A norovirus gastroenteritis outbreak in an Australian child-care center: A household-level analysis

There is a large burden of norovirus disease in child-care centers in Australia and around the world. Despite the ubiquity of norovirus outbreaks in child-care centers, little is known about the extent of this burden within the child-care center and the surrounding household clusters. Therefore, we performed an in-depth analysis of a gastroenteritis outbreak to examine the patterns of transmissions, household attack rates and the basic reproduction number (R0) for Norovirus in a child-care facility. We used data from parental interviews of suspected cases sent home with gastroenteritis at a child-care center between 24th of August and 18th of September 2020. A total of 52 persons in 19 household clusters were symptomatic in this outbreak investigation. Of all transmissions, 23 (46.9%) occurred in the child-care center, the rest occurring in households. We found a household attack rate of 36.5% (95% CI 27.3, 47.1%). Serial intervals were estimated as mean 2.5 ± SD1.45 days. The R0, using time-dependent methods during the growth phase of the outbreak (days 2 to 8) was 2.4 (95% CI 1.50, 3.50). The count of affected persons of a child-care center norovirus outbreak is approximately double the count of the total symptomatic staff and attending children. In the study setting, each symptomatic child-care attendee likely infected one other child-care attendee or staff and just over one household contact on average.

L’Ambulatorio protetto: visitare ai tempi del Covid-19

On the eve of the reopening of the school year, as Associated Pediatricians of District 10 ASL3, Val Polcevera and Valle Scrivia, we created a shared outpatient clinic, called Ambulatorio Protetto, which allowed us, on the one hand, to resume our assistance activities directed to the symptomatic child not strongly suspected for SARS-CoV-2, contributing, according to WHO indications, to the 3 T strategy (Testing Tracing Treating) even in disadvantaged and poorly connected areas, on the other hand, to ensure the prevention and management of chronic patients and non-infectious patients with the best possible safety measures. The realization was made possible with self-financing and as a form of volunteering of the participating pediatricians. The Health District contributed with the supply of PPE and molecular swabs.

Salmonella bongori 48:z35:– The first Italian case of human infection outside Sicily

<em>Salmonella bongori</em> 48:z35:– is considered endemic to Sicily (Italy) due to its epidemiological peculiarity. To our knowledge, no previous cases of human infection caused by <em>S. bongori</em> 48:z35:– have ever been reported in mainland Italy. Here we describe the isolation of <em>S. bongori</em> 48:z35:– from a 1-year-old symptomatic child in northwest Italy (Piedmont Region). The strain showed no antimicrobial resistance. Reporting of <em>S. bongori</em> 48:z35:– in a previously safe area is important to identify epidemiological changes.

Giant true dorsal thoracic meningocele in a school-age child

✓A meningocele is a common form of spinal dysraphic lesions, but it is extremely uncommon in children in the upper thoracic region. The authors describe a rare case in which they found a giant true dorsal meningocele in the upper thoracic region in a symptomatic child, which, to their knowledge, is the first such reported case. A school-age child, who harbored a giant dorsal mass, complained of restriction of function. He underwent successful surgery in which the meningocele sac was totally removed.

Admitting Whole Families: An Alternative to Residential Care

This paper is an examination of the effectiveness of a programme (described in detail elsewhere) designed to admit whole families for short-term intensive assessment and treatment. The goals of this programme are to eliminate residential care for symptomatic children who are admitted with their families to this service, to decrease the length of stay of the symptomatic child in residential treatment, if this is required following admission of the whole family to this unit, and to provide these services at costs comparable to or less than that currently being spent with conventional residential treatment. Results stemming from a number of pre- and post-treatment measures indicate that one half of children initially assessed and recommended for inpatient treatment had successfully avoided inpatient treatment for six months following admission of their family to this unit. For children recommended for residential care after admission of their families to the family unit, a reduction of approximately 35% of total time in residence occurred (when compared with a comparison group). A cost saving of over $12,000 per case was realized as a result of admission of the whole family when compared with residential treatment.

The Identified Patient in Family Therapy and Jesus Christ: A Limited Analogy

Family therapists have recognized the importance of analogic or metaphoric thinking in the conceptualization of family problems. In this article, we develop an analogy pertaining to a frequently studied phenomenon in family therapy, the symptom bearing child or Identified Patient (IP). By exploring certain similarities and differences between the IP and Jesus Christ, we hope to increase the reader's awareness of the richness and poignancy of the saving role in human relations. Also, an understanding of the Christ/IP analogy may be helpful to family therapists who must avoid idealizing or identifying with the symptomatic child.

Pyuria: A Useful Finding or Not?

One of our readers asks: "This may seem like a request from the dark ages, but in reading the article on urinary tract infection on page 133 in the November issue of PEDIATRICS IN REVIEW I did not notice any reference to pyuria as an indicator of urinary tract infection in a symptomatic child. Our usual method of diagnosing urinary tract infection in a child who has a suspected urinary tract infection is to examine the urine for pyuria. I would appreciate an abstract on a review article or just a reference which gives hard data that this is not good practice.