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Influenza is a major cause of illness in children, and often results in complications such as lower respiratory tract and middle ear infections. About 42 out of every 100 children are infected with influenza annually, and 36 out of 100 children with influenza develop acute respiratory illness. Influenza epidemics in children usually spread to the rest of the population. Therefore, an important part of containing these epidemics is the control achieved by immunization of school-aged children. The efficacy of two different vaccines was compared; the vaccines were attenuated cold-recombinant (CR) influenza vaccine and trivalent inactivated vaccine (TIV). A total of 189 children aged 3 to 18 years old were monitored in this double-blind study conducted during 1985. The children were given the TIV, CR, or a placebo (ineffective) vaccine. The unvaccinated family contacts of these children were also followed. The results indicated that a significant immunologic response was produced as a result of both vaccines, but those who received the TIV type showed the greatest immunity. This response was especially remarkable because the virus used to produce this vaccine was a different type than the epidemic virus. Because the virus was not previously prevalent in this population, it was determined that prior exposure of the subjects to the virus did not contribute to their immunological response. A single dose of TIV prevented infection in 64 percent of the subjects, and protected against fever in 73 percent. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abstract. For more than 30 years, penicillin has been the agent of choice for pneumococcal infections. During this time the majority of strains of Streptococcus pneumoniae have been highly susceptible to penicillin. However, during the last ten years there have been sporadic reports of pneumococci with increased resistance to penicillin. The case report of an 18-month-old white boy with meningitis due to a strain of S. pneumoniae with increased resistance to penicillin is presented. The MIC of the organism to penicillin was 0.2 micro g/ml and the MBC 0.39 micro g/ml. The patient had normal immunity and no demonstrable sequestered focus of infection but failed to respond to appropriate doses of intravenous penicillin. Treatment with chloramphenicol caused a dramatic bacteriologic and clinical response. This experience reemphasizes the existence of pneumococcal strains of intermediate penicillin sensitivity and the importance of in vitro susceptibility tests. Pediatrics 58:378-381, 1976, MENINGITIS, PENICILLIN RESISTANCE, PNEUMOCOCCUS. [ABSTRACT FROM AUTHOR]

Abstract. The exact incidence and importance of side effects associated with methicillin therapy in children is unknown. During the ten-year period from 1964 to 1974 approximately 3,000 Houston children who received methicillin were observed for side effects. The great majority of these patients received the drug for less than ten days; however, side effects were more common in patients receiving long-term therapy. In order to assess these side effects, experiences with 124 children who received methicillin for ten days or longer were reviewed in depth. The average dose of methicillin was 200 mg/kg/day and the average duration was 22 days. In this highly selected group there were no adverse side effects in 54.8% and only eosinophilia in an additional 13%. Leukopenia occurred in 16%, microscopic hematuria in 8%, gross hematuria in 4%, skin rash in 6%, and "drug fever" in 6%. In many instances several of these side effects occurred within a single patient so that the total number of patients with definite side effects was 39 of 124 (31.5%). The true incidence figure of overall side effects is much lower than 31.5%. Corrected incidence rates based on a conservative figure of 3,000 methicillin-treated children are less than 1.5% for all side effects. In some patients the mechanism producing the adverse reactions seemed to be chemical irritation or toxicity and in others hypersensitivity. In nine of the 39 patients follow-up studies were not optimal. In the other 30 patients all side effects were reversible. Pediatrics, 58:329-334, 1976, METHICILLIN, PENICILLIN, HEMATURIA, LEUKOPENIA, NEPHROPATHY. [ABSTRACT FROM AUTHOR]

Abstract. In a double-blind study, bronchiolitis associated with respiratory syncytial virus infection in 12 randomly selected patients treated with ribavirin aerosol improved more rapidly than in 14 control patients given saline aerosol (P = .044, Wilcoxon rank sum test, two-tailed). An estimated 10 mg of ribavirin per kilogram of body weight was administered in daily 12-hour treatments over a five-day period. Respiratory syncytial virus disappeared from secretions at about the same rate in treated and control patients. There was no local or systemic intolerance, and there was no evidence of hematologic or other organ toxicity in the ribavirin-treated patients. [ABSTRACT FROM AUTHOR]

Abstract. Thirty-nine breast-fed and 42 bottle-fed infants were followed up from birth over a four-year period. Virus infection was documented by culture and serologic testing, and history and physical examination were recorded for all episodes of respiratory illness. There were no statistically significant differences in rates or distributions of infection with individual viruses or with all viruses over the first three or six months or during the second six months of life in the two groups, nor were there statistically significant differences in rates or distributions of disease of the upper and lower respiratory tract or total respiratory disease, except for decreased disease of the lower respiratory tract in bottle-fed infants in the second six months. There were trends to decreased morbidity in breast-fed infants in the first three and six months and more episodes of pneumonia and bronchiolitis in bottle-fed infants in the first six months (P < .05) but similar use of medical care by both groups. High cord blood titers to two viruses were not associated with evidence of breast-feeding protection from infection with those two agents. Breast-fed babies do not have fewer respiratory virus infections or illnesses but may experience less severe illness. INSET: DRIED SKIMMED MILK, BREAST-FEEDING, AND ILLNESS EPISODES. [ABSTRACT FROM AUTHOR]