Kawasaki Disease in Children and Pediatric Multisystem Inflammatory Syndrome Associated with SARS-CoV-2 During the Pandemic (Clinical Lecture).

The article presents modern data about Kawasaki disease, which is a genetically determined systemic vasculitis with damage to the coronary arteries and multisystem manifestations. The etiology is not fully understood, but there is considered a possible role of viruses in the initiation of the aggravated immune response with possible development of macrophage activation syndromes and shock, which can lead to death. There are difficulties in diagnosing Kawasaki disease due to a variety of symptoms that are typical for a lot of infectious and autoimmune diseases (scarlet fever, measles, yersiniosis, systemic juvenile idiopathic arthritis). Early diagnosis and treatment (in the first 10 days of illness) using high doses of intravenous immunoglobulin and aspirin are associated with a low risk of development of coronary aneurysms and other complications. The authors also presented the data on the characteristics of severe Kawasaki-like diseases, which were recorded in several countries of Europe and America at the peak of the COVID-19 pandemic, and diagnostic criteria for the pediatric multisystem inflammatory syndrome associated with SARS-CoV-2, proposed by the Royal College of Pediatrics and Children Health (UK).Copyright © 2020, Professionalnye Izdaniya. All rights reserved.

Kawasaki Disease in Children and Pediatric Multisystem Inflammatory Syndrome Associated with SARS-CoV-2 During the Pandemic (Clinical Lecture).

The article presents modern data about Kawasaki disease, which is a genetically determined systemic vasculitis with damage to the coronary arteries and multisystem manifestations. The etiology is not fully understood, but there is considered a possible role of viruses in the initiation of the aggravated immune response with possible development of macrophage activation syndromes and shock, which can lead to death. There are difficulties in diagnosing Kawasaki disease due to a variety of symptoms that are typical for a lot of infectious and autoimmune diseases (scarlet fever, measles, yersiniosis, systemic juvenile idiopathic arthritis). Early diagnosis and treatment (in the first 10 days of illness) using high doses of intravenous immunoglobulin and aspirin are associated with a low risk of development of coronary aneurysms and other complications. The authors also presented the data on the characteristics of severe Kawasaki-like diseases, which were recorded in several countries of Europe and America at the peak of the COVID-19 pandemic, and diagnostic criteria for the pediatric multisystem inflammatory syndrome associated with SARS-CoV-2, proposed by the Royal College of Pediatrics and Children Health (UK).Copyright © 2020, Professionalnye Izdaniya. All rights reserved.

Yersiniosis in Poland in 2018-2020.

AIM: The aim of the study was to assess the epidemiological situation of yersiniosis in Poland in 2018-2020 and compare it to previous years. MATERIAL AND METHODS: To assess the epidemiological situation of yersiniosis in Poland, data from individual case reports prepared by Sanitary Epidemiological Stations as part of routine epidemiological surveillance were used. Incidence, number of cases and data on hospitalizations by voivodship included in the bulletins "Infectious Diseases and Poisons in Poland" for 2015-2020 were also used. RESULTS: In 2018-2020, a total number of 542 cases of yersiniosis were registered, including 456 intestinal and 86 extraintestinal forms. The incidence in 2018 was 0.53/100,000 in 2019 0.59/100,000 and in 2020 0.29/100,000. The number of cases in 2020 compared to 2019 decreased by 52%, and compared to 2018 by 45.8%. The percentage of hospitalizations in each year was at a similar level of 65.5% in 2018, 62.4% in 2019, and 60% in 2020. The highest incidence was noted in the 0-4 age group at 44.7% of cases in 2018, 42.9% in 2019 and 55.6% in 2020, respectively (all cases of the intestinal form). The predominant species was Y. enterocolitica in both intestinal and extraintestinal forms. The most common serotype was serotype O:3, which was identified in 34 isolates in 2018, 43 isolates in 2019 and 9 isolates in 2020. SUMMARY AND CONCLUSIONS: Since 2009, Poland has had a decreasing trend in the incidence of yersiniosis. In 2020, both Poland and Europe saw a sharp decline in the number of cases compared to previous years. This is a result of the occurrence of the COVID-19 pandemic in March 2020, during which many measures were introduced to limit the spread of the SARS-CoV-2 virus, which may also have affected the number of other infections. Although the numbers of cases and incidence of yersiniosis among children under the age of 5 are the highest compared to other age groups, the highest number of hospitalizations was reported in the 10-19 age group, which most likely reflects the decreasing number of laboratory tests ordered on an outpatient basis with age and the significant underreporting of cases in this and older age groups.

Outbreak in African lions of Yersinia pseudotuberculosis infection, with aberrant bacterial morphology.

A concurrent outbreak of infection with Yersinia pseudotuberculosis occurred in adult captive African lions (Panthera leo). Two 17-y-old male lions and one 14-y-old female lion developed respiratory distress, lethargy, ataxia, and hyporexia. Within 3-5 d of the onset of clinical signs, one male and the female lion died and were submitted for postmortem examination. Macroscopically, the liver and spleen had multifocal-to-coalescing, semi-firm, pale-tan nodules throughout the parenchyma. The lungs were non-collapsed and marked by petechiae. Histologic examination identified lytic, necrosuppurative foci in the liver, spleen, lungs, and kidney, with abundant intralesional gram-negative coccobacilli in the male lion. Similar findings were seen in the female lion in the liver, spleen, kidney, and mesenteric lymph node; however, the intralesional bacterial colonies were more pleomorphic, comprising rod and filamentous morphologies. Aerobic bacterial culture of the liver, spleen, and lung revealed Y. pseudotuberculosis growth. The source of infection is unknown, and an epidemiologic study was performed. Sources to be considered are from the predation of rodent and/or bird reservoirs, or contaminated soil or water. Mortality associated with Y. pseudotuberculosis has been described in an African lion cub, however, to our knowledge, Y. pseudotuberculosis has not been reported in adult African lions, and this is only the second report of Y. pseudotuberculosis with aberrant bacterial morphology observed histologically.

EFSA and ECDC publishes EU One Health 2020 zoonoses report

The European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control (ECDC) have published the EU One Health 2020 Zoonoses Report. Campylobacteriosis was the most reported zoonosis in the EU in 2020, with 120,946 cases compared to more than 220,000 the previous year. This was followed by salmonellosis, which affected 52,702 people, compared to 88,000 in 2019. The number of reported foodborne outbreaks fell by 47%, with the report acknowledging the impact of the COVID-19 pandemic in the drop in reported zoonotic diseases in humans. The next most commonly reported diseases were yersiniosis, with 5,668 cases, and infections caused by Shiga toxin-producing Escherichia coli, with 4,446 cases. Listeriosis was the fifth most reported zoonosis, mainly affecting people over the age of 64. Listeriosis and West Nile virus (WNV) infections were the diseases with the highest case fatality and hospitalisation rates, with most locally acquired human infections of WNV reported in Greece, Spain and Italy. The report also monitors foodborne outbreaks in the EU, events during which at least two people contract the same illness from the same contaminated food. A total of 3,086 foodborne outbreaks were reported in 2020, with Salmonella remaining the most frequently detected agent, causing around 23% of outbreaks. The most common sources of salmonellosis outbreaks were eggs, egg products and pig meat. The report also includes data on Mycobacterium bovis, Mycobacterium caprae, Brucella, Trichinella, Echinococcus, Toxoplasma gondii, rabies, Q fever and tularaemia.