Michiyo Sakamoto

Clinical Features of Influenza C Virus Infection in Children

BACKGROUND Seroepidemiological studies have revealed that influenza C virus is widely distributed globally. However, because the isolation of this virus is difficult, there have been few reports on its clinical features. METHODS Between December 1990 and November 2004, 84,946 respiratory-tract specimens were obtained from patients < or = 15 years old. On the basis of the results of isolation of virus, we examined the clinical data on children infected with influenza C virus. RESULTS Of 170 children infected with influenza C virus, 157 (92.4%) were < 6 years old. Fever (frequency, 90.0%), cough (frequency, 74.1%), and rhinorrhea (frequency, 61.8%) were the most frequent symptoms. The mean duration of fever was 2.88 days (standard deviation, 1.66 days). Of the 170 children, 29 were hospitalized, and 21 (72.4%) of these 29 had lower-respiratory-tract illness such as pneumonia, bronchitis, and bronchiolitis. The rate of hospital admission was significantly higher in children < 2 years old than in children 2-5 years old (30.4% vs. 11.9%; P = .0043). CONCLUSIONS Influenza C virus is a significant cause of upper-respiratory-tract illness in children < 6 years old, and the risk of complications with lower-respiratory-tract illness is particularly high in children < 2 years old.

Vertebral osteomyelitis and paravertebral abscess due to Salmonella oranienburg in a child.

distinct clinical manifestations can develop, including acute gastroenteritis, bacteremia, extraintestinal focal infections or asymptomatic infections.1 Focal suppurative infections in salmonellosis may occur almost anywhere, but the Salmonella organism is a rare pathogen of osteomyelitis in children and has been reported to account for only 2% of infections.2 The main target bone in Salmonella osteomyelitis is unknown but, in general, the vertebra is rarely infected in the pediatric age group.2 Salmonellosis, a wellknown complication in children with sickle cell disease,3 is seldom appreciated as a cause of osteomyelitis in those without predisposing disorders.4–7 In the present study, we describe a previously healthy child who developed thoracic vertebral osteomyelitis and paravertebral abscess due to Salmonella oranienburg. From our review of the literature, we believe ours to be the first reported case of a child with Salmonella vertebral osteomyelitis associated with paravertebral abscess due to Salmonella oranienburg.

Re-emergence of echovirus type 13 infections in 2002 in Yamagata, Japan

OBJECTIVES To analyze the prevalence of echovirus type 13 (Echo13) in Yamagata, Japan. METHODS Virus isolation was performed from 6514 clinical specimens using six cell lines between January 1999 and December 2002. We also carried out a seroepidemiological study against Echo13, using 234 serum samples collected in 2001. RESULTS In 2002, we isolated a total of 50 Echo13 strains, which had not been detected from 1981 until 2001 in Japan. The antibody positive rate was higher (57.2-62.0%) in subjects 50 years or over than in those under 50 years (0-14.4%). CONCLUSIONS Serological study suggested that Echo13 had been present in Yamagata until around 1960, at which time the antibody positive persons were exposed to Echo13 in their childhood. Furthermore, results of virus isolation demonstrated that Echo13 re-emerged in around 2002 after a hiatus of several decades.

A Slow Spread of Adenovirus Type 7 Infection after Its Re‐Emergence in Yamagata, Japan, in 1995

We have continued the epidemiological study on adenovirus type 7 (Ad7), which re‐emerged in 1995 in Yamagata, Japan. Between 1999 and 2004, we isolated only four strains from 10,778 throat swab specimens among children with acute respiratory infections. A serological survey of 303 specimens revealed the antibody‐positive rate against Ad7 to be 0–7.4% in children under 10 years of age in 2005, although it was 3.3–16.7% in 1997 and 0% in 1993. Our results suggest that a re‐emergence does not always provoke a sudden major outbreak, even if the antibody‐positive rate against Ad7 is low in the local community.

Campylobacter coli bacteremia in an 11‐year‐old boy

Campylobacter infections predominantly cause intestinal illnesses and rarely produce bacteremia. Campylobacter bacteremia occurs mostly in malnourished children or patients with chronic, debilitating illnesses or immunodeficiency.1 The most common species of Campylobacter causing bacteremia is C. jejuni, however C. coli is rare.1–8 We describe herein a previously healthy child with bacteremia due to C. coli.

Three patients with different phenotypes in a family with chromosome 22q11.2 deletions

phenotypes. The most extreme is DiGeorge syndrome;1,2 velocardiofacial syndrome2,3 and conotruncal anomaly face syndrome4 are less severe manifestations. In addition, the deletions have been documented in other syndromes, such as Cayler cardiofacial syndrome.5,6 Recent reports have addressed a relatively high frequency of familial transmission of 22q11.2 deletions and different phenotypes have been proposed among members with deletions, even within a family.7–9 We present here two siblings and their mother who have 22q11.2 deletions with their different clinical expressions and stress that an asymmetric crying face can be a clue for detecting the deletions.