2023 Murray Valley Encephalitis outbreak in Australia

In January 2023, an outbreak of Murray Valley Encephalitits (MVE) was reported on January 16, 2023.  Cases have subsequently been detected in Victoria (VIC)1, Northern Territory (NT)4, New South Wales (NSW)5, and Western Australia (WA), Australia. with 9 confirmed cases and 3 deaths as of April 6, 2023. This marks the first human case of MVE in Victoria since the last outbreak in 1974 and the first ever reported cases in NSW. Significant weather patterns throughout 2022 are thought to have contributed to the resurgance of MVEV. People of all ages are affected by MVE and those frequenting inland riverine regions, extending up towards the Murray River may be at increased risk of infection. This watching brief serves to inform on the increased transmission of MVE across Australia in 2023

Resurgence of Sudan Virus Disease (SUVD) in Uganda

On September 20th, 2022, a case of ebola virus disease was confirmed in Uganda by the World Health Organization. The presumed index case of a 24-year-old male was sequenced and identified as the Sudan strain. This was the first known outbreak of ebola in Uganda since 2012. At the time of publication, 43 cases have been confirmed, including nine deaths. Of all confirmed, suspected, and probable cases, 63 have been identified, with 29 deaths. The current outbreak has spread across five districts within Uganda. The rapid increase in a short period and the growing list of close contacts make outbreak control difficult. Furthermore, a lack of viable vaccines preventing protection and poor health infrastructure with limited finances seem to contribute to the current outbreak. Whilst the true natural reservoir and how spillover to human hosts occurs remains unknown, these outbreaks of EVD will continue to occur in African countries where the virus remains endemic

COVID-19-associated encephalitis.

COVID-19 associated encephalitis has been reported in patients infected with SARS-CoV-2 since February 2020. The index case was reported in Japan, but since then, reports have emerged worldwide, with a global incidence rate of 0.215%, and regional incidence rates of up to 18%. While in the acute phase of infection, COVID-19-associated encephalitis can biologically mimic infectious limbic encephalitis, immune-inflammatory-mediated encephalopathy, herpes simplex encephalitis, produce hyperintensities in multiple regions of the brain, and mimic Alzheimer’s Disease. With a high mortality rate of 13.4%, COVID-19-associated encephalitis poses a significant burden on health systems and resources, requiring a combination diagnostic approach, supportive treatment regimens, and regular monitoring for secondary worsening of symptoms. COVID-19-associated encephalitis can emerge up to six weeks post-infection, and elevated risk levels can persist for six months post-infection. Despite emerging evidence and research, significant longitudinal research is required to ascertain the true prevalence and lifetime health risk of developing encephalitis following SARS-CoV-2 infection. This report aims to provide a summary of COVID-19 associated encephalitis

SARS-CoV-2 Delta variant: a systematic review of transmissibility and severity in children

Objectives: To review the evidence of the transmissibility and severity of infection with the Delta variant of SARS-CoV-2 in children. Design: Systematic review. Data sources: PubMed, Embase, medRxiv, Web of Science, and WHO COVID database. Study selection: English language original articles, case reports, commentaries, and letters with relevant primary data, which examined evidence for the transmissibility and severity of infection with the Delta variant of SARS-CoV-2 in children. Methods: Five databases were searched for articles from the period October 2020 to March 2022. Reference lists of eligible studies and grey literature were hand searched for additional studies for inclusion. Articles that provided adequate epidemiological data including infection, transmission, or severity (including hospitalisation and death) with probable or confirmed cases of the Delta variant of SARS-CoV-2 in children (aged ≤9 years) and adolescents (aged 10 to 19 years) were included. Data were extracted for country of origin; participant characteristics (age and sex); sample size; vaccination status; and outcomes, including incidence, secondary attack rate, hospitalisation, ICU, and mortality. All included studies were assessed for bias using the Joanna Briggs Institute Critical Appraisal checklists. Results: 298 studies were found through database searching. After screening, 21 studies were included in the systematic review. Of the included studies, all were deemed to be of moderate to high quality, therefore all were included in the final analysis. Increased incidence was reported in two population studies in the USA and Australia during the period of Delta predominance. Age-related data were available for 14 studies and showed higher rates of infection in older children compared to younger children. Attack rates in educational settings were higher when an adult was the primary case. Data on severity were available from 12 studies and showed that severe disease remained rare, with increasing hospitalisation numbers in proportion to increasing paediatric cases. Vaccination was protective for severe disease, with studies in the United States, Israel and Europe showing less healthcare encounters, emergency department presentations and hospitalisations amongst vaccinated adolescents. Several studies pointed to educational and household settings as key sites for paediatric infection with the Delta variant. Conclusion: A growing proportion of COVID-19 cases were diagnosed in children during the study period due to increased transmissibility of the SARS-CoV-2 Delta variant, with an increasing number of outbreaks observed in household and educational settings likely attributed to low vaccine coverage among children. While severe disease remains uncommon, the impact of vaccination in both adults and adolescents has been shown to reduce paediatric hospitalisation rates

Safety netting in healthcare settings: what it means and for whom?

Everyday thousands of children are presented to health care practitioners by concerned parents with the vast majority being simple self-limiting illness. However serious bacterial illness, chronic inflammatory conditions and mental health problems are repeatedly missed with significant morbidity, mortality, financial and social implications. A conceptual framework detailing the mechanism of effective Safety Netting has yet to be described however and there is increasing evidence parents want guidance on when to seek medical advice (a key part of safety netting) prior to initial consultation. This article explores current understanding of safety netting in relation to child health and argues there is a need to develop a more standardised approach