英国和爱尔兰的人类疱疹病毒-6和-7均可导致神经系统疾病的发病率升高

Background: Primary human herpesvirus-6 and -7 (HHV-6/-7) infections cause febrile illness sometimes complicated by convulsions and rarely encephalopathy. Aims: To explore the extent of such HHV-6 and -7 induced disease in young chi ldren. Methods: In a three year prospective study in Britain and Ireland, 205 ch ildren (2-35 months old) hospitalised with suspected encephalitis and/or severe illness with fever and convulsions were reported via the British Paediatric Sur veillance Unit network. Blood samples were tested for primary HHV-6 and -7 inf ections. Results: 26/156 (17%) of children aged 2-23 months had primary infect ion (11 HHV-6; 13 HHV-7; two with both viruses) coinciding with the acute illness; this was much higher than the about three cases expected by cha nce. All 26 were pyrexial; 25 had convulsions (18 status epilepticus), 11 requir ing ventilation. Median hospital stay was 7.5 days. For HHV-6 primary infection the median age was 53 weeks (range 42-94) and the distribution differed from t hat of uninfected children; for HHV-7, the median was 60 weeks (range 17-102) and the distribution did not differ for the uninfected. Fewer (5/15)-children w ith primary HHV-7 infection had previously been infected with HHV-6 than expec ted. Conclusions: Primary HHV-6 and HHV-7 infections accounted for a significa nt proportion of cases in those< 2 years old of severe illness with fever and co nvulsions requiring hospital admission; each virus contributed equally. Predispo sing factors are age for HHV-6 and no previous infection with HHV-6 for HHV-7 . Children with such neurological disease should be investigated for primary HHV -6/-7 infections, especially in rare cases coinciding by chance with immunisat ion to exclude misdiagnosis as vaccine reactions.

The clinical and immunological features of pediatric COVID-19 patients in China

In December 2019,the corona virus disease 2019(COVID-19)caused by novel coronavirus(SARS-CoV-2)emerged in Wuhan,China and rapidly spread worldwide.Few information on clinical features and immunological profile of COVID-19 in paediatrics.The clinical features and treatment outcomes of twelve paediatric patients confirmed as COVID-19 were analyzed.The immunological features of children patients was investigated and compared with twenty adult patients.The median age was 14.5-years(range from 0.64 to 17),and six of the patients were male.The average incubation period was 8 days.Clinically,cough(9/12,75%)and fever(7/12,58.3%)were the most common symptoms.Four patients(33.3%)had diarrhea during the disease.As to the immune profile,children had higher amount of total T cell,CD8t T cell and B cell but lower CRP levels than adults(P<0.05).Ground-glass opacity(GGO)and local patchy shadowing were the typical radiological findings on chest CT scan.All patients received antiviral and symptomatic treatment and the symptom relieved in 3e4 days after admitted to hospital.The paediatric patients showed mild symptom but with longer incubation period.Children infected with SARS-CoV-2 had different immune profile with higher T cell amount and low inflammatory factors level,which might ascribed to the mild clinical symptom.We advise that nucleic acid test or examination of serum IgM/IgG antibodies against SARS-CoV-2 should be taken for children with exposure history regardless of clinical symptom.