JOURNAL WATCH

https://doi.org/10.5005/jp-journals-10081-1394
Pediatric Infectious Disease
Volume 5 | Issue 2 | Year 2023

What’s New in Pediatric Emerging and Reemerging Infectious Diseases: Journal Watch

Vikram S Kumar

Department of Pediatrics, Subbaiah Medical College, Shivamogga, Karnataka, India

Corresponding Author: Vikram S Kumar, Department of Pediatrics, Subbaiah Medical College, Shivamogga, Karnataka, India, Phone: +91 9241495056, e-mail: vikramskumar@yahoo.co.in

Received on: 05 June 2023; Accepted on: 30 June 2023; Published on: 30 June 2023

How to cite this article: Kumar VS. What’s New in Pediatric Emerging and Reemerging Infectious Diseases: Journal Watch. Pediatr Inf Dis 2023;5(2):65-70.

Source of support: Nil

Conflict of interest: None

Source: Spernovasilis N, Tsiodras S, Poulakou G. Emerging and Re-emerging infectious diseases: humankind’s companions and competitors. Microorganisms 2022;10(1):98. DOI: 10.3390/microorganisms10010098

Emerging infectious diseases (EIDs) are diseases that have recently appeared in a population or are rapidly increasing in incidence or geographic range. EIDs can be caused by a variety of factors, including:

Changes in human behavior: Emerging infectious diseases (EIDs) can be caused by changes in human behavior, such as the increased consumption of wild animals, the deforestation of rainforests, and the growth of cities.

Changes in the environment: Emerging infectious diseases (EIDs) can also be caused by changes in the environment, such as climate change, the spread of invasive species, and the pollution of water and air.

Changes in the pathogen: Emerging infectious diseases (EIDs) can also be caused by changes in the pathogen itself, such as the emergence of new strains of bacteria or viruses that are more resistant to treatment.

Emerging infectious diseases (EIDs) can have a significant impact on human health and society. They can cause illness, death, and economic disruption. EIDs can also be a major source of anxiety and fear.

There are a number of things that can be done to prevent EIDs, including:

Vaccination: Vaccination is one of the most effective ways to prevent EIDs. Vaccines can protect people from a variety of diseases, including measles, mumps, rubella, polio, and influenza.

Public health measures: Public health measures, such as handwashing, sanitation, and mosquito control, can also help to prevent the spread of EIDs.

Research: Research is essential to develop new vaccines and treatments for EIDs. Research is also needed to understand the factors that contribute to the emergence of EIDs and to develop strategies for preventing them.

The COVID-19 pandemic is a reminder of the threat posed by EIDs. The pandemic has caused widespread illness, death, and economic disruption. It has also highlighted the need for better preparedness for future EIDs.

A critical appraisal of the response to the COVID-19 pandemic will help to improve preparedness for future EIDs. By understanding the strengths and weaknesses of the response to the COVID-19 pandemic, we can develop better strategies for preventing and responding to future EIDs. Even if we cannot completely eliminate the threat of EIDs, we can take steps to minimize their impact. By vaccinating people, implementing public health measures, and supporting research, we can help to protect ourselves and our communities from EIDs (Fig. 1).

Fig. 1: Factors that precipitate the occurrence and transmission of emerging and re-emerging infectious diseases. Source: Spernovasilis N, Tsiodras S, Poulakou G. Emerging and re-emerging infectious diseases: humankind’s companions and competitors. Microorganisms 2022;10(1):98. DOI: 10.3390/microorganisms1001009

Source: Campbell H, Lopez Bernal J, Bukasa A, et al. A re-emergence of subacute sclerosing panencephalitis in the United Kingdom. J Pediatr Infect Dis 2023;42(1):82–84. DOI: 10.1097/INF.0000000000003744

Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, and fatal brain disease that can occur years after a person is infected with the measles virus. The disease is caused by a persistent infection of the brain with the measles virus. In the United Kingdom, there were no new pediatric SSPE cases reported between 1996 and 2016. However, in 2017, three new pediatric SSPE cases were reported. These cases were associated with an increase in measles cases in the UK in the years leading up to 2017.

The reemergence of SSPE in the United Kingdom is a reminder that measles is a serious disease that can have long-term consequences. Measles vaccination is the best way to prevent SSPE. To prevent further SSPE cases, it is essential to ensure that measles vaccination coverage is maintained at ≥95%. This will require reversing recent declines in vaccination coverage.

Source: Singh A, Prasad R, Sharma IK, Agarwal P, et al. Diphtheria in Western Uttar Pradesh: A Re-emerging Threat. J Pediatr Infectious Dis 2022;41(11):e499–e500. DOI: 10.1097/INF.0000000000003673

A prospective study was conducted in a tertiary care hospital in rural Uttar Pradesh, India, over a period of 3 years. The study included children who had clinical manifestations of pharyngitis, nasopharyngitis, tonsillitis, or laryngitis with adherent pseudomembrane and positive throat swab for Klebs–Löffler Bacillus by Albert’s stain.

Of the 53 children included in the study, 52.9% were in the age group 1–5 years, 52.9% were males, 20.8% were severely malnourished, 5.6% were completely immunized, and 47.2% had incomplete immunization. Fever was the most common presenting complaint (86.8%), while airway compromise (47.2%) was the most frequent complication. Other complications included thrombocytopenia (9.4%), myocarditis (7.5%), and renal failure (5.3%). Tracheostomy and mechanical ventilation were required in 20 (37.7%) children during treatment, and only 35 (66%) children received antidiphtheritic serum (ADS).

About 11 (20.7%) children in the study were severely malnourished, of which only one survived. Severe malnutrition, male sex, airway compromise, myocarditis, and requirement of tracheostomy with ventilation were associated with poor outcome. In the study of 53 participants, 24 (45.3%) had died, which may be due to late presentation, poor vaccination coverage, and associated severe acute malnutrition.

The study found that the age of occurrence of diphtheria has shifted to late childhood and adolescence. The low incidence of myocarditis in the study may be due to the fact that diagnosis was based on Troponin kits only rather than echocardiograms. The outcome in diphtheria was not affected by ADS administration, which may be due to late administration, poor availability, and the high cost of ADS in rural settings.

In conclusion, this study found that diphtheria is still a serious disease in rural India, with a high mortality rate. The study also found that severe malnutrition, male sex, airway compromise, myocarditis, and requirement of tracheostomy with ventilation are associated with poor outcome.

Source: Kachooei A, Tava Koli A, Minaeian S, et al. Molecular characterization of rotavirus infections in children less than 5 years of age with acute gastroenteritis in Tehran, Iran, 2021–2022: Emergence of uncommon G9P[4] and G9P[8] rotavirus strains. J Med Virol 2023;95(2):e28529. DOI: 10.1002/jmv.28529

This study was conducted to monitor the types of rotavirus circulating in Iran during the 2021–2022 seasons. Researchers collected samples from patients with acute gastroenteritis and analyzed them for the presence of rotavirus. They found that the most common types of rotavirus in Iran were G9P[4] and G9P[8]. However, they also found several other types of rotavirus, including some that had not been previously reported in Iran.

The researchers also found that some of the rotavirus strains had mixed genes from different groups. This suggests that these strains may have evolved through a process called reassortment. Reassortment occurs when two different rotavirus strains infect the same cell and exchange genes. This can lead to the emergence of new strains that are more resistant to vaccines or treatments.

The researchers concluded that further research is needed to understand how rotavirus is evolving in Iran. This research could help to develop new vaccines and treatments that are effective against the latest strains of rotavirus.

Here is a summary of the key findings of the study:

Source: Nallan K, Rajan G, Sivathanu L, et al. Molecular detection of multiple genotypes of orientia tsutsugamushi causing scrub typhus in febrile patients from Theni district, South India. Trop Med Infect Dis 2023;8(3):174. DOI: 10.3390/tropicalmed8030174

Scrub typhus (St) is a reemerging mite-transmitted public health problem in Southeast Asia. The disease is caused by the bacterium Orientia tsutsugamushi, which has >40 known genotypes. In India, there is limited information on the circulating genotypes of O. tsutsugamushi.

A hospital-based retrospective screening was conducted to map the circulating molecular subtypes of the etiological agent in serologically confirmed St human cases. The study found that nine out of 34 samples (26%) were positive for St. DNA sequencing analysis of the six positive samples revealed that they were related to three major genotypes: Karp, Kato, and Kawasaki.

The St-positive samples exhibited 100% and 99.45%, 97.53% and 97.81%, and 96.99% nucleotide identity with the closely related Karp, Kato, and Kawasaki-related sequences, respectively. Overall, 94% of the nucleotides were conserved, and the variable site was 20/365 (5.5%).

The prevalence of multiple genotypes among human cases further stresses the need to conduct in-depth studies to map the genotypes and their clinical relevance, and the contributing risk factors for the emergence of St cases in this area.

Source: Chala B, Hamde F. Emerging and re-emerging vector-borne infectious diseases and the challenges for control: a review. Front Pub Health 2021;9:715759. DOI: 10.3389/fpubh.2021.715759

Vector-borne diseases are a major public health concern worldwide. They are caused by pathogens that are transmitted to humans by vectors, such as mosquitoes, ticks, and fleas. The emergence and reemergence of these diseases is a complex issue with many contributing factors, including human population growth, urbanization, globalization, climate change, and the evolution of pathogens. Despite the efforts of public health officials, the number of vector-borne diseases is increasing. This is a serious threat to global health and development. More research is needed to understand the factors that contribute to the emergence and reemergence of vector-borne diseases and to develop effective strategies for their control.

Here are some of the most important vector-borne diseases:

These diseases can cause a range of symptoms, from mild to severe, and can even be fatal. They can also have a significant impact on the economy and society.

The article concludes by calling for increased investment in research and development to address the threat of vector-borne diseases.

Source: Choi YK. Emerging and re-emerging fatal viral diseases. Experiment Mol Med 2021;53(5):711–712. DOI: 10.1038/s12276-021-00608-9

The emergence of novel fatal viral diseases has been a major threat to global health. These diseases are caused by viruses that are constantly evolving and adapting to new hosts. In this special issue, the authors focus on emerging RNA viruses, such as coronaviruses, influenza virus, and severe fever with thrombocytopenia syndrome virus (SFTSV). The authors discuss the mechanisms by which these viruses evade the host immune system, the evolution of influenza pandemic preparedness, and the latest findings regarding SFTSV. They conclude by highlighting the importance of understanding host–virus interactions in order to overcome emerging fatal viral diseases and prepare for potential pandemics.

Here are some key points from the text:

Source: Harrington WN, Kackos CM, Webby RJ. The evolution and future of influenza pandemic preparedness. Exp Mol Med 2021;53:737–749. DOI: 10.1038/s12276-021-00603-0

The influenza virus is a global threat to human health. It has caused four pandemics in the past 100 years, and there is no reason to believe that the next pandemic will not be worse.

Influenza viruses are constantly evolving, which makes it difficult to develop effective vaccines. The virus can also mutate rapidly, which can make it difficult to treat.

The World Health Organization (WHO) and the Center for Disease Control and Prevention (CDC) have developed programs to help countries prepare for an influenza pandemic. These programs include surveillance, vaccine development, and public education.

However, there is still more that needs to be done to prepare for an influenza pandemic. Countries need to invest in research and development, and they need to have plans in place to distribute vaccines and other medical supplies.

The COVID-19 pandemic has shown that the world is not prepared for a major influenza pandemic. We need to take steps now to increase our preparedness.

Here are some specific measures that can be taken to improve influenza pandemic preparedness:

By taking these steps, we can help to protect ourselves from the next influenza pandemic.

Source: Casel MA, Park SJ, Choi YK. Severe fever with thrombocytopenia syndrome virus: emerging novel phlebovirus and their control strategy. Exp Mol Med 2021;53:713–722. DOI: 10.1038/s12276-021-00610-1

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel Phlebovirus first identified in China in 2009. The virus is most likely transmitted by ticks, but human-to-human transmission has also been reported. The virus can infect a variety of animals, including domestic and wild animals. The major clinical manifestation of SFTS infection is high fever, thrombocytopenia, leukocytopenia, gastrointestinal symptoms, and a high case-fatality rate. Several animal models have been developed to study the pathogenesis of the virus and to develop therapeutics and preventive measures.

Here are some additional details about SFTS:

Source: Patel M, Goel AD, Bhardwaj P, et al. Emerging and re-emerging viral infections in India. J Prevent Med Hyg 2021;62(3): E628–E634. DOI: 10.15167/2421-4248/jpmh2021.62.3.1899

The number of outbreaks in India has increased in recent years. This is due to a number of factors, including globalization, rapid international travel, and climate change. Outbreaks of Nipah, Zika, Crimean–Congo hemorrhagic fever, and Kyasanur forest disease have been reported in recent years. The COVID-19 pandemic is the most recent outbreak.

One of the challenges in preventing outbreaks is that as the number of cases decreases, the public demand for mitigation measures also decreases. This can lead to a false sense of security, which can make it more difficult to respond to future outbreaks.

The One Health approach is a movement to promote collaboration between medicine, veterinary medicine, and environmental sciences to improve the health of humans, animals, and the environment. This approach can help to prevent outbreaks by identifying and addressing the risk factors that contribute to them.

There is an urgent need for better surveillance and disease burden assessments in India. This will help to identify emerging threats and to develop effective prevention and control measures.

Specifically, there is a need to gain detailed insights into vector biology, factors of the environment influencing the diseases, mapping of endemic areas, strengthen intersectoral coordination, and infection control practices, and ensure the use of Personal Protective Equipment (PPE) and availability of drugs and vaccines to handle the outbreaks in a better way.

Source: Ranawaka UK. Emerging tropical neurological infections. Clin Med (Lond) 2022;22(1):18–20. DOI: 10.7861/clinmed.2021-0799

A large majority of neurological infections worldwide are undiagnosed. Emerging and reemerging infections are likely to be responsible for a significant proportion of these.

Over the last two decades, several new organisms producing neurological infections and the neurotropic potential of many other known pathogens have been identified. Large outbreaks caused by reemerging pathogens such as Chikungunya virus, Zika virus, and Ebola virus have led to better delineation of their neurological manifestations.

Recognition of the pandemic potential of emerging pathogens and an improved understanding of their host–vector–environment interactions would help us be better prepared to meet these emerging threats.

Here are some additional details:

By understanding the factors that contribute to the emergence and reemergence of neurological infections, we can develop better strategies for preventing and controlling them.

Source: Cárdenas G, Salgado P, Laura-Foronda E, et al. Neglected and (re-)emergent infections of the CNS i n low-/middle-income countries. Infez Med 2021;29(4):513–525. DOI: 10.53854/liim-2904-3. eCollection 2021

Low- and middle-income countries (LMICs) have long suffered from health system deficiencies, which have been worsened by poor living conditions, lack of sanitation, restricted access to health facilities and running water, overcrowding, and overpopulation. These factors have led to a high burden of infectious diseases in these countries.

Despite the international community’s commitment to eradicating neglected tropical infections (NTIs) by 2030, the current epidemiological landscape and its impact on health and economic development in LMICs are not promising. Neglected and reemerging infectious diseases affecting the central nervous system (CNS) are a major public health concern in these countries. These diseases cause significant morbidity and mortality, and survivors often suffer from severe neurological disabilities.

This paper presents a retrospective review of studies on selected neglected and reemerging infectious diseases in LMICs. The review included reports by the World Health Organization (WHO) published within the last 5 years. Data on infection by SARS-CoV-2 was provided by the John Hopkins University Coronavirus Resource Center.

The review found that CNS neglected and reemerging infectious diseases remain as important causes of disease in LMICs. An alarming increase in the prevalence of malaria, tuberculosis, and cysticercosis has been observed in recent years, compounded by the COVID-19 pandemic. The WHO is currently supporting programs/efforts to cope with these diseases.

The paper highlights the epidemiological burden of some CNS infections in LMICs, and their clinical and neuroimaging features, to facilitate an accurate diagnosis. It is important to recognize these diseases, as most of them will not be eradicated in the short term. Instead, their incidence is likely to increase along with poverty, inequality, and related socioeconomic problems.

Here are some of the key points from the paper:

Source: Malange VNE, Hedermann G, Lausten-Thomsen U, et al. The perinatal health challenges of emerging and re-emerging infectious diseases: a narrative review. Front Public Health 2023;10:1039779. DOI: 10.3389/fpubh.2022.1039779

Infectious disease outbreaks can have a significant impact on perinatal health. In many cases, these outbreaks can lead to preterm delivery, low birth weight, and even death in both mothers and infants. Pregnant women are at a higher risk of developing serious complications from infectious diseases, and they may also be more likely to transmit the disease to their unborn babies.

There are a number of things that can be done to protect pregnant women and their babies during an infectious disease outbreak. Vaccination is one of the most important preventive measures. Pregnant women should also be aware of the signs and symptoms of infectious diseases, and they should seek medical attention immediately if they become ill.

It is important to monitor perinatal health during infectious disease outbreaks. Disease surveillance programs should incorporate perinatal health monitoring, and health systems around the world should endeavor to continuously collect perinatal health data.

By taking these steps, we can help to protect pregnant women and their babies from the harmful effects of infectious disease outbreaks.

Here are some additional details about the perinatal health consequences of infectious disease outbreaks:

Source: Khandelwal V, Sharma T, Gupta S, et al. Stem cell therapy: a novel approach against emerging and re-emerging viral infections with special reference to SARS-CoV-2. Mol Biol Rep 2023;50(3):2663–2683. DOI: 10.1007/s11033-022-07957-2

Infectious viral agents, including flaviviruses, influenza, filoviruses, alphaviruses, and coronaviruses, have emerged and reemerged in recent decades, posing significant global health concerns.

Medicinal compounds such as antiviral, antimalarial, and antiinflammatory agents are being investigated for the treatment of these viral diseases.

While these therapies have shown effectiveness in improving recovery rates and overall survival, they are not effective in healing lung damage caused by SARS-CoV-2.

There is a critical need to identify effective treatments that can address this unmet clinical need.

Stem cell therapy, with its antioxidant and immunomodulatory properties, is considered a novel approach to regenerate damaged lungs and reduce inflammation.

Source: Mostafavi E, Ghasemian A, Abdinasir A, et al. Emerging and re-emerging infectious diseases in the WHO Eastern Mediterranean Region, 2001–2018. Int J Health Policy Manag 2021;11(8):1286–1300. DOI: 10.34172/ijhpm.2021.13

Countries in the WHO Eastern Mediterranean Region (EMR) are prone to highly contagious, severe, and fatal emerging infectious diseases (EIDs) and reemerging infectious diseases (RIDs). Leishmaniasis, hepatitis A virus (HAV), and hepatitis E virus (HEV) are reported in all countries in the region. Chikungunya, Crimean Congo hemorrhagic fever (CCHF), dengue fever, and H5N1 have shown an increasing number of cases, higher frequency, and wider geographical distribution. Middle East respiratory syndrome (MERS), which was first reported in the region in 2012, remains a significant public health concern. Controlling cholera, diphtheria, leishmaniasis, measles, and poliomyelitis presents challenges in certain countries.

Other salient points in the review are as follows:

ORCID

Vikram S Kumar https://orcid.org/0000-0002-1369-7682

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