Rotavirus Vaccines

Rotavirus, infantlarda ve küçük çocuklarda ağır gastro- enteritin en sık nedenidir. Dünya genelinde 5 yaş altı ishalli çocuklardaki hastane yatışlarının yaklaşık %40’ında etken rotavirustur. Demokratik virus olarak da bilinen rotavirus, hijyen koşullarından bağımsız olarak, gelişmiş ve gelişmekte olan ülkelerde benzer sıklıkta görülür. Çocukların hemen hepsi 5 yaşına kadar, en az 1 kez rotavirusla enfekte olmaktadır. Ancak rotavirusa bağlı mortalitenin %80’den fazlası gelişmekte olan ülkelerde görülmektedir. Daha önce geçirilmiş rotavirus enfeksiyonunun sonraki atakları %77 oranında, orta- ağır şiddetteki atakları ise %87 oranında engellediği gösterilmiştir. Bu nedenle yaşamın erken dönemindeki aşılama, çocuğun ilk doğal enfeksiyonuna benzer şekil- de, şiddetli rotavirus enfeksiyon ataklarını ve buna bağlı ölümleri önlemede en etkin yöntemdir. Dünya Sağlık Örgütü monovalan veya pentavalan oral rotavirus aşı- sının ulusal bağışıklama programına alınmasını öner- mektedir. Rotavirus aşısının uygulanması sonrasında rotavirus ilişkili mortalite ve morbiditede önemli azalma görülmüştür. Rotavirus aşı uygulaması, mortalitenin çoğunluğunun görüldüğü gelişmekte olan ülkelerde özellikle önemlidir. (J Pediatr Inf 2015; 9: 166-74)Rotaviruses are the most common cause of severe gastroenteritis in infants and children. Rotaviruses are responsible for approximately 40% of all diarrheal hospitalizations among children under 5 years of age worldwide. Rotavirus, which is known as democratic virus, occurs with similar frequency in both developed and developing countries regardless of the hygiene conditions. Almost all children up to 5 years of age are infected with rotavirus at least once. But the majority of death cases towing to rotaviruses occur in children from resource-poor countries. Many investigators have reported that previous rotavirus infections pro- tect against severe disease associated with reinfec- tion. For this reason, vaccination in the early period of infancy is the most important method for protection against severe rotavirus infections and death. World Health Organization recommends rotavirus vaccina- tion. After the introduction of rotavirus vaccines, sig- nificant reduction has been seen in morbidity and mortality because of rotaviruses. Rotavirus vaccine administration is particularly important in developing countries where majority of death cases are observed. (J Pediatr Inf 2015; 9: 166-74

Respiratory Syncytial Virus Infections Respiratuvar Sinsityal Virus Enfeksiyonları

Respiratuvar sinsityal virus (RSV) infant ve çocuklarda saptanan en sık solunum yolu patojenlerindendir. Çocukların hemen hepsi ilk iki yaşta en az bir kez RSV ile enfekte olurlar. RSV enfeksiyonlarında klinik özellikler hastanın yaşına, altta yatan hastalığına, enfeksiyonun primer veya reenfeksiyon oluşuna göre değişir. RSV çocuklarda genellikle üst solunum yolu enfeksiyonu biçiminde görülse de, %20-30 oranında alt solunum yolu enfeksiyonlarına (bronşiyolit ve/veya pnömoni) da yol açar. Bir yaş altı çocuklarda alt solunum yolu enfeksiyonlarının en sık nedeni RSV'dir. Daha önceden sağlıklı olan çocukların çoğunda bu enfeksiyonlar hafif seyreder. Ancak prematürite, kronik akciğer hastalığı, konjenital kalp hastalığı, primer ya da sekonder immün yetmezlikler ağır RSV enfeksiyonları için risk oluştururlar. Tanı çoğunlukla klinik olarak konabilir. Tanısal testler rutin olarak önerilmez. Alt ve üst solunum yolu enfeksiyonlarında tedavi genellikle destekleyicidir. Ribavirin immun yetmezliği olan olgularda kullanılabilir, ancak rutin olarak önerilmemektedir. RSV için rutin bir aşı bulunmamaktadır. RSV spesifik humanize fare monoklonal antikoru 'palivizumab' özellikle riskli gruplarda RSV profilaksisinde etkin ve güvenilirdir.Respiratory syncytial virus (RSV) is one of the most common respiratory pathogens in infants and young children worldwide. Almost all children are infected at least once by the age of 2 years. The clinical manifestations vary depending on age, health status, and whether the infection is primary or secondary. Most RSV-infected children experience upper respiratory tract symptoms and 20% to 30% develop lower respiratory tract disease (e.g., bronchiolitis and/or pneumonia). RSV is the most common cause of lower respiratory tract infection in children younger than 1 year. Most children who have been previously healthy have mild lower respiratory tract infections. However, prematurity, chronic lung disease, congenital heart disease, and primary or secondary immune deficiencies are risk factors for severe RSV infections. Diagnosis can often be clinical. Diagnostic testing is not routinely recommended. The treatment of upper and lower respiratory tract infections is generally supportive. Ribavirin can be used in patients with immune deficiency but is not routinely recommended. There is not a routine vaccine for RSV. The RSV-specific humanized mouse monoclonal antibody -palivizumab- is particularly safe and effective for prophylaxis in high-risk groups

A snapshot of pediatric inpatients and outpatients with COVID-19: a point prevalence study from Turkey

This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID-19). On February 2nd, 2022, inpatients and outpatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the study from 12 cities and 24 centers in Turkey. Of 8605 patients on February 2nd, 2022, in participating centers, 706 (8.2%) had COVID-19. The median age of the 706 patients was 92.50 months, 53.4% were female, and 76.7% were inpatients. The three most common symptoms of the patients with COVID-19 were fever (56.6%), cough (41.3%), and fatigue (27.5%). The three most common underlying chronic diseases (UCDs) were asthma (3.4%), neurologic disorders (3.3%), and obesity (2.6%). The SARS-CoV-2-related pneumoniae rate was 10.7%. The COVID-19 vaccination rate was 12.5% in all patients. Among patients aged over 12 years with access to the vaccine given by the Republic of Turkey Ministry of Health, the vaccination rate was 38.7%. Patients with UCDs presented with dyspnea and pneumoniae more frequently than those without UCDs (p < 0.001 for both). The rates of fever, diarrhea, and pneumoniae were higher in patients without COVID-19 vaccinations (p = 0.001, p = 0.012, and p = 0.027). Conclusion: To lessen the effects of the disease, all eligible children should receive the COVID-19 vaccine. The illness may specifically endanger children with UCDs. What is Known: • Children with COVID-19 mainly present with fever and cough, as in adults. • COVID-19 may specifically threaten children with underlying chronic diseases. What is New: • Children with obesity have a higher vaccination rate against COVID-19 than children without obesity. • Among unvaccinated children, fever and pneumoniae might be seen at a higher ratio than among vaccinated children