No abstract

Take home message (max 256 characters, including spaces): Cloth masks are a simple, economic and sustainable alternative to surgical mask as a means of source control of SARS-CoV-2 for general community.Running title: Face masks for success against COVID-19.

In most countries, attempts to reduce severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) circulation and new coronavirus disease 2019 (COVID-19) development have been mainly based on restrictive measures, including the avoidance of social interactions, the prohibition of movements within the national territory, and the closureofallnonessentialactivities,includingschools.While the closure of factories and the avoidance of other social interaction together with proper hand washing remain the best measures to reduce the total burden of COVID-19, the usefulness of school closure can be debated.It is highly likely that the most important reason leadinggovernmentstocloseschoolswastheevidencethatthe early introduction of this restrictive measure had been effective in reducing influenza incidence rates and related clinical,social,andeconomicproblemsduringbothseasonal and pandemic influenza outbreaks. 1 However, it is not at all certain that the same advantages can be expected in the case of the COVID-19 pandemic. It is even possible that schoolclosuremayhavenegativeeffectsandleadtogreater medical, economic, and social problems. Modeling studies seem to indicate that school closure can be significantly effective for infection control only when the outbreaks are due to viruses with low transmissibility and attack rates are higher in children than in adults. This applies to influenza viruses and influenza infection but does not seem valid for coronaviruses,includingSARS-CoV-2,whichhavedifferent transmission dynamics, or for COVID-19, which affects mainlyadultsandelderlyindividuals.Ithasbeencalculated that the expected number of cases directly generated by 1 case of SARS-CoV-2 infection (R 0 ) is high and not lower than 2.5. 2 Moreover, children younger than 10 years account for only 1% of COVID-19 cases, 3 and although a certain number of them can experience an asymptomatic infection, the total number of children with SARS-CoV-2 infection seems lower than expected. Although no official data are available, to our knowledge, on the effectiveness of school closure during the COVID-19 epidemic, the poor relevance of this restrictive measure seems confirmed by the evidence that in Taiwan, the spread of COVID-19 was minimized without widespread planned school closures. 4 On the other hand, using UK population and school data together with data on SARS-CoV-2 transmission dynamics calculated in the early COVID-19 pandemic in China, it was predicted that school closure would be insufficient to mitigatethepandemic.Finally,thepooreffectofschoolclosure during coronavirus epidemics has already been evidenced in some studies carried out during the SARS epidemic. In China,itwasfoundthatschoolclosurefor2monthswasnot significantlyeffectivefordiseasepreventionmainlybecause of the very low incidence of symptomatic disease among school-aged children. 5 Moreover, in Taiwan, it was evidenced that the risk of transmission of infection among

The specificity of H1N1 antibody responses can be shifted to epitopes near the HA receptor–binding domain after sequential infections with viral strains that share homology in this region.

Bacteriophages (BPs) are viruses that can infect and kill bacteria without any negative effect on human or animal cells. For this reason, it is supposed that they can be used, alone or in combination with antibiotics, to treat bacterial infections. In this narrative review, the advantages and limitations of BPs for use in humans will be discussed. PubMed was used to search for all of the studies published from January 2008 to December 2018 using the key words: “BPs” or “phages” and “bacterial infection” or “antibiotic” or “infectious diseases.” More than 100 articles were found, but only those published in English or providing evidence-based data were included in the evaluation. Literature review showed that the rapid rise of multi-drug-resistant bacteria worldwide coupled with a decline in the development and production of novel antibacterial agents have led scientists to consider BPs for treatment of bacterial infection. Use of BPs to overcome the problem of increasing bacterial resistance to antibiotics is attractive, and some research data seem to indicate that it might be a rational measure. However, present knowledge seems insufficient to allow the use of BPs for this purpose. To date, the problem of how to prepare the formulations for clinical use and how to avoid or limit the risk of emergence of bacterial resistance through the transmission of genetic material are not completely solved problems. Further studies specifically devoted to solve these problems are needed before BPs can be used in humans.

Our results suggest that there is a strong and long term relationship between exposure to large numbers of children in the first years of life and nasopharyngeal carriage of all respiratory pathogens. In addition antimicrobial restrictive guidelines should be tailored to local microbiologic sceneries.

In children, infectious discitis (D) and infectious spondylodiscitis (SD) are rare diseases that can cause significant clinical problems, including spinal deformities and segmental instabilities. Moreover, when the infection spreads into the spinal channel, D and SD can cause devastating neurologic complications. Early diagnosis and treatment may reduce these risks. The main aim of this paper is to discuss recent concepts regarding the epidemiology, microbiology, clinical presentation, diagnosis, and treatment of pediatric D and SD. It is highlighted that particular attention must be paid to the identification of the causative infectious agent and its sensitivity to antibiotics, remembering that traditional culture frequently leads to negative results and modern molecular methods can significantly increase the detection rate. Several different bacterial pathogens can cause D and SD, and, in some cases, particularly those due to Staphylococcus aureus, Kingella kingae, Mycobacterium tuberculosis, Brucella spp., the appropriate choice of drug is critical to achieve cure.

In order to evaluate the role of Mycoplasma pneumoniae and Chlamydia pneumoniae, we studied 613 children aged 2-14 years who were hospitalized for community-acquired lower respiratory tract infections (LRTIs). The patients were enrolled in the study by 21 centers in different regions of Italy from May 1998 through April 1999. Paired serum samples were obtained on admission and after 4-6 weeks to assay the titers of M. pneumoniae and C. pneumoniae antibodies. Nasopharyngeal aspirates for the detection of M. pneumoniae and C. pneumoniae were obtained on admission. Acute M. pneumoniae infections in 210 patients (34.3%) and acute C. pneumoniae infections in 87 (14.1%) were diagnosed. Fifteen of the 18 children with M. pneumoniae and/or C. pneumoniae infections whose treatments were considered clinical failures 4-6 weeks after enrollment had not been treated with macrolides. Our study confirms that M. pneumoniae and/or C. pneumoniae plays a significant role in community-acquired LRTIs in children of all ages and that such infections have a more complicated course when not treated with adequate antimicrobial agents.