The Canadian Paediatric Society: its early years.

The Canadian Paediatric Society has continued since its origin to be a consultative organization and has been recognized as the official voice for children in matters relating to health. It has appointed a number of special committees to study and recommend policy and action to the profession, government and other health bodies as new developments in child health have become important in Canada. The dedicated involvement of so many fellows of the society makes it apparent that in its nearly 60 years of existence it has lived up to the objectives of its founders.     

Recommendations for prevention of neonatal ophthalmia. Infectious Diseases and Immunization Committee,Canadian Paediatric Society.

Without preventive measures, gonococcal ophthalmia will develop in approximately 28% of infants born to women with gonorrhea, a disease that is relatively frequent and largely asymptomatic in pregnant women. In addition, in some settings conjunctivitis caused by Chlamydia trachomatis may be more frequent than gonococcal conjunctivitis among neonates. The Canadian Paediatric Society therefore recommends that, as soon as possible after birth, all infants receive prophylaxis with silver nitrate, tetracycline or erythromycin, administered according to specific guidelines.     

Effect of Measles Vaccination on Incidence of Measles in the Community

A study of the effect of measles vaccination on the incidence of the disease in eight separate areas of England and Wales was begun in 1966. It showed an inverse association between the proportion of children vaccinated and the incidence of measles in the area in the following year, but measles epidemics occurred in several of the areas in subsequent years, despite continuing vaccinations.Measles vaccination was introduced on a large scale in Britain in 1968. Analysis of the notification and vaccination statistics shows that the vaccination of about 10% of the child population (under 15 years) in 1968 sufficed to “replace” the measles epidemic which had been expected in the period October 1968 to September 1969 by a low incidence of the disease, typical of that in previous “interepidemic” years. Further, the effect of the vaccinations was to prevent the development of natural measles in susceptible unvaccinated children as well as in the vaccinated subjects. Thus the number of immune subjects in the community was increased by the vaccinations, but as a result there was a reduction in the number of subjects who acquired immunity from natural measles. These opposed results can therefore explain why vaccination may be effective in the community for only a year or two, though vaccination protects the individual for much longer.It is estimated that a continuing vaccination rate of 40 to 50% of the children born each year would be necessary to replace the regular biennial measles epidemics in Britain by a continuous endemic incidence, and might perhaps lead to the disappearance of the disease without a further major epidemic, but that a continuing vaccination rate of 80 to 90% of children born each year would then be necessary to prevent its reintroduction. The long-term control of measles by vaccination will thus probably prove more difficult than for any other infectious disease.     

Hepatitis B: update on perinatal management. Infectious Diseases and Immunization Committee,Canadian Paediatric Society.

Infants of women infected with hepatitis B virus (HBV) are at risk of acquiring hepatitis B, usually at the time of delivery but occasionally in utero or after delivery. Perinatally acquired HBV infections are noteworthy for their tendency to persist throughout life, predisposing victims to cirrhosis and hepatocellular carcinoma. In most instances perinatal infection can be prevented by combined passive-active immunization of infants at risk. It is recommended that attempts be made to identify pregnant women infected with HBV and that their infants be given hepatitis B immune globulin soon after birth, then be actively immunized with HBV vaccine. This approach is effective and safe and is subsidized in many provinces.