sediment amendment was explored by comparing the sorption properties of the engineered amendments in freshwater and saltwater (10 PPT salinity estuarine water) matrices. Self-assembled monolayers on mesoporous supports with thiols (Thiol-SAMMS™) and a titanosilicate mineral (ATS™) demonstrated the highest sorption capacity for cadmium (Cd) and lead (Pb), respectively. Sequential extraction tests conducted after mixing engineered sorbents with contaminated sediment demonstrated transfer of metal contaminants from a weakly bound state to a more strongly bound state. Biouptake of Cd in a freshwater oligochaete was reduced by 98% after 5-d contact of sediment with 4% Thiol-SAMMS and sorbed Cd was not bioavailable. While treatment with ATS reduced the small easily extractable portion of Pb in the sediment, the change in biouptake of Pb was not significant because most of the native lead was strongly bound. The selected sorbents added to sediments at a dose of 5% were mostly nontoxic to a range of sensitive freshwater and estuarine benthic organisms. Metal sorbent amendments in conjunction with activated carbon have the potential to simultaneously reduce metal and hydrophobic contaminant bioavailability in sediments. Environ. Toxicol. Chem. 2010;29:1883–1892. © 2010 SETAC [ABSTRACT FROM AUTHOR]