Search

SUMMARY The influenza virus causes epidemics and pandemics with high morbidity and mortality. According to the World Health Organization, this virus causes 3-5 million cases of severe illness and 250,000 to 500,000 deaths each year. The disease is mainly respiratory and the most common complications are pneumonia, exacerbation of underlying diseases and less frequently respiratory complications. We report a 6-year-old patient with meningoencephalitis due to a new influenza A (IA), strain pH1N1, with viral documentation in cerebrospinal fluid (CSF). We provide detailed clinical, laboratory and imaging of the case, which responded favorably to sequels. Knowledge of this form of presentation is of great clinical and epidemiological significance due to the limited scientific evidence pub

Meningococcal disease (MD) is a medical emergency and a serious public health problem. As new meningococcal vaccines become available, MD surveillance is crucial to provide baseline epidemiologic data before implementing preventive measures. We estimated MD incidence and epidemiology in Argentina using hospital-based surveillance.Three-year prospective active surveillance in patients ≤15 years of age was conducted at 6 pediatric hospital sentinel units (March 2012 to February 2015).Of 184,360 hospitalized patients, 1444 (0.78%) had suspected meningitis or MD. Of these, 268 (19%) presented probable acute bacterial meningitis or MD, 168 (63%) were culture positive and 51 (30%) tested positive for Neisseria meningitidis. Of 100 culture-negative cases, 30 had positive meningococcal polymerase chain reaction. Thirteen patients presented other uncommon MD manifestations, resulting in a total of 94 MD cases and an annual incidence of 5.1/10 hospitalized patients [95% confidence interval (CI): 4-6]. Fifty-four (57%) patients were males, 48% were1 year of age and the median age was 12.5 months (1 month to 15 years). Clinical presentations were the following: meningococcemia and meningitis (37%), meningitis (30%), meningococcemia (16%), arthritis (10%), bacteremia (5%) and pneumonia (2%). Twenty-eight percent had complications. Nine children died (case fatality rate: 10%), and 8 had sequelae. Serogroups were identified for 84 isolates. Serogroup W was associated with age1 year (odds ratio: 3.18; 95% CI: 1.14-8.99); meningococcemia was associated with mortality (P = 0.0038).Highest rates of MD were observed among young infants. This study provides baseline data to estimate the impact of introducing meningococcal vaccines in Argentina.

GlaxoSmithKline (GSK) Biologicals was the funding source and was involved in all stages of the study conduct and analysis. GSK Biologicals also funded all costs associated with the development and the publishing of the present manuscript. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Bel?m, PA, Brasil. Instituto Nacional de Pediatr?a. M?xico D.F., Mexico. Hospital del Ni?o. Panama City, Panama. Universidad de Valpara?so. Escuela de Medicina. Valpara?so, Chile. Instituto Costarricense de Investigaciones Cl?nicas. Urbanizaci?n de Los Arboles La Uruca. San Jos?, Costa Rica. Instituto Mexicano del Seguro Social. CMN-SXX. Pediatrics Hospital. Medical Research Unit on Infectious Diseases. Mexico City, Mexico. GlaxoSmithKline Biologicals M?xico. M?xico D.F., M?xico. Hospital Dr. Humberto Notti. Villa Nueva de Guaymall?n, Mendoza, Argentina. Hospital Maternidad Nuestra Sra de la Altagracia. Santo Domingo, D.N., Dominican Republic. GlaxoSmithKline Biologicals Argentina. Victoria, Buenos Aires, Argentina. Organizaci?n para el Desarrollo y la Investigaci?n Salud en Honduras. Colonia Humuya, Sendero Pastizal, Tegucigalpa, Honduras. Ciudad Hospitalaria Dr. Enrique Tejera. Hospital de Ni?os Dr. Jorge Lizarraga. Carabobo, Valencia, Venezuela. Fundaci?n para el Avance de la Investigaci?n Cl?nica y Translacional. Consultores M?dicos Am?rica. V?a Espa?a, Carrasquilla, Panama. GlaxoSmithKline Biologicals Costa Rica. San Jose, Costa Rica. GlaxoSmithKline Biologicals Belgium. Rixensart, Belgium. Rotavirus is the leading cause of severe diarrheal disease and dehydration in infants in both developed and developing countries. Vaccines have recently been developed, but detailed epidemiological information, which is needed for decisions about how and where to introduce vaccination, was lacking for many Latin American countries. The primary objective of this study was to measure the incidence and disease burden of rotavirus in young children presenting to Latin American hospitals with gastroenteritis. In addition it allowed to setting up the methodology to further conduct a large phase III trial with a rotavirus vaccine in the region. This was a prospective, multi-center surveillance study of gastroenteritis in children

Introduction: Kawasaki disease (KD) is a vasculitis that affects vessels of small and medium caliber. Objectives: 1 Determine clinical and epidemiology of KD in children in 22 pediatric referral centers in Argentina. 2 Identify risk factors for coronary complications (CC). Material and Methods: A retrospective and analytical study from 01/01/2010 to 31/12/2013. Variables: age, sex, heart rate (HR), clinic features, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), leukocytes (Gb), neutrophils, hemoglobin (Hb) and CC. Color Doppler echocardiography: acute phase and 4-6 weeks. Results: Subjects: 191, age (Md) 29 months (R: 2-144) .Ratio v / m: 1.8 / 1. Clinical: fever 100% (191/191) more frequent and adenopatía: 57% (110/191) less frequent. CC: 15.7% (30/191). Mortality: 0.52% (1/191 cases). Increased risk of CC: leukocytosis> 20,000 / mm3 Odds ratio (OR) = 4.235 (95% CI 1704-10529). Hematocrit Conclusions: Increased frequency in males. Increased risk of CHD in subjects from western Argentina. Low mortality. Increased risk of CC: low hematocrit and hemoglobin; leukocytes, neutrophils, ESR, CRP, FC, high, Presence of other heart alterations and more days of fever at the time of establishing of treatment. Risk factors for coronary involvement

Five hundred and thirty-seven children admitted to Hospital Dr. Notti and diagnosed with invasive pneumococcal disease between 1993 and 2011 were studied. Their median age was 19 months (range= 0-192 months); 34.82% were 60 months old. Pneumonia with or without effusion (48.04%) and meningitis (29.05%) were the most predominant conditions, with a case fatality rate of 6.14%. Identified serotypes corresponded to 14, 5 and 1 in56.86% of cases. Sensitivity to penicillin was observed in99.74% of non-meningeal strains, while sensitivity to ceftriaxone was found in 98.08% ofmeningeal strains. Risk factors inpneumonia with effusionwere associated to age >60 months old, RR: 1.47 (1.06-2.04), p= 0.02, to serotype 5, RR: 2.57 (1.71-3.87), p= 0.0001, and to serotype 1, RR: 1.86 (1.17-2.96), p= 0.014; in the case of meningitis, risk factors were mainly associated to age

Vaccines Adjuvanted with Adjuvant Systems from Concept to Clinical Evidence N. Garcon1,∗, M. Van Mechelen1, G. Leroux-Roels2, L. Stanberry3, A. Osterhaus4, G. Heppner5, K.E. Kester5, M. Polhemus6, Y. Horsmans7, J. Cohen1 1 GlaxoSmithKline Biologicals, Rixensart, Belgium 2 Ghent University and Hospital, Centre for Vaccinology, Ghent, Belgium 3 Columbia University, Department of Pediatrics, New York, NY, USA 4 Erasmus MC, Department of Virology, Rotterdam, Netherlands 5 Walter Reed Army Institute of Research, Silverspring, MD, USA 6 Walter Reed Project, Kisumu, Kenya 7 St. Luc University Hospital, Brussels, Belgium

Hospital del Ni?o. Infectious Disease Department. Ciudad de Panam?, Panama. Instituto Mexicano del Seguro Social. Medical Research Unit on Infectious Diseases. CMN-SXXI. Mexico City, Mexico. Centro de Estudios en Infectologia Pediatrica. Clinica Materno Infantil Los Farallones. Cali, Colombia. Universidad Nacional Aut?noma de Nicaragua. Edificio Central. Le?n, Nicaragua. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Hospital Dr. Humberto Notti. Villa Nueva de Guaymall?n, Mendoza, Argentina Universidad de Concepci?n. Concepci?n, Chile. Universidad de Concepci?n. Concepci?n, Chile. Universidad de Valpara?so. Escuela de Medicina. Valpara?so, Chile. Hospital Nacional de Ni?os. Paseo Col?n, San Jos?, Costa Rica. Organizaci?n para el Desarrollo y la Investigaci?n Salud en Honduras. Colonia Humuya, Tegucigalpa, Honduras. Hospital General de Tlanepantla ?Valle Ceyl?n?. Tlanepantla, Mexico. Hospital Infantil de Mexico. Calle Dr. M?rquez . M?xico DF, Mexico / Ministry of Health. National Center for Child and Adolescent Health. Colonia Merced Gomez, Mexico DF, Mexico. Instituto Nacional de Pediatr?a. M?xico DF, Mexico. Instituto Nacional de Ciencias M?dicas y Nutrici?n Salvador Zubir?n. Mexico DF, Mexico. Hospital Maternidad Nuestra Sra de la Altagracia. Santo Domingo, DN, Rep?blica Dominicana. Fundaci?n para el Avance de la Investigaci?n Cl?nica y Translacional, Consultorios M?dicos Am?rica. V?a Espa?a, Carrasquilla, Panama / GlaxoSmithKline Vaccines. Clayton, Panama. GlaxoSmithKline Vaccines M?xico. M?xico DF, Mexico. GlaxoSmithKline Vaccines Argentina. Buenos Aires, Argentina / Independent Medical Professional. Buenos Aires, Argentina. GlaxoSmithKline Vaccines Costa Rica. San Jose, Costa Rica / GlaxoSmithKline Vaccines. Ciudad del Saber, Clayton, Panama. GlaxoSmithKline Vaccines. Philadelphia, USA / Merck & Co., Global Health Outcomes Vaccines. Philadelphia, PA, USA. GlaxoSmithKline Vaccines. Rixensart, Belgium / Philadelphia Department of Public Health. Philadelphia, USA. GlaxoSmithKline Vaccines. Rixensart, Belgium / P95 Excellence in Pharmacovigilance and Epidemiology, Leuven, Belgium. GlaxoSmithKline Vaccines. Rixensart, Belgium / GlaxoSmithKline Vaccines, Parc de la Noire Epine. Wavre, Belgium. Background: Intussusception (IS) is a form of acute intestinal obstruction that occurs mainly in infants and is usually of unknown cause. An association between IS and the first licensed rotavirus vaccine, a reassortanttetravalent, rhesus-based rotavirus vaccine (RRV-TV), led to the withdrawal of the vaccine. New rotavirus vaccines have now been developed and extensively studied for their potential association with IS. This study aimed to describe the epidemiology and to estimate the incidence of IS in Latin American infants prior to new vaccine introduction. Methods: Children under 2 years of age representing potential IS cases were enrolled in 16 centers in 11 Latin American countries from January 2003 to May 2005. IS cases were classified as definite, probable, possible or suspected as stated on the Brighton Collaboration Working Group guidelines. Results: From 517 potential cases identified, 476 (92 per cent) cases were classified as definite, 21 probable, 10 possible and 10 suspected for intussusception. Among the 476 definite IS cases, the median age at presentation was 6.4 months with 89 per cent of cases aged 1 year. The male to female ratio was 1.5:1. The incidence of definite IS per 100,000 subject-years ranged from 1.9 in Brazil to 62.4 in Argentina for children 2 years of age, and from 3.8 in Brazil to 105.3 in Argentina for children aged 1 year. Median hospital stay was 4 days with a high prevalence of surgery as the primary treatment (65 per cent). Most cases (88 per cent) made a complete recovery, but 13 (3 per cent) died. No clear seasonal pattern of IS cases emerged. Conclusions: This study describes the epidemiology and estimates the incidence of IS in Latin American infants prior to the introduction of new rotavirus vaccines. The incidence of IS was found to vary between different countries, as observed in previous studies.