The impact of the lockdown and the re-opening of schools and day cares on the epidemiology of SARS-CoV-2 and other respiratory infections in children : A nationwide register study in Finland

Background: Nationwide restrictions started in Finland in March to prevent the spread of COVID-19, leading to school and day care closures. The aim of this study is to describe the effect of closures and re-openings on the respiratory pathogen epidemiology. Methods: Laboratory-confirmed cases of SARS-CoV-2; respiratory syncytial virus (RSV); influenza (A & B); parainfluenza-, adeno-, and rhinoviruses; Mycoplasma pneumoniae; and Streptococcus pneumoniae in children were collected from the National Infectious Disease Register over the period of 2017–2020. Weekly incidences (weeks 1 to 35) with 95% confidence intervals (CIs) were calculated per 100 000 children in 2020 and compared by incidence rate ratios (IRRs) to corresponding periods in 2017−2019. Findings: The lockdown had immediate impact on the incidences of respiratory pathogens except SARS-CoV-2. Week after the lockdown began IRR was 0•3 (CI 0•3–0•4) and next week the IRR was 0•1 (0•1–0•2). The incidence of SARS-CoV-2 started to decline eight weeks after the lockdown began. The highest recorded weekly incidence of SARS-CoV-2 was 7•2/100 000 children. The effect of the lockdown lasted until late summer. Rhinovirus and SARS-CoV-2 began to increase before the schools or day cares opened in August. The re-opening of schools seemed to have no impact on the incidence of any pathogen. Interpretation: Our results suggest that general social distancing, including school and day care closures, played a crucial role in reducing infections, and the effect lasted for several weeks. The re-opening of schools and day care centres seems to have had no immediate impact on the incidences of any respiratory pathogens. Funding: This study had no funding source.publishedVersionPeer reviewe

Noro- and rotavirus detections in children during COVID-19 pandemic—A nationwide register study in Finland

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Incidence of Neonatal Developmental Dysplasia of the Hip and Late Detection Rates Based on Screening Strategy A Systematic Review and Meta-analysis

IMPORTANCE Universal ultrasonographic screening for developmental dysplasia of the hip (DDH) has gained increasing popularity despite the lack of benefit in terms of reducing the rates of late-detected cases (age >= 12 weeks) in randomized clinical trials.OBJECTIVE To report the reported incidence of DDH in the English scientific literature and compare rates of late-detected cases in settings with different DDH screening strategies.DATA SOURCES PubMed, Scopus, and Web of Science databases were searched on November 25 and 27, 2021. No time filters were used in the search.STUDY SELECTION All observational studies reporting the incidence of early-detected or late-detected (age >= 12 weeks) DDH were included. Non-English reports were excluded if the abstract did not include enough information to be included for analysis.DATA EXTRACTION AND SYNTHESIS The number of newborns screened and the detection rates were extracted. Meta-analysis calculated the pooled incidence of DDH per 1000 newborns with 95% CIs using a random- or fixed-effects model. This study is reported according to the PRISMA and MOOSE guidelines.MAIN OUTCOMES AND MEASURES The main outcome measures were early detection, early treatment, late detection, and operative treatment incidences.RESULTS A total of 1899 studies were identified. 203 full texts were assessed, and 76 studies with 16 901079 infants were included in final analyses. The early detection rate was 8.4 (95% CI. 4.8-14.8) infants with DDH per 1000 newborns with clinical screening, 4.4(95% CI, 2.4-8.0) infants with DDH per 1000 newborns with selective ultrasonographic screening, and 23.0 (95% CI, 15.7-33.4) infants with DDH per 1000 newborns with universal ultrasonographic screening. Rates for nonoperative treatment were 5.5 (95% CI, 2.1-14) treatments per 1000 newborns with clinical screening, 3.1(95% CI, 2.0-4.8) treatments per 1000 newborns with selective ultrasonographic screening, and 9.8 (95% CI, 6.7-14.4) treatments per 1000 newborns with universal ultrasonographic screening. The incidence of late-detected DDH was 0.5 (95% CI, 0.2-1.5) infants with DDH per 1000 newborns with clinical screening, 0.6 (95% CI. 0.3-1.3) infants with DDH per 1000 newborns with selective ultrasonographic screening, and 0.2 (95% CI, 0.0-0.8) infants with DDH per 1000 newborns with universal ultrasonographic screening. The corresponding incidences of operative treatment were 0.2 (95% CI, 0.0-0.9) operations per 1000 newborns with clinical screening, 0.5 (95% CI, 0.4-0.7) operations per 1000 newborns with selective ultrasonographic screening, and 0.4(95% CI, 0.2-0.7) operations per 1000 newborns with universal ultrasonographic screening.CONCLUSIONS AND RELEVANCE This meta-analysis found that early detection rates and nonoperative treatments were higher with universal screening. The late detection and operative treatment rates with universal screening were similar to those among selectively and clinically screened newborns. Based on these results, universal screening may cause initial overtreatment without reducing the rates of late detection and operative treatment.Peer reviewe

Parkinson-potilaiden syömisen ja nielemisen sensomotoriset valmiudet. Ryhmätutkimus.

Parkinsonin tauti on yksi yleisimmistä etenevistä neurologisista sairauksista. Oireet johtuvat keskiaivojen, erityisesti tyvitumakealueen hermosolujen vähittäisestä rappeutumisesta. Tyypillisiä motorisia oireita Parkinsonin tautia sairastavilla henkilöillä ovat vapina, lihasten jäykkyys sekä erilaiset lihasten toiminnan muutokset liikelaajuuksien väheneminen, liikkeiden hidastuminen ja katoaminen. Motoristen oireiden lisäksi esiintyy myös muita ongelmia, kuten masennusta ja muistin heikkoutta. Parkinsonin taudin aiheuttamat karkea- ja hienomotoriikan häiriöt ovat jo varsin yleisesti tiedossa, mutta ruoankäsittelyn ja nielemisen häiriöt ovat edelleen heikommin tunnettuja. Tämän tutkimuksen teemana on Parkinsonin tautia sairastavien henkilöiden syömiseen ja nielemiseen liittyvien vaikeuksien kartoittaminen. Tutkimukseen osallistui 30 vapaaehtoista Parkinsonin tautia sairastavaa henkilöä, joiden syömisen ja nielemisen sujumista arvioitiin kliinisesti sekä subjektiivisesti. Kliinisiä tutkimusmenetelmiä olivat vedennielemistesti, suun alueen sensomotorinen tutkimus sekä kohonnutta aspiraatioriskiä seulova testi. Tutkittavien subjektiivisia kokemuksia kartoitettiin ruokailuun ja syömiseen liittyvällä haastattelulla. Tutkimustulosten perusteella Parkinsonin tautia sairastavilla henkilöillä voi esiintyä vaihtelevan paljon erilaisia ruoankäsittelyn ja nielemisen vaikeuksia. Tulokset ovat yhteneviä aiempien Parkinsonin tautia sairastavien henkilöiden nielemistoimintoja kartoittaneiden tutkimusten kanssa. Esille nousseet vaikeudet olivat sidoksissa käytettyyn tutkimusmenetelmään, ja tästä syystä nielemistoimintoja arvioitaessa onkin tärkeää tehdä päätelmät usean kliinisen tutkimusmenetelmän avulla kokonaiskuvan saavuttamiseksi. Kun ruoankäsittelyn ja nielemisen sujumista kysyttiin itse tutkittavilta, he kokivat, että nielemisvaikeudet vaikuttavat myös psyykkisesti ja sosiaalisesti heidän elämäänsä. Ruokailun nautinnollisuuden sekä turvallisuuden tunteen koettiin muuttuneen sekä useat tutkittavat kokivat muiden kiinnittävän heidän ruokailuunsa huomiota. Tyytymättömyyden tunteesta ruokailua kohtaan kertoivat useammin ne henkilöt, jotka olivat joutuneet muuttamaan ruuan koostumusta sekä ne henkilöt, joilla nielemisen jälkeen jäi yhä ruokaa suuhun. Nielemisvaikeudet eivät siis ole vain fysiologisten toimintojen muutoksia, vaan vaikuttavat henkilön elämään kokonaisvaltaisesti. Tuen ja tiedon saaminen vaivan helpottamiseksi ja ahdistuksen lievittämiseksi on ensiarvoisen tärkeää, vaikkei suoranaista aspiraatioriskiä vielä olisikaan

Record high parainfluenza season in children after relaxation of COVID-19 restrictions in fall 2021—A nationwide register study in Finland

Social restrictions interrupted the circulation of common respiratory viruses among children in spring 2020. In the winter season 2020–2021, only rhinovirus spread in Finland. As the restrictions were ended in September 2021, we saw record high epidemic peak of parainfluenza. Typically, the epidemic peak is in springtime, but now, it started in the early fall 2021. The monthly incidence among children aged 0–4 years (120 per 100,000 children) was six times higher than the second highest reported monthly incidence (21 per 100,000 children) during the last 10 years. Our finding highlights the importance of active surveillance of viral respiratory pathogens during the pandemic.publishedVersionPeer reviewe

Respiratory virus circulation in children after relaxation of COVID-19 restrictions in fall 2021 : A nationwide register study in Finland

Social restrictions interrupted the normal respiratory virus circulation in Spring 2020. This report describes virus circulation in the pediatric population before and after the restrictions ended in Finland in September 2021. ​​​​​​We used data from the Finnish Infectious Disease Register. Nationwide influenza A and B, rhinovirus, severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), and respiratory syncytial virus (RSV) findings from January 2018 to December 2021. Age stratified (0–4, 5–9, and 10–14 years) weekly incidences per 100 000 children were calculated. ​School and day-care closures interrupted completely the circulation of all other respiratory viruses than rhinovirus in spring 2020. After restrictions were relaxed in September 2021, SARS-Cov-2 detections increased majorly. We observed high RSV season atypically early. SARS-Cov-2 was detected in older children whereas RSV season peaked especially among children aged under 5. Influenza seemed to return to normal circulation. ​In conclusion, we report that the ending of social restrictions in September 2021 led to an increase in SARS-Cov-2 detections and high epidemic peaks of RSV and parainfluenza in atypical timing in children. Our results highlight the importance of continuous pathogen surveillance during the pandemic, as atypical surges of non-COVID-19 respiratory viruses were observed.publishedVersionPeer reviewe

Urinary tract infections decreased in Finnish children during the COVID-19 pandemic

Social restrictions reduced the rates of respiratory infections in 2020, but studies on the rates of urinary tract infections (UTIs) during lockdown have had conflicting results. This study aimed to report UTI incidence during the first and second waves of COVID-19 pandemic in Finland. We conducted a retrospective register-based cohort study. The whole Finnish pediatric population (children under the age of 15 years, N = 860,000) was included. The yearly and monthly incidences of UTIs per 100,000 children in 2020 were compared to that of three previous years (2017–2019) by incidence rate ratios (IRRs) with 95% confidence intervals (CIs). A total of 10,757 cystitis and 4873 pyelonephritis cases were included. The yearly incidence of cystitis was 12% lower (IRR 0.88, CI 0.83–0.94) among children aged 1–6 in 2020 and 11% (IRR 0.89, CI 0.83–0.95) lower among children aged 7–14 in 2020 compared with previous years. The yearly incidence of pyelonephritis was 16% lower (IRR 0.84, CI 0.76–0.94) among children aged 1–6. No significant decrease were observed among children aged < 1 and 7–14. Conclusion: The incidence of cystitis and pyelonephritis during a period of social restrictions was lower than during 2017–2019, especially in children aged 1–6 years. These results raise the possibility of reducing the occurrence of urinary tract infections in children by improving hygiene measures.What is known:• Social restrictions have reduced the rate of common respiratory infections globally.• Previous studies have presented a decreased or unchanged incidence of urinary tract infections during the COVID-19 pandemic.What is new:• During the pandemic, there was a decrease in the incidence of urinary tract infections in Finnish children and the most prominent decrease was in daycare-aged children.• Improved hygiene measures and social restrictions may have influenced the transmission of uropathogens.publishedVersionPeer reviewe