Hot Topics in Infection and Immunity in Children IV

Contents.- Contributing Authors.- The Enteroviruses: an Emerging Infectious Disease? The Real, the Speculative…and the Really Speculative.- Mark J. Abzug.- Introduction.- Enterivirus 71: a "New" Neurologic Threat.- Modern Epidemiology and Clinical Presentations.- EV71 Brainstem Encephalitis.- EV71 Acute Flaccid Paralysis.- EV71 Diagnosis.- EV71 Pathogenesis.- EV71 History and the Emergence of Severe Epidemic Disease.- Therapy of EV71 Infection.- Congenital EV Infection.- Previous Evidence of In Utero EV Infection.- New Evidence for Congenital EV Infection: Amniotic Fluid Studies.- New Evidence for Congenital EV Infection: Placental Studies.- New Evidence of Congenital EV Infection: What Does it Mean?.- Chronic Fatigue Syndrome.- Evidence implicating EVs: the European Experience.- Evidence from Europe Not Implicating Evs.- New Evidence Implicating EVs: the American Experience.- Evidence Linking EV Infection and CFS: Possible Explanations.- Conclusions.- References.- Science and Society: The HIV Epidemic and South African Political Responses.- Hoosen M. Coovadia and Imraan Coovadia.- Introduction.- South Africa: The AIDS Advisory Committee.- Sarafina.- The Virodene Saga.- The Presidential AIDS Advisory Panel (Mbeki Panel, 2001).- The Durban Declaration.- The Enigma of President Mbeki.- Pragmatism.- Preoccupation with Governance.- The Politics of Negotiation.- AIDS and the Global Context.- Conclusion.- References.- Pathogenesis of Group A Streptococcal Infections and Their Sequelae.- Madeleine W. Cunningham.- Introduction.- Virulence Determinants and the Host Response.- Acute Rheumatic Fever.- 3.1 Immune Mechanisms in Rheumatic Carditis.- 3.1.1 Antibody Reacts with Valve Endothelium.- 3.1.2 T cell Infiltration through Valve Endothelium.- 3.1.3 Immune Mechanisms in Sydenham’s Chorea.- Post-Streptococcal Glomerulonephritis.- Acknowledgements.- References.- 4. Snakes, Jellyfish and Spiders.- Bart J. Currie.- Introduction.- Toxins andclinical relevance.- Snakebite.- Jellyfish stings.- Spider bites.- Conclusions.- Acknowledgements.- References.- Current Status of Group A Streptococcal Vaccine Development.- James B. Dale.- Introduction.- Burden of Disease Caused by GAS Infections.- Current Strategies for Vaccine Development.- Rationale for M Protein-Based GAS Vaccines.- Preclinical Evaluation of a 26-Valent M Protein-Based Vaccine.- Clinical Experience with the 26-Valent GAS Vaccine.- Development of Vaccines Designed to Prevent Rheumatic Fever.- Summary and Conclusions.- Acknowledgements.- References.- New Aspects on Diagnosis and Transmission of Hepatitis B in Paediatric Patients and Pregnant Women.- Robert A. de Man, Annemiek van der Eijck and Irene Veldhuijzen.- Horizontal transmission of hepatitis B and the paediatric patient.- Infectivity of body fluids.- Implications for the paediatric patient.- Chronic hepatitis B in pregnancy.- References.- Pertussis Immunisation in Adolescents and Adults.- Ulrich Heininger.- Introduction.- Epidemiology.- 2.1 Incidence of pertussis disease compared to B. pertussis.- infections in adolescents and adults.- 2.2 Adolescents and adults as the source for pertussis in infants.- Disease.- Diagnosis.-Treatment.- Prevention by Immunisation.- Successful Childhood Programmes.- Expanding Programmes Beyond Childhood.- Summary.- References.- 8. Trachoma: Revent Developments.- David Mabey.- Introduction.- Epidemiology.- Trachoma assessment.- Clinical signs and C. trachomatis infection.- Pathogenesis of Trachoma.- The SAFE strategy.- Surgery.- Antibiotic.- References.- 9. Gonococcal Infections in Newborns and in Adolescents.- Noni MacDonald, Tim Mailman, Shalini Desai.- 1. Introduction.- 2. The Microbe.- 3. Gonococcal Infection in Newborns.- 4. Gonococcal Ophthalmia Neonatorum.- 5. Neonatal Gonococcal Scalp Abscess and Disseminated Gonococcal Infection.- 6. Diagnosis of Neonatal Gonococcal Infections.- 7. Treatment of Neonatal Gonococcal Infections.- 8. Prevention of Neonatal Gonococcal Infection.- 9. Gonococcal Infection in Adolescents.- 10. Why are Adolescents STI Rates so high?.- 11. Partners, Condom Use and Sexual Networks.- 12. Clinical Presentations of Gonococcal Infection in Adolescents.- 13. Diagnosis Testing for N gonorrhoea Infections in Adolescents.- 14. Treatment pf Adolescent Gonococcal Infections.- 15. Prevention of Gonococcal Infections in Adolescents.- 16. Summary.- References.- 10. Management of Severe Dengue in Children.- Christopher Moxon and Bridget Wills.- 1. Introduction.- 2. Clinical features of severe dengue infection in children.- 3. Pathogenesis.- 4. Management – theoretical considerations.- 5. Management – practical guidelines.- 5.1 Fluid resuscitation.- 5.2 Management of bleeding.- 6. Summary/Conclusion.- References.- 11. Human Papillomavirus Vaccines: Who should get them and why?.- Stephane Paulus and Simon Dobson.- 1. Introduction.- 2. HPV epidemiology.- 3. Cervical cancer epidemiology.- 4. Age of sexual debut.- 5. Education/school leaving.- 6. HPV vaccines: nature and characteristics of immunising agent.- 7. Vaccine Safety.- 8. HPV vaccine implementation.- References.- 12. Antimicrobial Resistance Among Enteric Pathogens.- Larry K. Pickering.- 1. Introduction.- 2. Advantages of antimicrobial therapy.- 3. Limitations and challenges of antimicrobial therapy.- 4. Reasons for mechanisms of resistance.- 5. Resistance patterns of enteric pathogens.- 5.1 Campylobacter jejuni/coli.- 5.2 Shigella species.- 5.3 Salmonella species.- 6. Effect of resistance on clinical manifestations and treatment options.- 7. Future directions.- References.- 13. What the paediatrician needs to know when pandemic influenza arrives in clinical practice.- Nicole Ritz and Nigel Curtis.- 1. Introduction.- 1.1 The media outbreak.- 2. The impact of pandemic influenza.- 2.1 How many people will be affected?.- 2.2 How fast will pandemic influenza spread?.- 2.3 Is human-to-human transmissionlikely to occur?.- 3. Diagnosis and clinical features of H5N1 avian influenza.- 3.1 Differences between pandemic influenza and seasonal influenza.- 3.2 Clinical features.- 3.2.1 Clinical features at presentation.- 3.2.2 Presentation with delayed respiratory features.- 3.2.3 Complications.- 3.3 Radiology.- 3.4 Laboratory features.- 3.4.1 Routine investigations.- 3.4.2 Laboratory confirmation.- 4. The treatment of H5N1 avian influenza.- 4.1 Adamantanes (M2 blockers).- 4.2 Neuraminidase inhibitors.- 4.2.1 Mechanism of action.- 4.2.2 Administration.- 4.2.3 Formulations.- 4.2.4 Effectiveness.- 4.2.5 Adverse effects.- 4.2.6 Dosing in children.- 4.3 Resistance to anti-influenza drugs.- 4.4 Prophylaxis.- 4.5 Who should be treated?.- 4.6 Additional and other treatments.- 4.7 Personal stockpiling of antiviral drugs.- 5. Limiting the spread of influenza during a pandemic.- 6. The prevention of pandemic influenza.- 7. Conclusion.- Acknowledgements.- References.- 14. Lyme Disease.- Eugene D. Shapiro.- 1. Introduction.- 1.1 Etiology and Epidemiology.- 2. Clinical Manifestations.- 3. Diagnosis.- 4. Treatment.- 5. "Chronic" Lyme Disease.- 6. Congenital Lyme Disease.- 7. Prevention of Lime Disease.- 8. Lyme Hysteria.- 9. Summary.- References.- 15. Management of Myocarditis in Children: the current situation.- Brigitte Stiller.- 1. Introduction.- 2. Viral Myocarditis: three different phases.- 2.1 Phase 1: Viral Infection.- 2.2 Phase 2: Autoimmune Injury.- 2.2.1 T cells.- 2.2.2 Cytokines.- 2.3 Phase 3: Dilated Cardiomyopathy.- 3. Diagnosis and Treatment of the Different Phases: Current Recommendations.- Phase 1: Diagnosis and Treatment in Viral Replication.- Phase 2: Diagnosis and Treatment during Autoimmune Activation.- Phase 3: Diagnosis and Treatment during Dilative Cardiomyopathy.- 4. Clinicopathological Subtypes of Myocarditis.- 4.1 Fulminant myocarditis.- 4.2 Acute myocarditis.- 4.3 Chronic active myocarditis.- 4.4 Chronic persistent myocarditis.- 5. Therapeutic Strategies for Paediatric heart Failure and Haemodynamic Instability.- 6. Conclusions.- References.- 16. Therapy of Herpes Virus Infections in Children.- Richard J. Whitley.- 1. Introduction.- 2. Neonatal Herpes Simplex Virus Infection.- 3. Activiral Therapy of neonatal HSV Infection.- 3.1 Mortality.- 3.2 Morbidity.- 3.2.1 Disseminated and CNS Neonatal HSV Disease.- 3.2.2 Skin Eye and Mouth Disease.- 3.2.3 Summary.- 4. Herpes Simplex Encaphalitis.- 4.1 Treatment.- 5. Varicella Zoster Virus.- 5.1 Treatment of Varicella in the Immunocompetent Host.- 5.2 Treatment of Varicella in the Immunocompromise Host.- 5.3 Valacyclovir and Famciclovir.- 5.4 Resistant Varicella Zoster Virus Infections.- 6. Cytomegalovirus.- 6.1 Diagnosis.- 6.2 Treatment.- 7. Summary.- References