[Screening for cytomegalovirus infection in very low birth weight infants]. / Cribado de la infección por citomegalovirus en recién nacidos de muy bajo peso.

INTRODUCTION: Cytomegalovirus (CMV) is the most common congenital and acquired vertically transmitted viral infection in humans. The aim of the study is to determine the clinical relevance of this infection in very low birth weight (VLBW) infants in our area. PATIENTS AND METHOD: Preterm infants (gestational age ≤ 31 weeks) with a birth weight ≤ 1500g treated between March 2006 and December 2010 were included. They underwent the screening protocol for diagnosing CMV infection. CMV serology was performed on the mothers. When it was positive, their breast milk was frozen at -20°C for 72hours from the 7th day of birth. At 5 weeks, the urine of the newborn was tested for CMV-DNA. In case of a positive result, CMV-DNA was performed in breast milk and in the dry blood sample from metabolic screening. RESULTS: A total of 342 preterm infants were studied, with 53 (15.5%) infected by CMV: 8 (2.3%) with congenital infection, 35 (10.2%) with acquired infection, and 10 (2.9%) in which it was impossible to determine precisely. IgM-CMV+in the mother was found in two congenital infections and two acquired infections. Newborns affected by congenital CMV infection showed a lower birth weight, more intrauterine growth restriction, thrombopenia, need for platelet transfusions, early sepsis (including clinical sepsis), and cerebral ultrasound anomalies. Late sepsis was more frequent in cases of acquired CMV infection. CONCLUSIONS: Congenital or acquired CMV infections are frequent in VLBW infants, and our protocol enables them to be diagnosed and probably prevents some acquired CMV infections by selecting which patients should freeze the breast milk.

[Clinical and epidemiological characteristics of influenza A virus infection in children aged less than 7 years old in primary care]. / Aspectos clínico-epidemiológicos de la infección por virus de la gripe A en menores de 7 años en atención primaria.

INTRODUCTION: The aim of this study was to describe the clinical and epidemiological features of confirmed influenza A virus infection in patients aged less than 7 years old. PATIENTS AND METHODS: We performed a retrospective, descriptive study of the clinical and epidemiological features of influenza A virus infection in patients aged less than 7 years old attending three primary care centers during the 2003-2004 influenza season. Patients with influenza A infection confirmed by immunofluorescence, cell culture, or polymerase chain reaction were interviewed to obtain clinical and epidemiological data on their disease. RESULTS: Influenza A virus was detected in 47 patients aged between 5 months and 7 years (mean: 37.3 +/- 5.7 months). Of these, 35 children (74.4 %) were aged between 0 and 4 years. The most frequent symptoms were fever (100 %), cough (95.7 %), and rhinorrhea (76.6 %). Gastrointestinal symptoms were present in 40.4 % of the patients. The mean duration of fever was 5.2 +/- 1.8 days (range 2-8). Complications occurred in nine patients (19.2 %). The frequency of influenza-like disease in parents was 9.1 % (8/88) at diagnosis of the index case and was 23.9 % (21/88) immediately after the episode in the child (p 5 0.01). The mean number of days of absence from school was 7.5 +/- 3.6 days. CONCLUSIONS: The mean age of our patients confirms that influenza is a frequent disease in infancy and childhood. The results demonstrate that the infection is transmitted from children to parents in the household setting, since the frequency of influenza-like symptoms in adults increases after influenza episodes in children.