Introduction
The epidemic of coronavirus disease 2019 (COVID-19) rapidly spread worldwide, and the various infection control measures have a significant influence on the spread of many infectious diseases. However, there have been no multicenter studies on how the number of hospitalized children with various infectious diseases changed before and after the outbreak of COVID-19 in Japan.
Methods
We conducted a multicenter, prospective survey for hospitalized pediatric patients in 18 hospitals in Hokkaido Prefecture, Japan, from July 2019 to February 2021. We defined July 2019 to February 2020 as pre-COVID-19, and July 2020 to February 2021 as post-COVID-19. We surveyed various infectious diseases by sex and age.
Results
In total, 5,300 patients were hospitalized during the study period. The number of patients decreased from 4,266 in the pre-COVID-19 period to 701 (16.4%) post-COVID-19. Patients with influenza and RSV decreased from 308 and 795 pre-COVID-19 to zero and three (0.4%) post-COVID-19. However, patients with adenovirus (respiratory infection) only decreased to 60.9% (46 to 28) of pre-COVID levels. Patients with rotavirus, norovirus, and adenovirus gastroenteritis decreased markedly post-COVID-19 to 2.6% (38 to 1), 27.8% (97 to 27) and 13.5% (37 to 5). The number of patients with UTIs was similar across the two periods (109 and 90). KD patients decreased to 31.7% (161 to 51) post-COVID-19.
Conclusions
We suggest that current infection control measures for COVID-19 such as wearing masks, washing hands, and disinfecting hands with alcohol are effective against various infectious diseases. However, these effects vary by disease.
Background:
Many reports have reported a reduction in respiratory infectious diseases and infectious gastroenteritis immediately after the coronavirus disease 2019 (COVID-19) pandemic, but data continuing into 2022 are very limited. We sought to understand the current situation of various infectious diseases among children in Japan as of July 2022 to improve public health in the post-COVID-19 era.
Methods:
We collected data on children hospitalized with infectious diseases in 18 hospitals in Japan from July 2019 to June 2022.
Results:
In total, 3417 patients were hospitalized during the study period. Respiratory syncytial virus decreased drastically after COVID-19 spread in early 2020, and few patients were hospitalized for it from April 2020 to March 2021. However, an unexpected out-of-season re-emergence of respiratory syncytial virus was observed in August 2021 (50 patients per week), particularly prominent among older children 3–6 years old. A large epidemic of delayed norovirus gastroenteritis was observed in April 2021, suggesting that the nonpharmaceutical interventions for COVID-19 are less effective against norovirus. However, influenza, human metapneumovirus, Mycoplasma pneumoniae, and rotavirus gastroenteritis were rarely seen for more than 2 years.
Conclusions:
The incidence patterns of various infectious diseases in Japan have changed markedly since the beginning of the COVID-19 pandemic to the present. The epidemic pattern in the post-COVID-19 era is unpredictable and will require continued careful surveillance.
We report on a 15-year-old Japanese female patient with hypotonia and global developmental delay from the neonatal period who was revealed to carry a known pathogenic PURA variant (NM_005859.5:c.697_699del, p.Phe233del) by whole-exome sequencing. She had previously unreported clinical features, including a rectovestibular fistula, extremely short stature, and underweight, expanding the known phenotype of PURA syndrome.
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Neonatal diabetes mellitus (NDM) is a rare metabolic disorder that is mainly present in
the first 6 months of life and necessitates insulin treatment. Sensor-augmented pump (SAP)
therapy has been widely used in children with type 1 diabetes mellitus, but its use in
patients with NDM is limited. We report three patients with NDM who received SAP therapy
using the MiniMed™ 640G system starting in the neonatal period. Two patients were treated
for 3 months, and one patient continued treatment up to an age of 22 mo. The MiniMed 640G
system can automatically suspend insulin delivery (SmartGuard™ Technology) to avoid
hypoglycemia when the sensor glucose level is predicted to approach the predefined
threshold. We suggest that SmartGuard Technology is particularly useful for infants in
whom hypoglycemia cannot be identified. The MiniMed 640G system automatically records the
trends of sensor glucose levels and the total daily dose of insulin, which can make the
management more accurate and reduce the family’s effort. SAP therapy for patients with NDM
automatically prevents severe hypoglycemia and is useful for long-term management;
however, attention should be paid to its application.
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