Epidemiological pattern of scarlet fever in recent years

During the period of 1953-2001 scarlet fever morbidity level fluctuated from 670.3 to 65.9 per 100,000 of the population in Moscow and from 531.9 to 35.0 per 100,000 of the population of the Russian Federation. In recent years an increased morbidity was more pronounced in Moscow than in the Russian Federation as a whole. Children formed the greater part of scarlet fever patients, the cases of scarlet fever among children in Moscow occurring more often than, on the average, in Russia. As before, annual morbidity among children attending children's institutions was higher 3- to 4-fold than among children brought up at home. This difference was most sharply pronounced among young children during the first two years of their life. In contrast to morbidity observed during previous 20-30 years, a drop in morbidity among children during the first two years of their life was registered, while morbidity level among children aged 3-6 years and 7-14 years increased. Scarlet fever morbidity had a pronounced seasonal (autumn-winter) pattern. In a group of children aged 3-5 years who attended organized groups, on the average, 78.6% of scarlet fever cases fell on seasonal morbidity, the most prolonged one.     

Basic patterns in the epidemic process of measles under conditions of massive immunization]

Observations over the measles epidemic process in Leningrad showed that the sporadic morbidity level reached in 1974--4.1 per 100 000 residents; however periodic elevation and decline of morbidity and tis seasonal variations persisted. A rise of morbidity in 1972--1973, and by preliminary data--in 1975, occurred on account of the older age groups. There was revealed no dependence of the disease incidence among the persons vaccinated on the time lapse after their vaccination. Individual batches of live measles vaccine issued in 1963--1969 were not up to the standard, this serving as one of the cases of the occurence of group incidence of the infection in some foci.     

The epidemic spread of the influenza A and B viruses in the USSR in 1985-1986

The data on the spread of influenza A and B in the autumn and winter of 1985-1986 are given. Three epidemics caused by all presently circulating viruses, B, A (H3N2) and A (H1N1), were registered in the USSR. Of these, the greatest one was the epidemic of influenza B; morbidity rate among the adult population during this epidemic was at the level with the morbidity rate characteristic of the epidemics registered at the period of 1962-1972, and morbidity rate among children, especially school children, was even higher.     

Therapeutic and preventive vaccination of persons bitten by wolves in the Aktiubinsk region]

A total of 46 cases of wolves attacking people were registered in the Aktyubinsk region during the period of 1972--1976. These attacks resulted in 1 person dying of wounds and 2 persons being infected with rabies. In more than a half of the wolves available for examination after the attack rabies was confirmed by laboratory investigation. All the victims of such attacks received antirabies gamma globulin (0.25--0.5 ml per kg body weight) and the maximum doses of rabies vaccine (daily injections of 5 ml for 25 days, then 2 more injections in the same dose 10 and 20 days later). No complications were observed after the injections. The vaccination schedule recommended for use in the USSR for the prophylaxis of rabies proved to be effective.     

Register of newly diagnosed diabetic children.

In November 1972 the British Diabetic Association sponsored a register to which notification was invited of all new cases of diabetes occurring in children aged 0-15 years in Great Britain and Ireland. More than 2000 cases were notified in the first two years. Notification suggested that there was a minimum yearly incidence of 7-67 cases per 100 000, though incidences varied from year to year and by geographical area. Several reports of simultaneous onset of diabetes in sibs of different ages provided evidence of clustering. A seasonal variation in incidence was found in children aged 5-15 years with peaks in the autumn and winter. The age distribution was bimodal with a main peak at about 11 years and a secondary peak at about 5 years. The sex ratio showed a male excess from 0-4 years and from 11-15 years and a female excess from 5-10 years. Overall there were slightly more male cases. Altogether 11% of patients had a first-degree relative with diabetes. The register and several investigations based on it will continue.     

Patterns in the spread and serovirological diagnosis of serous meningitis

The epidemiological and clinico-etiological study of cases of acute serous meningitis with unknown etiology in children was carried out in a large industrial city at the period of a considerable morbidity rise caused by this infection. The maximum morbidity was registered among younger children under school age attending children's institutions. In 26 closed groups of children group morbidity was revealed (4 cases and more), in 5 such groups small local outbreaks were registered. The clinico-instrumental methods of study permitted one to differentiate the groups of children having serous meningitis of supposedly enteroviral etiology, and sero virological studies carried out with the use of a wide range of diagnostic reagents revealed the etiological role of group B Coxsackie virus, mainly type 4, in 20.6% of cases, ECHO virus, serotypes 3 and 11, in 20.7% of cases, and parotitis virus in 5.3% of cases.     

The epidemiological characteristics of meningococcal infection in the USSR

The epidemiological analysis of morbidity in meningococcal infection in the USSR in the period of 1969-1987 showed that the second rise of the morbidity level occurred in 1984 and was followed by its decrease in most of the regions of the USSR. This study also revealed that the characteristic feature of the second rise of morbidity in meningococcal infection was a considerable involvement of young children (aged up to 3 years), as well as the increased etiological role of group B meningococci in cases of meningococcal infection and the circulation of these microorganisms among the population. Besides, the preservation of the etiological importance of group A meningococci in many regions of the USSR, especially among adults, was noted. In this connection, the use of Soviet group A meningococcal polysaccharide vaccine on epidemiological indications was considered to be epidemiologically substantiated.     

The manifestations of an epidemic process of typhoid infection in Moscow

The work deals with the results of typhoid morbidity in Moscow for the period of 1980-1988. The morbidity rate varied from 0.98 to 0.17 cases per 100,000 of population with a tendency towards decrease. In the structure of morbidity local cases accounted for 46.8% and cases of infection contacted outside Moscow accounted for 53.2%. The morbidity level was low throughout the whole territory, only in two districts morbidity rate was significantly higher (P = 95%) than the average morbidity rate in the whole of the city. In the group of local cases morbidity had no pronounced seasonal character, in contrast to cases due to infection contacted outside the city which were mostly registered in summer and autumn. Persons aged 21-30 years were found to be the most affected age group. The general factors, and not the contact route, are supposed to play the main role in the realization of the mechanism of infection transfer. Under modern conditions, some manifestations of the epidemic process of typhoid infection can be detected only at the level of the whole city, or even the whole country.     

Incidence of epidemic parotitis in different countries]

The authors analyzed the incidence of epidemic parotitis in various countries in 1960--1969 on the basis of the data published by the WHO. It can be supposed that there was no significant difference in the morbidity in various countries and that discrepancy in the official data of individual countries was apparently caused by the errors in recording. In the majority of the countries morbidity curve was fluctuating in character with a 4--5-year periodicity. In the countries of the northern hemisphere the greatest number of cases occurred in spring, and in the southern--in autumn. Monthly distribution of cases during the years with a high and low morbidity level displayed no significant changes.     

许昌市2010年麻疹疫情分析

研究许昌市麻疹流行特征,为消除麻疹提供科学依据.对许昌市2010年麻疹疫情进行描述流行病学分析.结果显示2010年全市共报告麻疹确诊病例158例,报告发病率为3.74/10万;流行毒株为麻疹病毒H1a基因型.3-5月份是发病高峰;0～3岁龄儿童为主,其中小于8月龄病例占报告发病数的32.91％;8- 17月龄病例,68...     

Hereditary blood factors and infectious diseases in children in the 1st 7 years of life

Infectious morbidity in respect to 23 nosological forms was studied in 958 children with known blood groups and Rh factors during the first 7 years of their life. The absence of statistically significant differences in morbidity rates in children with different age groups was revealed in respect to 16 nosological forms. Significant differences in morbidity rates in children with different blood groups were revealed in respect to parotitis, rubella, scarlet fever, E. coli infections, bronchitis and pneumonia; similar differences linked with Rh factor were observed only in cases of measles, rubella and tonsillitis.     

The etiological structure of acute bacterial meningitis in different regions]

In 1985-1989 the etiological structure of acute bacterial meningitides (ABM) in children was studied in 4 largest industrial cities in different regions of the European part of the former USSR, as well as in 2 industrial cities of western Siberia. Due to the common methodological approach used in all investigations, comparable data were obtained in all cities. These investigations revealed that meningococci caused 53.0-86.7% of all cases of ABM in children, which corresponded to moderately increased morbidity rate in meningococcal infection (3.9-11.0 cases per 100,000 of the population, mostly 5.0-7.0 cases) in these cities with its progressive decrease during 3-4 years of observation. The gradual change of meningococci from group A, prevailing in the '70s and early '80s, to group B and in some cases the appearance of group C meningococci, accompanied by a decrease in morbidity rate, were noted. In St. Petersburg the indices of ABM morbidity in children aged up to 5 years for 1987 and 1988, caused by Haemophilus influenzae (0.74 and 4.13) and pneumococci (3.23 and 4.86), could be calculated. A great number of ABM cases of unclear etiology (15.9-33.3%) suggests that the number of ABM cases caused by these two infective agents was underestimated.     

The cause of the activation of an epidemic process of intestinal infections in the 70s]

In the seventies a considerable rise in dysentery morbidity was observed in all republics of the USSR, in the whole of the USSR, in Bulgaria and in the German Democratic Republic. An increase in cholera morbidity in the world, as well as in the number of countries affected by this infection, was registered. A tendency towards a rise in virus hepatitis incidence was observed in the USSR. The dynamic study of the ozone content in the stratosphere, solar activity, disturbances in the magnetic field of the Earth, air temperature for the period of 1967-1980 was carried out. Strong and moderate correlation between dysentery and air temperature in summer was established. The maximum morbidity level in the USSR in 1972 was probably the consequence of unusually high air temperature in summer.     

Analysis of the dynamics of typho-paratyphoid infection morbidity over the years in the USSR]

Statistical materials of recording the number of patients and of the typhoid-paratyphoid infections morbidity level in Russia and the USSR from 1891 to 1976 was studied. A stable tendency to reduction of this morbidity was noted. In analysing the empirical and flattened--by 3 and 5 points--curves of the number of patients and the morbidity level a regularity of declining morbidity rises was revealed. Elevation periodicity persisted, despite the reduction of morbidity level. The mean duration of the whole cycle constituted 12 years. The period of increasing morbidity from minimal to maximal in each cycle constituted 4 years, and of the declination period--8 years. Formalized empirical series of the number of patients and of the morbidity level deviated from 1908 to 1956 not more than by 1 year from the formalized basic curve. Cyclic changes of typhoid-paratyphoid infections morbidity should be taken into consideration in determining the efficacy of prophylatic measures, particularly of mass vaccination.     

Increased incidence and clinical picture of childhood narcolepsy following the 2009 H1N1 pandemic vaccination campaign in Finland

Background

Narcolepsy is a rare neurological sleep disorder especially in children who are younger than 10 years. In the beginning of 2010, an exceptionally large number of Finnish children suffered from an abrupt onset of excessive daytime sleepiness (EDS) and cataplexy. Therefore, we carried out a systematic analysis of the incidence of narcolepsy in Finland between the years 2002–2010.

Methods

All Finnish hospitals and sleep clinics were contacted to find out the incidence of narcolepsy in 2010. The national hospital discharge register from 2002 to 2009 was used as a reference.

Findings

Altogether 335 cases (all ages) of narcolepsy were diagnosed in Finland during 2002–2009 giving an annual incidence of 0.79 per 100 000 inhabitants (95% confidence interval 0.62–0.96). The average annual incidence among subjects under 17 years of age was 0.31 (0.12–0.51) per 100 000 inhabitants. In 2010, 54 children under age 17 were diagnosed with narcolepsy (5.3/100 000; 17-fold increase). Among adults ≥20 years of age the incidence rate in 2010 was 0.87/100 000, which equals that in 2002–2009. Thirty-four of the 54 children were HLA-typed, and they were all positive for narcolepsy risk allele DQB1*0602/DRB1*15. 50/54 children had received Pandemrix vaccination 0 to 242 days (median 42) before onset. All 50 had EDS with abnormal multiple sleep latency test (sleep latency <8 min and ≥2 sleep onset REM periods). The symptoms started abruptly. Forty-seven (94%) had cataplexy, which started at the same time or soon after the onset of EDS. Psychiatric symptoms were common. Otherwise the clinical picture was similar to that described in childhood narcolepsy.

Interpretation

A sudden increase in the incidence of abrupt childhood narcolepsy was observed in Finland in 2010. We consider it likely that Pandemrix vaccination contributed, perhaps together with other environmental factors, to this increase in genetically susceptible children.     

Prevention of mumps in preschool institutions using a live mumps vaccine made from strain L-3

The effectiveness of the emergency vaccinal prophylaxis of epidemic parotitis was studied in 19 children's day-care centers. As revealed in this study, the immunological effectiveness of vaccination did not depend on the age of vaccinees, but sharply decreased if live parotitis vaccine contained less than 10,000 HADU50 per immunization dose. After a single administration of the vaccine 91.1 +/- 0.98% of children were found to produce mumps antibodies. The immunization of children with live parotitis vaccine prepared from strain l-3 immediately after the first case of parotitis had been registered proved to be a highly effective measure. The coefficient of epidemiological effectiveness was 96.4%.     

Rheumatic fever in native children in Manitoba.

From data reported to a central computer file, cases of rheumatic fever in persons under 17 years of age in Manitoba were reviewed. Although the overall incidence of the disease declined throughout the study period, Jan. 1, 1970 to July 1, 1979, the rates per 100 000 population were higher overall (36) and for non-natives (29) and much higher for natives (126) than average rates in urban centres around the world. Rates of death and readmission showed that the disease was also more severe in the native Manitoba children.     

Clinical use of rubomycin in neuroblastoma in children]

The results of treatment of 23 children at the age of 7 months to 11 years suffering from neuroblastoma are presented; 22 patients with tumors, relapses or metastases were subjected to the treatment and 1 child was treated prophylactically after radical operation. Four patients were subjected to roentgen therapy in addition to the treatment with rubomycin. The antibiotic was administered intravenously in doses of 0.7--1.5 mg/kg in 1--3 days or daily. The caurse dose (3--12 mg/kg) was determined by the treatment efficiency and the side reactions. The objective effect was observed in 68 per cent of the patients, including the pronounced objective effect (marks 3 and 2) in 41 per cent of the cases. Leucopenia (less than 4000 cells in 1 mm3 of the blood). thrombocytopenia, vomiting (or nousea) and changes in the ECG were registered in 20 (87 per cent), 4,9 and 2 patients respectively. When the results of the treatment were positive, repeated courses of the therapy within 1.5--2 years were carried out; 18 patients died within 4 months to 2 years after the first course of the treatment with rubomycin because of the disease development. No signs of the disease were observed in 4 children with in 3--6 years of observation.     

Analysis of the trends in typhoid-paratyphoid morbidity in the USSR]

Mathematico-statistical analysis of typhoid-paratyphoid infection morbidity in the USSR during 1900--1940 revealed a regular many-year cyclic recurrence of the changes in the morbidity level. The intensity of the morbidity level reduction at the periods of decline--in 1900--1917, 1920--1928, and in 1932--1939--was similar. A successive reduction of morbidity of this group of infections, by 6.45% on the average, annually, occurred in 1930--1976. The character of reduction of typhoid-paratyphoid infections morbidity level in the USSR during that period is well described by the exponential function.     

Mutation rates for unbalanced Robertsonian translocations associated with Down syndrome. Evidence for a temporal change in New York State live births 1968--1977.

The mutation rate for translocation Down syndrome was investigated for New York State live births for each of the years 1968--1977 using data from the New York State Chromosome Registry. The overall rate was 2.5 X 10(-5) per gamete (1.4 X 10(-5) for G/21 and 1.0 X 10(-5) for D/21 rearrangements), about 20% higher than rates previously reported by two other studies. For the first 5-year period, 1968--1972, the rate was 1.8 X 10(-5), and for the second 5-year period, 3.1 X 10(-5); there was an abrupt change in 1973 and 1974 to rates more than twice that in the 3 preceding years. These rates were derived by applying completeness estimates for all cases of Down syndrome, mostly 47,trisomy 21, in the jurisdiction to cases with translocation Down syndrome mutations. If completeness corrections are ignored and only the minimum boundaries of rates are considered, however, the increase in 1973 and 1974 was even greater compared with the previous 3 years. The trends, if not attributable to an undetected artifact, may have been caused by an increased frequency of mutant zygotes and/or enhanced intrauterine survival of mutant translocations.