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1.
BMC pediatrics ; 22(1), 2022.
Article in English | EuropePMC | ID: covidwho-1737821

ABSTRACT

Background Kawasaki disease (KD) is an acute, febrile, systemic vasculitis of unknown etiology that primarily affects the coronary arteries and generally occurs at around 1 year of age. Although the diagnosis of KD is generally not difficult, it is challenging in cases of incomplete KD lacking characteristic clinical manifestations. The incidence of incomplete KD is higher in infants younger than 6 months of age. Pneumonia is an extremely rare complication of KD and can be misinterpreted as atypical pneumonia rather than KD. Herein, we report a neonate with atypical KD and severe pneumonia who required mechanical ventilation. Case presentation Japanese one-month-old infant had only fever and rash on admission (day 1), and he was transferred to the intensive care unit for severe pneumonia on day 2. Although pneumonia improved following intensive care, he was diagnosed with KD on day 14 because of emerging typical clinical manifestations such as fever, bulbar nonexudative conjunctival injection, desquamation of the fingers, and coronary artery aneurysm. KD symptoms improved after three doses of intravenous immunoglobulin plus cyclosporine. However, small coronary aneurysms were present at the time of discharge. In a retrospective analysis, no pathogens were detected by multiplex real-time PCR in samples collected at admission, and the serum cytokine profile demonstrated prominent elevation of IL-6 as well as elevation of neopterin, sTNF-RI, and sTNF-RII, which suggested KD. Conclusions The patient’s entire clinical course, including the severe pneumonia, was caused by KD. As in this case, neonatal KD may exhibit atypical manifestations such as severe pneumonia requiring mechanical ventilation.

2.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-305037

ABSTRACT

Background: School closures are a subject of debate during the present coronavirus disease 2019 (COVID-19) pandemic. Because children are not the main driver of COVID-19 transmission in the community, school education must be prioritized in conjunction with appropriate infection prevention and control measures, as determined by local COVID-19 incidence.Methods: We investigated causes and transmission routes of a primary school cluster of COVID-19 that occurred during November and December 2020 in Niigata, Japan.Findings: In the cluster, the virus spread among teachers, then from teachers to students, and then to their family members. This primary school cluster comprised 26 infected patients and included teachers (13/33, 39%), students (9/211, 4%), and family members (4/65, 6%). The secondary attack rate from the three index teachers to the remaining 30 teachers was 33%;however, the rate to students was only 4%. Factors contributing to cluster formation include the fact that two of the index teachers continued working while symptomatic and that the environment and infection prevention measures in the teachers’ room were inadequate.Interpretation: To open schools safely and without interruption, adequate measures to prevent COVID-19 infection in schools should be emphasized not only for children but also for teachers and their work environment.Funding Information: Health and Labour Sciences Research Grants (20CA2035).Declaration of Interests: The authors have no competing interests to declare.Ethics Approval Statement: Because COVID-19 is designated as an infectious disease by the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases Act, investigations of outbreaks and contact tracing are led by the public health service of health centres, under the authority of the Department of Health and Welfare, Niigata Prefectural Office. We used anonymous and public data;thus, the requirement for informed consent was waived for this study. This study was approved by the Ethics Committee of Niigata University (2020-0499).

3.
Pediatr Infect Dis J ; 41(3): e90-e92, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1684867

ABSTRACT

Incidences of community-acquired infectious diseases other than COVID-19 decreased during the coronavirus disease 2019 pandemic; however, exanthema subitum incidence before (2016-2019) and during the pandemic (2020) in Niigata, Japan, did not substantially differ, although the proportion of age less than 1-year-old was lower in 2020. These findings suggest that exanthema subitum is transmitted mainly among family members, not in the community.


Subject(s)
COVID-19/epidemiology , Exanthema Subitum/epidemiology , Adolescent , Child , Child, Preschool , Female , Humans , Incidence , Infant , Japan/epidemiology , Male , Pandemics , Retrospective Studies , SARS-CoV-2 , Sentinel Surveillance
4.
Pediatr Infect Dis J ; 40(11): e418-e423, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1494050

ABSTRACT

BACKGROUND: School closures are a subject of debate during the present coronavirus disease 2019 (COVID-19) pandemic. Because children are not the main driver of COVID-19 transmission in the community, school education must be prioritized in conjunction with appropriate infection prevention and control measures, as determined by local COVID-19 incidence. METHODS: We investigated the causes and transmission routes of a primary school cluster of COVID-19 that occurred during November and December 2020 in Niigata, Japan. RESULTS: In the cluster, the virus spread among teachers, then from teachers to students, and then to their family members. This primary school cluster comprised 26 infected patients and included teachers (13/33, 39%), students (9/211, 4%), and family members (4/65, 6%). The secondary attack rate from the 3 index teachers to the remaining 30 teachers was 33%; however, the rate to students was only 4%. Factors contributing to cluster formation include the fact that 2 of the index teachers continued working while symptomatic and that the environment and infection prevention measures in the teachers' room were inadequate. CONCLUSIONS: To open schools safely and without interruption, adequate measures to prevent COVID-19 infection in schools should be emphasized not only for children but also for teachers and their environment.


Subject(s)
COVID-19/epidemiology , COVID-19/virology , Disease Outbreaks , SARS-CoV-2 , School Teachers , Schools , Adolescent , Adult , Aged , COVID-19/diagnosis , COVID-19/transmission , Child , Female , Humans , Incidence , Japan/epidemiology , Male , Middle Aged , Public Health Surveillance , Young Adult
5.
Vaccine ; 39(29): 4006-4012, 2021 06 29.
Article in English | MEDLINE | ID: covidwho-1240643

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has greatly affected daily life. COVID-19 often causes asymptomatic or mild disease in children; however, delayed routine childhood immunization is a concern, as it could increase the risk of vaccine-preventable disease. No study has evaluated the status of childhood vaccinations in Japan during the COVID-19 pandemic. METHODS: This retrospective observational study evaluated the number of vaccine doses administered to children in 4 Japanese cities (2 cities in the Tokyo metropolitan area and 2 cities far from Tokyo) during the period from 2016 to 2020. Vaccine doses administered between January and September 2020 during the COVID-19 pandemic were compared, by month, with those given during 2016-2019. Age-stratified demographic data were collected to determine whether factors other than change in the child population over time affected vaccination trends. RESULTS: In all cities the decrease in vaccine doses administered was most apparent in March and April 2020, i.e., just before or coincident with the declaration of a nationwide COVID-19 emergency on April 7, 2020. The decrease started as early as February in the Tokyo metropolitan area. As child age increased, the decrease became more apparent. Before the lift of national emergency on May 25, catch-up of the vaccination was observed in all age groups in all cities. Vaccine doses persistently increased in older age groups but not in infants. The overall vaccination trends did not differ significantly among the 4 cities. CONCLUSIONS: The COVID-19 pandemic significantly affected routine childhood immunization in Japan. Thus, a nationwide electronic surveillance system and announcements for guardians to encourage timely routine immunization are warranted.


Subject(s)
COVID-19 , Pandemics , Aged , Child , Humans , Immunization Programs , Infant , Japan/epidemiology , SARS-CoV-2 , Vaccination
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