The Continued Threat of Influenza A Viruses

Seasonal IAV was responsible for an average of 12,000–52,000 deaths annually between 2010 and 2020 in the U.S. before the onset of the COVID-19 pandemic, according to the Centers for Disease Control and Prevention, with preventive measures addressing the latter respiratory infection also reducing the impact of seasonal influenza. The H7N9 hemagglutinin shows limited binding to human receptors;however, if a single amino acid mutation occurs, this would result in structural changes within the receptor binding site that allow extensive binding to human receptors present in the upper respiratory tract [15]. [...]persons born after 1968 are expected to have little or no immunity to an H2N2 virus. The impact of the waterfowl avian flyways, even in this era of extensive global airline traffic, should not be underestimated, as illustrated by the delivery of highly pathogenic Eurasian avian H5N1 virus to commercial and backyard avian flocks in multiple states currently, in 2022, resulting in culling of flocks and, of course, potential risk of transmission to humans, as noted above.

Children Lagging with COVID-19 Vaccination.

Children account for a growing share of coronavirus disease 2019 (COVID-19) infections in the United States. Since the widespread availability of COVID-19 vaccine in adults, there has been an upward trend of cases in children, accounting for approximately 20% of the weekly new cases. The majority (38.3%) reported in high school students age 14 to 17 years. Children are also at risk of a postinflammatory condition, known as multisystem inflammatory syndrome in children, after COVID-19. In addition, infected children could transmit the virus to vulnerable adults, contributing to ongoing pandemic. We believe that children need to be vaccinated against COVID-19 and review the available evidence. [Pediatr Ann. 2022;51(5):e180-e185.].

Diurnal Temperature Variation: Addressing Once-Daily Nighttime Fevers in the Era of COVID-19.

Pediatric patients with "once-daily" fevers are often referred to pediatric infectious disease specialists for evaluation. Often, these fevers occur at nighttime in the absence of additional symptoms and come to the caregiver's attention after a viral illness. It is crucial for caregivers and providers to be able to define and measure fever accurately when trying to ascertain the true etiology of this clinical picture. Fever education is critical in providing reassurance to parents, and fever diaries should be encouraged. In a well-appearing child without any additional symptoms, at least a percentage of these fevers can be explained by normal diurnal variation of temperature. [Pediatr Ann. 2022;51(5):e202-e205.].

An Overview of the Ongoing Clinical Issues of COVID-19.

Childhood cases of coronavirus disease 2019 (COVID-19) are on the rise as the pandemic continues to rage across the globe. Most children acquire infection from an adult household member. Children may stay asymptomatic, have a pre-symptomatic stage, or present with symptoms (fever, cough, and difficulty breathing being the most common). Nearly one-third of the pediatric cases (32%) in the United States occurred in children age 15 to 17 years. Children are also at risk of a postinfectious hyperinflammatory syndrome called multisystem inflammatory syndrome in children (MIS-C). The risk of vertical transmission is low (2%) in newborns of mothers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Nucleic acid amplification testing (NAAT) is the gold standard for (SARS-CoV-2). Serology should be considered in a child with high clinical suspicion for COVID-19 when NAAT is negative and at least 2 weeks have passed since symptom onset and for assessment of MIS-C. Easy fatigability after COVID-19 infection is reported in adults; however, data in children are lacking. Implementation of early and robust containment strategies coupled with universal COVID-19 vaccination are vital to halt the spread. [Pediatr Ann. 2021;50(2):e84-e89.].

Multisystem inflammatory syndrome in children associated with COVID-19

Department of Pediatrics, New York University (NYU) Winthrop Hospital, and professor of Pediatrics at NYU Long Island School of Medicine, Mineola, New York. Since the first report of an outbreak of respiratory disease in Wuhan, China, in December 2019 caused by a novel coronavirus (SARS CoV2), coronavirus disease (COVID-19) has reached pandemic proportions. The Centers for Disease Control and Prevention (CDC) established the following definition for MIS-C:3 * An individual aged 21 years and younger with fever for 1 or more days, laboratory evidence of inflammation, and illness requiring hospitalization with multisystem (2 or more) organ involvement (cardiac, renal, hematologic, gastrointestinal, dermatologic, neurologic), AND * No alternative plausible diagnosis, AND * Evidence of current or recent SARS-CoV-2 infection by reverse transcription polymerase chain reaction (RT-PCR), serology or antigen test, or exposure to a suspected or confirmed COVID-19 case within the 4 weeks prior to the onset of symptoms. Ripha-gen and colleagues described 8 previously healthy children aged 4 to 14 years from Evelina London Children's Hospital who presented with hyperinflammatory shock and features similar to atypical Kawasaki disease (KD), KD shock syndrome (KDSS), or toxic shock syndrome (TSS) in mid-April 2020.4 Of the 8 cases, 6 were children of African-Caribbean descent, most were teenagers, and 5 were males. A series of 10 children aged 3 to 16 years (mostly teenagers) from Bergamo, Italy, presenting between February 18 and April 20, 2020, with what the authors labeled as severe Kawasaki-like disease was published in the Lancet on May 13, 2020.5 By definition, these children met the 2017 American Heart Association criteria for KD or incomplete KD with 5 or more days of fever, compatible rash, and mucous membrane findings, but the overall picture was not consistent with classic KD.