The importance of vaccination during pregnancy lies not only in directly protecting vaccinated women, but also by indirectly protecting small infants during the first few months of life. Vaccination against the flu and whooping cough is a priority within the comprehensive care strategy for pregnant women and small infants in Argentina, in the context of transitioning from child vaccination to family vaccination. In 2011, the flu vaccine was included in the National Immunization Schedule (NIS) as mandatory and free of charge, with the aim of decreasing complications and death due to influenza in the at-risk population in Argentina. The national vaccination coverage attained in pregnant women in the past 4 years (2011-2014) has been satisfactory; 88% coverage was attained in the year this program was introduced to the schedule. In the following years, coverage was maintained at greater than 95%. In February 2012, Argentina became the first country in Latin America to have universal vaccination strategy for pregnant women against whooping cough. This recommendation was implemented throughout the country by vaccination with the diphtheria toxoid, tetanus toxoid, and acellular pertussis (Tdap) vaccine starting at 20 weeks of pregnancy, with the aim of decreasing morbimortality due to whooping cough in infants under 6 months of age. The vaccine was incorporated into the NIS in 2014. More than 1,200,000 doses were applied in this period. Both vaccines showed a suitable safety profile and no serious events were reported. Argentina is an example of a middle-income country that has been able to implement a successful strategy for primary prevention through vaccines, making it a health policy.

Women who received a TdapV during pregnancy had significantly a higher serum/cord IgG-PT concentration at birth than mothers who did not receive a TdapV. Timing of the immunization was not correlated with antibody concentrations. Infants born to immunized mothers had significantly higher antibody levels during their first 2 months of life.

RESUMENLa forma infantil de la enfermedad de Pompe conduce al óbito antes del año de vida por miocardiopatía o insuficiencia ventilatoria. Presentamos la experiencia de siete años de terapia de reemplazo enzimático en un niño diagnosticado a los 7 días de vida; se trata del seguimiento más prolongado en el país. El tratamiento fue bien tolerado, sin reacciones adversas asociadas. Los parámetros ecocardiográficos y electrocardiográ-ficos se normalizaron progresivamente en el primer año y se mantuvieron estables. El niño logró rolar y sentarse sin sostén, pautas que se perdieron a partir del tercer año. Ingresó en respirador a los 16 meses. Se mantiene vivo con 7 años de edad, con debilidad muscular generalizada grave. El niño superó notablemente la edad promedio de sobrevida y de ingreso a respirador. Fue clara la mejoría cardíaca, pero el beneficio sobre el músculo esquelético fue limitado. Palabras clave: enfermedad de Pompe, terapia de reemplazo enzimático, alfa-glucosidasa ácida, Argentina, Myozyme ® . SUMMARYThe infantile form of Pompe disease drives children to death before the first year of life due to cardiomyopathy and respiratory insufficiency. We present the seven-year follow-up experience with enzyme replacement therapy on a child with Pompe disease, being the longest follow-up in the country. The treatment was well tolerated without adverse reactions. The echocardiographic and electrocardiographic parameters clearly improved during the first year and remain stable. Motor milestones (like rolling over or sitting down without support) were initially achieved, but, after the third year were getting lost. The average age of ventilator dependence was also delayed (16 months). The 7-year old patient remains alive with severe generalized muscle weakness. The child notably overcame the average age of survival and onset of ventilator dependence. Although the cardiovascular improvement was clear, enzyme replacement therapy efficacy on skeletal muscle was limited in this patient. La forma infantil de la enfermedad de Pompe se caracteriza por hipotonía, debilidad muscular y miocardiopatía, aunque también se aprecia dificultad para alimentarse, retraso motor, hepatomegalia y dificultad respiratoria. Generalmente, estos niños mueren antes del año de vida 3,4 por fallo cardiorrespiratorio. 5El mayor avance en el tratamiento de la enfermedad de Pompe fue el desarrollo de la terapia de reemplazo enzimático, que consiste en realizar infusiones periódicas de alfa-glucosidasa ácida humana recombinante.El objetivo del presente artículo es presentar la experiencia de siete años de seguimiento de un niño con enfermedad de Pompe infantil, en tratamiento con terapia de reemplazo enzimático. CASO CLÍNICOPrimer hijo de padres no cosanguíneos, nacido de término. A los 5 días presentó cianosis peribucal, palidez, hipotonía y bradicardia, por lo que ingresó a cuidados intensivos neonatales. El electrocardiograma presentó intervalo PR acortado y complejos QRS gigantes. El ecocardiograma mostró miocardiopatía hipertrófica no obstru...

Introduction. In Argentina, an estimated 400 000 varicella cases occur annually. Given the under-recording of existing cases, the actual burden of disease is unknown. Objective. To assess the burden of varicella before the introduction of the varicella vaccine in the national immunization schedule. Materials and methods. Retrospective, analytical, observational study carried out in three hospitals of Argentina. Review of medical records from outpatient visits to the Emergency Department and from patients younger than 18 years hospitalized for varicella. Period: 1/2011-12/2013. Results. A total of 382 782 outpatients were seen; 3367 (0.88 %) corresponded to visits due to varicella; 57.6 % were ≤ 4 years old. A total of 164 (4.9 %) patients required hospitalization, with an overall hospitalization rate of 65.3/10 000 hospitalized patients/year (95 % confidence interval [CI]: 55.4-76.5); hospitalization rate in healthy children: 57.2/10 000 (95 % CI: 67.7-48.0); median age: 31.5 months. The most common causes of hospitalization were skin and/or soft tissue infections (61.1 %) and respiratory infections (10.1 %). Also, 54.3 % were treated with acyclovir and 73.1 %, with antibiotics. Bacteremia developed in 5/67 patients (7.5 %), all cases were caused by Gram-positive cocci and occurred in immunocompetent patients. Out of 19 immunocompromised patients, 36.8 % had complications (5 skin and/or soft tissue infection and 2 pneumonia cases). The median length of stay was 4 days, which is significantly more prolonged in immunocompromised patients. One patient required intensive care. No patient died. Conclusion. The burden of disease was significant, with a considerable impact in patients without an underlying disease.