National calendar of preventive vaccinations: present and future

In the context of a pandemic of a new coronavirus infection, vaccine prophylaxis within the framework of the National Calendar of Preventive Vaccinations (NCPV) is an absolute priority in the fight against infectious diseases. The lecture presents the structure and features of the NCPV, the main directions of its improvement, information on the priority infections for vaccination. The strategy of immunization throughout life, which guarantees the creation of maximum protection against infections and preservation of the optimal level of health of people without age restrictions, is considered. Information is provided on approaches to vaccination of various patient populations against new coronavirus, pertussis, pneumococcal, and rotavirus infections. The presented lecture materials can be useful both to medical students and doctors of various specialties (infectious disease specialists, pediatricians, epidemiologists, bacteriologists).Copyright © 2022 by the authors.

Dynamics of the frequency of hospitalizations of children under 5 years of age with rotavirus infection in the absence of universal vaccination against rotavirus (15-year follow-up)

Purpose - to monitor the dynamics of the frequency of hospitalization of children under 5 years of age with rotavirus infection during 15 years in the absence of universal vaccination and to determine the burden of rotavirus infection and the feasibility of introducing a rotavirus vaccine into the National Vaccination Calendar. Materials and methods. Active surveillance of rotavirus infection among hospitalized children under 5 years of age was conducted according to a standard protocol prepared by WHO for the global rotavirus infection surveillance network. A comparison was made of the frequency of hospitalization of children under 5 years of age with rotavirus acute gastroenteritis (AGE) by sentinel years. Stool samples were collected within 2 days of hospitalization and sent to the virology laboratory for testing. Detection of rotavirus was carried out using ELISA. Genotyping of rotaviruses was carried out in WHO laboratories by the method of multiplex RT-PCR. Results. During 15 years (2007-2021) of observation, there were 7,821 children underthe age of 5 who were hospitalized in connection with an acute intestinal infection at the Kyiv Surveillance Center. Rotavirus infection was determined in 3387 children (43.3%). A consistently high frequency of hospitalizations with rotavirus AGE was observed with a slight downward trend over the years (from 50-75% in the first years to 33-39% in 2018-2019). In 2021 (the 15thyear of observation), the average annual frequency of rotavirus AGE decreased even more significantly and amounted to 21 % (a 61 % decrease compared to the first years of oPservation). The unexpected decrease in the frequency of rotavirus diarrhea among hospitalized children in the 15thyear of observation in the absence of universal vaccination against rotavirus is difficult to explain. A number of factors could have contributed to the above-mentioned decrease, the most likely of which could be the coincidence in time with the endemic of COVID-19, in which anti-ebidemic measures are similar to those for intestinal infections. While the average annual freguency of hospitalizations with rotavirus infection decreased, the frequency of hospitalizations remained high in certain months of the year, starting from January to June, which increased the Purden on inpatients in certain, mostly cold, months of the year. Further active monitoring of rotavirus infection is necessary to definitively resolve the issue of whether the decrease in the frequency of rotavirus infection by the 15thyear is temporary or is a natural course of the epidemic process and will continue to occur. Conclusions. In Ukraine, in the absence of universal vaccination against rotavirus, during the 15-year (2007-2021) observation period, a consistently high frequency of rotavirus infection was noted among hospitalized children under 5 years of age with AGE, with a slight downward trend overthe years. In the 15thyear of follow-up (2021), there was an unusual decline in the proportion of rotavirus infection among hospitalized children, which may have been contributed to by a number of factors, the most likely of which could be the coincidence in the period with the COVID-19 epidemic, in which anti-epidemic measures are similar to those for intestinal infections. Even with a decrease in the average annual frequency of rotavirus AGE in the 15thyear of observation, a consistently high rate of hospitalization with rotavirus gastroenteritis remains in certain months of the year, which increases the burden on inpatients. The significant burden of rotavirus infection among children under the age of 5 years old determines the expediency of including the rotavirus vaccine in the National Vaccination Calendar of Ukraine. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. © 2022 The authors

Diagnostic and therapeutic challenges in SARS-CoV-2 and Rotavirus coinfection

The SARS-CoV-2 infection in children associates multiple challenges related especially to the diagnosis due to the lack of symptoms or due to the polymorph clinical picture that might occur in these children, and which can often mimic a wider spectrum of pathologies. The Rotavirus infection is one of the most common etiologies of acute gas-troenteritis in children which might result in increased mortality rates in small ages or in patients at risk. We report the case of a 2-month-old male infant, without significant personal history admitted to the Pediatrics Clinic 1, COVID Compartment, Targu-Mures, for vomiting, loss of appetite, and diarrhea. The family history revealed that the paternal grandfather was confirmed with SARS-CoV-2 infection. Based on the patient's symptoms and an-amnesis, he was tested and confirmed with SARS-CoV-2 by RT-PCR. The stool viral antigens confirmed also Rotavirus infection. The clinical exam at the time of admission pointed out influenced general status, diminished cutaneous turgor, abdominal tenderness at palpation and accelerated bowel movements. The laboratory tests revealed severe dehydration associated with positive inflammatory biomarkers. Taking into account the small age, the presence of coinfection and the severe dehydration, we initiated supportive treatment with rehydration solutions by vein, antibiotics, anticoagulant and symptomatic treatment. The patient's evolution was favorable with the previously mentioned treatment. The early diagnosis of a possible coinfection in pediatric ages represents the cornerstone in preventing potential complications. © 2022, Amaltea Medical Publishing House. All rights reserved.