Pattern of varicella and associated complications in children in United Arab Emirates: 5-year descriptive study

The objective of this study was to characterize the epidemiology of varicella and varicella associated complications in Al-Ain, United Arab Emirates [UAE] during 2000-04. The annual number of reported cases varied from 373 to 790 per 100 000 population. Most [89%] occurred in children < 15 years old. Of 187 children requiring hospital admission, 50.3% had febrile illness due to secondary bacterial infection and 17.6% had neurological complications. The overall mortality rate among hospitalized children was 1.1%, all due to invasive group A Streptococcus. Varicella and associated complications in previously healthy children is becoming an important clinical and public health problem in the UAE

Haemophilus influenzae type b diseases in children: a pre-vaccination study

Haemophilus influenzae type b [Hib] can now be prevented by vaccination. We present the clinical and laboratory characteristics of acute invasive H. influenzae diseases in children admitted over a 4-year period to a tertiary paediatric ward of the Al-Ain medical district hospital, before vaccination became available in the United Arab Emirates. In all, 38 children had bacteriologically proven H. influenzae invasive diseases and all the isolates were serotype b. Meningitis was diagnosed in 60.5% of the children and 66% of the studied children were under 12 months. There were no deaths but substantial morbidity occurred in 12 children

Varicella susceptibility among children and healthy adults in the United Arab Emirates

The serological evidence of varicella zoster virus infection was determined among healthy individuals from infancy to 47 years of age living in this region. Of 648 people, 126 [19.4%] had no detectable antibody and were susceptible to infection. The overall adult seroprevalence rate was 81.3%. The rate among Emirati citizens increased with age; < 10 years, 45.8%; 11-20 years, 68.4%; 21-30 years, 89.5%; 31-40 years, 94.7%; and > 41 years, 88.9%. Adults from the Indian subcontinent and Philippines had variable prevalence rates and Sri Lankans living in the region were highly serosusceptible [35%]. Because of the clinical impact of varicella in adult populations, vaccine prevention might be beneficial

Gestational and neonatal toxoplasma infection in the United Arab Emirates-serologic and clinical analysis

To establish regional incidences of the maternal and neonatal toxoplasma infection in the UAE. Method: A prospective serologic study of women of UAE nationality and their newborn infants was conducted from November 1992 to October 1993 in Al Ain Medical District. Paired sera collected from the mother at the time of delivery and umbilical cord blood specimens were tested for the presence of anti toxoplasma IgG and IgM antibodies. Specific IgG antibodies were tested by enzyme linked immunosorbent assay. The presence of anti toxoplasma IgM antibodies in seropositive subjects was determined by immunocapture assay directed against an immunodominant epitope of P 30 antigen. A total number of 1503 paired serum samples of mother and cord were analysed. The seroprevalence rate in pregnant women was ascertained by the presence of antitoxoplasma IgG in maternal serum. Gestational infection was established by testing all the seropositive subjects for the presence of toxoplasma specific IgM antibody. A similar detection of specific IgM in a cord blood specimen indicated a foetal infection. Result: Of the 1503 pregnant women tested, 344 [22.9%] were seropositive at the time of delivery and toxoplasma specific IgM was detected in 43 of them. The rate of estimated acute gestational infection was 29 per 1000 pregnancies over a period of one year. Toxoplasma specific IgM test was positive in 18 infants of the 43 infected mothers, giving a neonatal incidence rate of 12 per 1000 live birth. The maternal to foetal transmission rate was estimated to be 42%. There were no overt clinical features of congenital infection at birth in these infants, but symptoms could appear months or years later and therefore many years of clinical follow up are required. A nationwide data is required to assess the need for initiating a toxoplasmosis screening in the UAE. Until then, promotion of a national health education programme towards primary prevention may reduce the overall incidence considerably

Occurrence and outcome of haemophilus influenzae type B meningitis in children of Al Ain in the United Arab Emirates

Bacterial meningitis is still a major cause of morbidity and mortality in United Arab Emirates infants and children. A prospective review of 34 treated cases of culture-proven meningitis in a hospital documents the prevalence of Haemophilus influenzae type b as the leading pathogen. The peak age when the incidence was the highest was around 6 to 7 months and 71% of the patients were < 12 months old. Sixty two% of cases were Emirates nationals. The overall estimated annual incidence rate of Haemophilus influenzae meningitis was 78 cases per 100,000 children < one year of age. The case fatality rate was 9% and among the survivors 38% developed neurologic sequelae. The results indicate strongly the importance of considering early immunisation in this population

Invasive haemophilus influenzae disease

A 6 month old Indian child with haemophilus influenzae type b [Hib] invasive disease and residing in Al Ain area of the UAE is described. The infant presented with fever and progressive orbital cellulitis of 12 hours duration. His clinical course deteriorated rapidly over the ensuing few hours and he eventually died of irreversible septic shock 2 weeks after admission. Blood and cerebrospinal fluid culture grew Hib. Hib infection is totally preventable with active immunization of children

One out of three infants is susceptible to measles at 9 months of age: is earlier vaccination required?

A study was conducted at King Fahad Hospital of the University. Alkhobar, in the Eastern Province of Saudi Arabia to determine seroprevalance and to establish the susceptibility status to measles in infancy at the time of the first dose of measles immunization. One hundred and fourteen children aged 9 months were studied and one out of every three infants was found to be seronegative and at risk of developing measles while awaiting vaccination. This may justify initiating measles vaccination at an earlier date than the recommended age of 9 months in regions where clinical measles is prevalent during early infancy

study of the umbilical bacterial colonization and infection in a newborn nursery unit

Rates of early umbilical colonization and infection were determined for 1635 newborns admitted to the newly started nursery unit of a general hospital. An overall colonization and infection rate of 30.76% and 5.7% respectively were observed during the entire study period. Antimicrobial susceptibility of the colonized organisms are presented. The newborn nursery is a frequent site for epidemics of infectious diseases. To prevent infection in the nursery, microbiological surveillance by specially trained personnel is important. Review of data previously collected in the hospital is critical in the evaluation of suspected epidemics. A surveillance study of this nature should help to asses or to estimate the increased occurrence of nursery infections