Chandra Abeysekera

Human Parechovirus Infection in Children Hospitalized with Acute Gastroenteritis in Sri Lanka

ABSTRACT Of 362 fecal specimens collected from infants and children hospitalized with acute gastroenteritis in Sri Lanka from September 2005 to August 2006, 30 (8.3%) were positive for human parechovirus (HPeV). Six different HPeV genotypes, including HPeV1, -3, -4, -5, -10, and -11, were identified, of these, HPeV11 was reported for the first time.

Novel Human Parechovirus, Sri Lanka

Of 362 fecal samples collected from children with acute gastroenteritis in Sri Lanka during 2005–2006, 30 (8.3%) were positive for human parechovirus (HPeV) by reverse transcription–PCR. A novel HPeV, designated as HPeV10, was identified in 2 samples by sequence analysis of the viral protein 1 gene of the detected HPeVs.

Vesicoureteric reflux and reflux nephropathy

Reflux nephropathy i.e. renal scarring associated with vesico-ureteric reflux (VUR) and urinary tract infection (UTI) was originally considered an acquired disease. The renal scarring seems to get worse with recurrent urine infections especially in the young. Therefore, in the past much effort was undertaken to correct the VUR surgically and minimize the number of recurrent urinary tract infections by antibiotic prophylaxis with the hope of reducing if not arresting the onset of complications that follow i.e. hypertension and renal failure. However, it is now becoming clear that reflux nephropathy encompass at least two major categories of disease; “acquired” renal scarring secondary to UTI and VUR predominantly affecting females and “congenital” scarring with dysplastic features associated with prenatal VUR but with no infection and predominantly affecting boys. The latter is much less common but is disproportionately represented in the group of patients with reflux nephropathy that go on to develop renal failure. Unfortunately, the susceptibility to renal scarring, the onset of hypertension and progression to renal failure seems to be significantly influenced by genetic factors and hence measures undertaken to prevent recurrence of UTI may not change the ultimate outcome although it will certainly improve the comfort of the individual. Therefore, the extensive investigation and management routines adopted today in these children may not be cost-effective in preventing end stage renal disease in VUR. The progression to renal failure, however, can be delayed but not halted with adequate control of high blood pressure and hence the need for life long follow-up.

Severe reaction following a combined vaccine

With the expanded programme of immunization (EPI) achieving near 100% coverage, the demand for non-EPI vaccines is rising. The combined vaccines have become popular among health care providers and the patients due to easier administration and a single injection covering many diseases. They have been shown to be safe and effective. We report a child who developed a severe febrile illness following a combined DPT+HepB+Hib vaccine. Key words: adverse reaction, DPT+HepB+Hib vaccine doi: 10.4038/sljch.v34i3.403 Sri Lanka Journal of Child Health , 2004; 34:96-7