Background

Rates of taste and smell dysfunction in COVID-19 positive children have not been reported. We analyzed sensory impairment in COVID-19 positive children and adults, and correlated our findings with data regarding nasal ACE2 expression.

Methods

Children (aged 5-10 and 11-17 years) and adults (aged 18-25 years, and 26 and older) residing in several households, were evaluated for impairment of olfactory and gustatory senses. Scores of sensory impairment in the four age groups were correlated with ACE2 expression in persons infected with COVID-19 of corresponding age groups. Statistical evaluation was performed using the T-test, chi square test and the Pearson correlation test.

Results

73 respondents, including 31 children and 42 adults were evaluated. Any impairment of taste and smell was reported in 51% of individuals, including 25.8% of the children and 71.4% of the adults (p=0.00014). Sensory impairment scores were higher in older (>25 years) than in younger adults (18-25 years) (p=0.038). Stratifying the pediatric group by age revealed higher scores of altered taste and smell in older (11-17 years) than in younger (<10 years) children (p=0.005). Sensory impairment differences correlated with reported differences in ACE2 expression among corresponding age groups (Fig. 1).

Conclusions

Sensory sensation was significantly less impaired in COVID-19 positive children than in adults. A stepwise increase in taste and smell impairment with increased age was observed, correlating with ACE2 expression in similar age groups. This supports the possibility that the distribution and expression of ACE2 receptors, could contribute to these differences suggesting that ACE2 expression is a key factor for the different manifestations between COVID-19 infected children and adults.

Background

In 2015 zika virus (ZIKV) quickly spread and caused an outbreak in Brazil. Several studies have shown that ZIKV has positive tropism for neuronal cells including direct effects on development, proliferation, differentiation and cell death of neural progenitor cells, culminating in tissue damage. Cerebrospinal fluid (CSF) proteins have the potential to help understand the disease development. To compare cell adhesion molecules concentrations in CSF between Zika virus (ZIKV)-exposed neonates with and without microcephaly (cases) and controls.

Methods

Sixteen neonates underwent lumbar puncture (LP) during the ZIKV epidemic (2015-2016), 8 (50%) with and 8 (50%) without microcephaly. All mothers reported ZIKV clinical symptoms during gestation, all neonates presented with congenital infection findings and other congenital infections were ruled out. Fourteen neonates fulfilled criteria to be controls and underwent LP in the same laboratory (2017- 2018). Five cell adhesion proteins were measured in the CSF by mass spectrometry and compared in the studied subgroups.

Results

Three cell adhesion proteins were significantly lower in the CSF of the case group. When only microcephalic or non-microcephalic cases were compared to controls, all of these proteins were significantly lower among cases. When cases with or without microcephaly were compared, no protein was significantly lower in the microcephalic subgroup. Positive correlation was found between cephalic perimeter and concentration of 2 cell adhesion proteins.

Conclusions

Several cell adhesion proteins are significantly lower in the CSF of neonates exposed to ZIKV before birth, irrespective of being born with microcephaly. However, the lesser the cephalic perimeter is, the lower the CSF cell adhesion protein concentration. Some cell adhesion proteins levels in the CSF probably reflect the impact of ZIKV congenital infection in the brain.

Background

We recently published data on ESBL-producing Enterobacterales (ESBL-E) in stool-surveillance cultures at the NICU being not a risk factor for necrotizing enterocolitis in very low birth weight infants over an 11-year time period (Eberhart et al., Infection 2020). A large part of this population was now followed until the age of 6 years to avaluate the risk of gastrointestinal infections or complications.

Methods

Retrospective single center case-control study of preterm infants below 1500 grams (VLBW) with positive surveillance cultures of ESBL-E during neonatal stay between 2005 and 2013 were fopllowed until the age of 6 years. We looked for bacterial and viral diseases, febrile seizures, appendicitis, ileus, volvulus, gastritis/enteritis, diarhhea, gastroesophageal reflux disease, and neurodevelopmental impairments.

Ethical approval was given by the local ethic committeee of the Medical University of Graz (EK Nr 32-052 ex 19/20)

Results

Conclusions

ESBL-E positive VLBW infants did not experience more health problems during the first six years of life than matched controls.

Background

Despite a high coverage of 97–99% for at least three doses of acellular pertussis (aP) vaccination for the last 2 decades in Sweden, pertussis is the least controlled vaccine-preventable disease with a significant burden in infants too young to have received the full infant series.

This study estimates vaccine effectiveness (VE) in preschool children after vaccination (2+1 schedule), 2007–2018.

Methods

Reported laboratory confirmed pertussis cases, aged 24–71 months, from 2007 to 2018 with complete information on vaccination status were included. Full vaccination was defined as ≥ three doses of aP vaccine ≥ 15 days before disease onset for cases.

Data on pertussis vaccine three-dose coverage was systematically collected from healthcare centres. Only 2- or 3-component DTaP combination vaccines approved by the Swedish Medical Product Agency were used during this period.

VE was calculated using the screening method, comparing the proportion of fully vaccinated laboratory confirmed cases (PCV) and vaccination coverage.

Results

For each age group under surveillance from 2007 to 2018, vaccination coverage varied between 98.1–98.3%, while the proportion of fully vaccinated laboratory confirmed cases varied between 57–72%, corresponding to VEs varying between 95–97% (Table).

Conclusions

This study indicates high effectiveness of routine aP vaccination in the Swedish national immunization program for the studied age groups. There is, however, still a risk of pertussis for young infants in Sweden before the first vaccination.

Background

Following the introduction of a 2, 4 and 12 month schedule of a group B meningococcal vaccine (4CMenB) into the UK infant immunisation schedule in 2015, there has been a 57% reduction in group B meningococcal (MenB) disease in the immunised 2 year-old cohort. Here we report the serum bactericidal antibody titres (SBA) observed in this cohort following the UK ‘reduced-dose’ schedule.

Methods

Blood samples were taken at approximately 2 years of age from children previously enrolled into the Sched3 study, in which they were randomised 1:1 to receive a 2+1 or 1+1 schedule of 13-valent pneumococcal vaccine, and received 4CMenB at 2, 4 and 12 months. Human complement SBA (hSBA) titres against MenB reference strains 5/99 (NadA), NZ98/254 (PorA) and 44/76-SL (fHbp) were determined and compared to those measured post-booster (13 months).

Results

Seventy-six children had bloods taken between 21 and 33 months of age. No significant difference in hSBA titres was seen between the PCV schedules. The proportion of overall participants with hSBA titres ≥4 were 26% for NZ98/254, 43.8% for 44/76-SL and 85.9% for 5/99. hSBA Geometric mean titres for NZ98/254 fell from 26.6 post-booster (13 months) to 1.7, for 44/76-SL from 34 to 2.5, and for 5/99 from 1394.8 to 54.2.

Conclusions

Despite the observed fall in hSBA titres, the effectiveness of the 4CMenC vaccine appears to be sustained with surveillance data suggesting a reduction in meningococcal B disease following the introduction of the schedule. Understanding the significance of these results will require ongoing surveillance for MenB disease, with particular consideration of which strains are causing vaccine failures. Funded by NIHR Policy Research Programme and Gates Foundation.

Clinical Trial Registration

Assessment of Post Booster Antibody Responses in UK Infants Given a Reduced Priming Schedule of Meningococcal Serogroup B and 13 Valent Pneumococcal Conjugate Vaccines

ClinicalTrials.gov identifier (NCT number): NCT02482636