Influenza vaccination in the prevention of acute otitis media in children

Article Abstract:

It is estimated that more than 60 percent of the children in the United States will have at least one attack of acute otitis media (AOM, inflammation of the inner part of the ear) during their first year of life, and greater than 80 percent will have AOM by the age of 3. Research has focused on developing a bacterial vaccine for Streptococcus pneumoniae, a common cause of AOM. However, efforts have been unsuccessful. In many cases, AOM is preceded by a viral respiratory infection that can be caused by respiratory syncytial viruses, rhinoviruses, influenza A viruses or adenoviruses; infection with any of these viruses can cause AOM. Since a vaccine for influenza A is available, the effectiveness of this vaccine in preventing AOM caused by influenza A virus was evaluated. The vaccine was administered to 187 children (aged 1 to 3 years) attending a day-care center; 187 children who did not receive influenza A vaccine served as a control group. The vaccination took place prior to the 1988-1989 influenza A epidemic. During a 6-week period, 5 of the 187 vaccinated children developed an infection with influenza A virus, and 3 of the 5 developed AOM. A total of 29 unvaccinated children developed infection with influenza A, and 18 developed AOM. Overall, 35 vaccinated children developed AOM, while 55 of the children who were not vaccinated had AOM. These results demonstrate that vaccination of children against influenza A virus reduces the incidence of AOM due to that virus. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Influenza vaccines, Viral vaccines, Otitis media

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The causes of hospital-treated acute lower respiratory tract infection in children

Article Abstract:

Acute lower respiratory tract infections (ALRI), which include pneumonia and bronchiolitis, are a frequent cause of illness in children. However, many of the underlying causes of ALRI are unclear. This limits vaccine development and knowledge of the best treatment. To better determine causes of ALRI, 121 urban children (50 female) who were hospitalized with ALRI were evaluated using newly available laboratory tests. Evidence for causes of ALRI was found in 84 patients (70 percent), which included 30 bacterial infections, 30 viral infections, and 24 mixed infections. Haemophilus influenzae and Streptococcus pneumoniae were the most common bacteria. Respiratory syncytial virus was the most common virus, with adenovirus infection detected half as often. The frequency of H. influenzae infection, especially in children under three years, has not previously been considered this high. Viral ALRI, alone or with bacteria, occurred most often in younger patients, and the proportion of bacterial ALRI increased with age. Use of the new tests allowed identification of more ALRI causes and of more bacterial infections than has previously been possible. The causes of infection in the remaining 30 percent of children may not have been identified due to microbes not tested for, lack of responses measurable by tests, or due to the effectiveness of drug therapy in eliminating infective agents. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Bacterial infections, Pneumonia in children, Childhood pneumonia, Bronchitis in children

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Signs and symptoms predicting acute otitis media

Article Abstract:

Children with upper respiratory infections that fail to resolve promptly should be checked for middle ear infection even if there is no complaint of earache. A group of 302 Finnish children age 4 or younger were followed up and examined during episodes of runny nose, cough, and/or fever. Parents kept records of symptoms. Eighty-three percent of the children with earache had an ear infection. However, 40% of children had ear infections without reported earache. This is probably because the younger the child, the less the child is able to communicate ear pain. Restless sleeping and fever were not useful indicators of ear infection. Half the children made a repeat visit about 5 days after the diagnosis of upper respiratory infection because symptoms were not subsiding. Among these children, 43% had ear infections, of whom half were not reported to have earache.

Children, Child health, Acute otitis media

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