Flaccid paralysis of the limbs after an asthmatic attack.

Acute exacerbations of asthma are common in children, but limb weakness after such exacerbations is very unusual. Hopkins' syndrome, a poliomyelitis-like illness associated with asthma, is seldom reported in the literature. We describe a child with weakness of the lower limbs after an asthmatic attack. The clinical profile, possible pathogenesis, and treatment of Hopkins' syndrome are discussed.

Hospital-based study of the economic burden associated with rotavirus diarrhea in Hong Kong.

BACKGROUND: Rotavirus infection is the most common cause of severe diarrhea in both developed and developing countries. METHODS: To estimate the economic burden associated with rotavirus infection in Hong Kong, we combined data on the disease burden of rotavirus-associated hospital admissions with detailed cost data for a subsample of 471 children with diarrhea admitted to hospitals. RESULTS: The annual total social cost and total direct medical cost for rotavirus-associated admissions were calculated as 4.3 US dollars and 4 million US dollars, respectively, by use of data collected during March 2001 to March 2003. The estimate of the direct medical costs was approximately 4-fold higher than a previous estimate; this difference largely reflects the greater disease burden identified through active disease surveillance conducted under the auspices of the Asian Rotavirus Surveillance Network. On average, families spent 120 US dollars when their child's admission was associated with rotavirus infection; this cost represents approximately 10% of the monthly salary of an unskilled or service worker. CONCLUSIONS: These data emphasize the potential for a safe and effective rotavirus vaccine to reduce the economic burden associated with rotavirus disease.

Estimates of rotavirus disease burden in Hong Kong: hospital-based surveillance.

BACKGROUND: We conducted prospective, hospital-based surveillance for rotavirus disease for a 2-year period at 4 of 12 public government (Hospital Authority [HA]) hospitals in Hong Kong. It has been estimated that HA hospitals provide 90% of inpatient care in Hong Kong. METHODS: Information was collected for children <5 years old who had a primary or secondary diagnosis of diarrhea or for whom a stool sample was tested for the presence of rotavirus (by enzyme immunoassay) or bacteria (by culture). Surveillance data were compared with routine discharge information from the HA's computerized Clinical Management System (CMS). RESULTS: During a 2-year period (1 April 2001 through 31 March 2003), 7391 children were admitted to the hospital with diarrhea or developed diarrhea during their hospital stay. Of these children, 5881 (80%) had a stool sample tested for the presence of rotavirus, and 30% were positive for rotavirus (representing 24% of all diarrhea-associated admissions). CMS data underreported the total percentage of diarrhea-associated admissions (15% vs. 20%) and the percentage of diarrhea-associated admissions that were the result of rotavirus infection (13% vs. 24%). Estimated rates of hospitalization for rotavirus infection (8.8 admissions/1000 children <5 years old and 18.4 admissions/1000 children <1 year old) were 4-fold higher than our previous estimates, which were determined on the basis of CMS data alone. We estimate that the cumulative risk of hospitalization with rotavirus diarrhea by age 5 years is 1 in 24. Combined active and passive (CMS) surveillance data indicate that 4.6% of all general pediatric admissions to HA hospitals in Hong Kong were associated with rotavirus infection. CONCLUSION: Our study combined passive surveillance data from all Hong Kong HA hospitals with active surveillance data from 4 sentinel hospitals. The estimates of rotavirus disease burden obtained will help emphasize the effect of this important disease and create awareness of the potential for rotavirus vaccines. The surveillance model developed could also be a powerful tool for monitoring the effect of a vaccine.