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ABSTRACT: The incidence of sporadic GII norovirus gastroenteritis associated with hospitalization was examined among 515 children aged < 5 years in a prospective study in Israel.Using real time-PCR, norovirus was detected in stools of 89 (17.3%) children, yielding an estimated incidence of 3.3 per 1000 children. Genotypes GII.3 (40.4%) and GII.4a, (21.3%), predominated, though year to year variation was observed. Our findings provide a basis for developing norovirus vaccines.
The Pediatric Infectious Disease Journal 02/2013; · 3.58 Impact Factor
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ABSTRACT: Pandemic influenza A/H1N1 carries a relatively high morbidity, particularly in young people. Early identification would enable prompt initiation of therapy, thereby improving outcomes.
To describe the epidemiological, clinical and laboratory characteristics of children admitted to hospital with the clinical diagnosis of influenza with reference to pandemic influenza A/H1N1.
We conducted a prospective study of all children aged 16 years or less admitted to the pediatric department with the clinical diagnosis of influenza-like illness from July to October 2009. The presence of A/H1N1 virus was confirmed using real-time reverse transcriptase polymerase chain reaction (RT-PCR) analysis of nasopharyngeal secretions. Positive cases were compared with negative cases concerning epidemiological data, risk factors, clinical presentation and laboratory parameters, with emphasis on changes in the differential blood count.
Of the 106 study patients, 53 were positive to influenza A/H1N1 and 53 were negative. In both groups nearly all patients had fever at presentation and approximately two-thirds had both fever and cough. All patients had a mild clinical course, no patient needed to be admitted to the intensive care unit and no mortalities were recorded. Hyperactive airway disease was more common in the A/H1N1-positive group. Pneumonia occurred in 30% of children in both groups. Laboratory findings included early lymphopenia and later neutropenia in theA/H1N1-infected patients.
Leukopenia consisting of lymphopenia and later neutropenia was common in patients with A/H1N1 infection but was not correlated with disease severity or clinical course, which were similar in both groups. However, reduced leukocyte count can be used as an additional criterion for diagnosing A/H1N1 infection until RT-PCR results are available.
The Israel Medical Association journal: IMAJ 07/2011; 13(7):408-12. · 1.02 Impact Factor
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Khitam Muhsen,
Lester Shulman,
Eias Kasem, Uri Rubinstein,
Jacob Shachter,
Adi Kremer,
Sophy Goren,
Ilana Zilberstein,
Gabby Chodick,
Moshe Ephros,
Dani Cohen
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ABSTRACT: The association between rotavirus gastroenteritis (RVGE)-associated hospitalization and rotavirus vaccine receipt was examined, and vaccine effectiveness was estimated in a case-control study conducted between 11/2007 and 12/2009 among Israeli children age eligible for rotavirus vaccination. Cases (n=111) were hospitalized children with diarrhea testing positive for rotavirus by immunochromatography. Controls (n=216) were hospitalized children with diarrhea testing negative for rotavirus. Among controls 36 (16.7%) children were vaccinated against rotavirus compared with two children (1.8%) among cases (p < 0.001). Rotavirus immunization was associated with lower risk of RVGE-associated hospitalization; adjusted OR 0.106 (95% CI 0.024, 0.481), yielding a vaccine effectiveness of 89.4% (95% CI 51.9%, 97.6%) in preventing hospitalization. These data demonstrate high effectiveness of rotavirus vaccines in a high income country.
Human vaccines 06/2010; 6(6):450-4. · 3.58 Impact Factor
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ABSTRACT: Limited data exist on the epidemiology and burden of rotavirus gastroenteritis in Israel. Objectives. Our objective was to examine the incidence, characteristics, and economic burden of rotavirus gastroenteritis associated with hospitalization of children <5 years of age in Israel.
A prospective study was initiated in pediatric wards at 3 hospitals in northern Israel. Presence of rotavirus in stool specimens was detected by immunochromatography, and G and P genotypes were determined by reverse-transcriptase polymerase chain reaction. Demographic data, clinical manifestations, and expenditures related to a child's illness were studied using parental interviews.
From November 2007 through October 2008, 472 children hospitalized with gastroenteritis were enrolled in the study. Rotavirus gastroenteritis was diagnosed in 39.1% of children, with a peak identification rate during November 2007-January 2008 (62.5%-71.0%). Most cases of rotavirus gastroenteritis (87.2%) occurred in children <2 years of age. In infections with 1 rotavirus genotype, G1P[8] was the most frequently detected (49.1%), followed by G1P[4] (11.1%) and G9P[8] (9.3%). Mixed rotavirus isolates were identified in 28.9% of the children. The estimated incidence of primary hospitalizations for rotavirus gastroenteritis among children aged 0-5 years was 5.7 hospitalizations per 1000 children per year (95% confidence interval, 5.1-6.3 hospitalizations per 1000 children per year), resulting in an estimate of 4099 annual national hospitalizations (95% confidence interval, 3668-4531 hospitalizations per year). This figure represents approximately 6.5% of the total annual hospitalizations among Israeli children <5 years of age. The annual calculated cost of hospitalizations for rotavirus gastroenteritis was US $7,680,444, including US $4,578,489 (59.6%) in direct costs to the health care system and US $3,101,955 in overall household costs.
Our findings are important for decision making regarding implementation and evaluation of a routine immunization program against rotavirus gastroenteritis.
The Journal of Infectious Diseases 11/2009; 200 Suppl 1:S254-63. · 6.41 Impact Factor
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ABSTRACT: The prevalence of pertussis and asthma in Israel increased during the last decade.
To examine the association between pertussis during infancy (<6 months of age) and childhood asthma (3-9 years).
We compared two groups of children >6 months of age who presented to the emergency room with a cough. Pertussis was diagnosed in the study group (SG) and ruled-out in the control group (CG) by Polymerase Chain Reaction. Asthma was diagnosed by a questionnaire.
Out of 393 children, presented to the emergency-room, 44 in the SG and 52 in the CG were detected and completed the questionnaire. There was no significant difference between the groups in their demographic data (time of presentation [median and range] 2.2 [1-6] months vs. 3 [1-6] months, gender and place of residence). There were more Arab children in the SG (38% vs. 15%, p<0.05). More children were hospitalized at presentation in the SG (75% vs. 46%, p<0.01). There was no significant difference between the groups in the rate of pertussis vaccination or in genetic or environmental variables that could affect asthma prevalence. There was no significant difference between the study and control groups in the prevalence of asthma (18% vs. 9.6%, p=0.24) or atopic diseases or in childhood asthma in children hospitalized at presentation (18.2% vs. 8.3%, respectively, p=0.44). However, the rate of the combination of asthma and/or atopy in hospitalized infants was significantly higher in the SG (33% vs. 8.3%. p=0.03).
Our study did not show that pertussis during infancy significantly increases the prevalence of childhood asthma.
Harefuah 03/2009; 148(2):80-3, 140-1.
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ABSTRACT: Tuberculosis is still one of the most prevalent infectious diseases worldwide with a high annual morbidity and mortality rate. Its mode of spread necessitates prompt investigation to identify those with active disease, possible carriers and as many contacts as possible. This article describes a pair of twins with endobronchial tuberculosis following close contact with a family relative who had active disease. Mycobacterium tuberculosis was isolated from the family relative and the two children. Laboratory diagnosis of the mycobacterial strain and epidemiologic follow-up were performed using a molecular biology tool, the restriction fragment length polymorphism method. Treatment was successful due to the close cooperation between the medical staff of the hospitals, the community clinics and the Center for Diagnosis and Treatment of Tuberculosis. Treatment was administered by the directly observed therapy (DOT) method recommended by the World Health Organization. This article describes the clinical course and treatment of the patients and reviews the new molecular biology methods currently being used for the diagnosis of tuberculosis and their important clinical applications.
Harefuah 04/2007; 146(3):170-2, 248.
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The Israel Medical Association journal: IMAJ 12/2005; 7(11):744-5. · 1.02 Impact Factor
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ABSTRACT: The unavailability of significant numbers of native-born children for adoption by local families has led to an upsurge in international adoptions throughout the Western world, including Israel. The sudden appearance here of large numbers of babies and young children from countries with a variety of indigenous infectious diseases has focused concern on the issue. It has also induced the Ministry of Health to issue guidelines to protect the well-being of the public at large, as well as to aid adoptive families in maintaining their own, as well as their newly adopted children's health. The great majority of community based primary caregivers are unfamiliar with the health issues surrounding internationally adopted children. These children merit special care and consideration. One possible solution, in addition to educational campaigns, and already implemented abroad, is the specialized training of physicians caring for large numbers of such children. [International Adoption, HIV, Hepatitis B, Hepatitis C, Tuberculosis, Syphilis].
Harefuah 06/2002; 141(5):483-6, 496.
