scholarly journals COVID-19 and Treatment and Immunization of Children—The Time to Redefine Pediatric Age Groups is Here

2021 ◽  
Vol 12 (2) ◽  
pp. e0010
Author(s):  
Klaus Rose ◽  
◽  
Jane M. Grant-Kels ◽  
Earl B. Ettienne ◽  
Oishi Tanjinatus ◽  
...  
Keyword(s):  
United States ◽  
Age Groups ◽  
Drug Approval ◽  
The United States ◽  
The Body ◽  
Kawasaki Syndrome ◽  
Pediatric Age ◽  
Prevention And Treatment ◽  
Control And Prevention ◽  
Inflammatory Syndrome

Children are infected with coronavirus disease 2019 (COVID-19) as often as adults, but with fewer symptoms. During the first wave of the COVID-19 pandemic, multisystem inflammatory syndrome (MIS) in children (MIS-C), with symptoms similar to Kawasaki syndrome, was described in young minors testing positive for COVID-19. The United States (US) Centers for Disease Control and Prevention (CDC) defined MIS-C as occurring in <21-year-olds, triggering hundreds of PubMed-listed papers. However, postpubertal adolescents are no longer children biologically; the term MIS-C is misleading. Furthermore, MIS also occurs in adults, termed MIS-A by the CDC. Acute and delayed inflammations can be triggered by COVID-19. The 18th birthday is an administrative not a biological age limit, whereas the body matures slowly during puberty. This blur in defining children leads to confusion regarding MIS-C/MIS-A. United States and European Union (EU) drug approval is handled separately for children, defined as <18-year-olds, ascribing non-existent physical characteristics up to the 18th birthday. This blur between the administrative and the physiological meanings for the term child is causing flawed demands for pediatric studies in all drugs and vaccines, including those against COVID-19. Effective treatment of all conditions, including COVID-19, should be based on actual physiological need. Now, the flawed definition for children in the development of drugs and vaccines and their approval is negatively impacting prevention and treatment of COVID-19 in minors. This review reveals the necessity for redefining pediatric age groups to rapidly establish recommendations for optimal prevention and treatment in minors.

scholarly journals 2765. Pediatric Mumps during the 2015–2017 Mumps Resurgence in the United States

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S975-S975
Author(s):  
Mariel Marlow ◽  
John Zhang ◽  
Nakia S Clemmons ◽  
Mona Marin ◽  
Manisha Patel ◽  
...  
Keyword(s):  
United States ◽  
Children And Adolescents ◽  
Surveillance System ◽  
Pediatric Patients ◽  
Age Groups ◽  
Exposure Period ◽  
The United States ◽  
College Campuses ◽  
Control And Prevention ◽  
Low Rate

Abstract Background Numerous mumps outbreaks occurred in the United States over the last decade, with outbreaks affecting young adults on college campuses being among the largest and most widely publicized. However, at least half of mumps cases and outbreaks occurred in other age-groups and settings. We describe reported mumps cases among children and adolescents during 2015 through 2017. Methods The Centers for Disease Control and Prevention (CDC) analyzed reports of confirmed and probable mumps cases in persons aged ≤18 years (defined here as pediatric mumps) transmitted electronically through the Nationally Notifiable Diseases Surveillance System (NNDSS) by the 52 reporting jurisdictions. Results Between January 1, 2015 and December 31, 2017, 49 jurisdictions reported 4,886 pediatric mumps cases (35% of all US reported cases, 13,807); 8 jurisdictions reported >100 cases each, representing 82% of all pediatric cases. Overall, 29 (1%) cases were in infants <1 yr, 406 (8%) were in children aged 1–4 years, 1,408 (29%) in children aged 5–10 years, 1,365 (28%) in adolescents aged 11–14 years, and 1,678 (34%) in adolescents aged 15–18 years. Most (3,548, 73%) cases did not travel outside the state during their exposure period; only 37 (1%) traveled outside the country. Cases in patients aged 1–4 years were more frequently non-outbreak associated (38%) than those in patients <1 years and 5–18 years (24% and 9%, respectively). Among 3,309 (68%) patients with known number of MMR doses received, 81% of those 5–18 years had ≥2 MMR doses, while 67% of those 1–4 years had ≥1 dose. Median time since last MMR dose for patients with 2 doses was 8 years (IQR: 4, 11 years). Four patients had meningitis and 1 had encephalitis; all were ≥10 years old and previously received 2 MMR doses. Of male mumps patients older than 10 years of age (2,113), 46 (2%) reported having orchitis; of these, 33 (72%) had 2 MMR doses. Sixty-four patients were hospitalized and there were no deaths. Conclusion About one-third of cases reported during the recent US mumps resurgence were in children and adolescents. The low rate of mumps complications compared with previous studies suggests mumps complications may not be adequately captured in national surveillance or identified by providers. Providers should remain vigilant that mumps can still occur among fully vaccinated pediatric patients, even those recently vaccinated. Disclosures All authors: No reported disclosures.

scholarly journals Modeling of COVID-19 Transmission Dynamics on US Population: Inter-transfer Infection in Age Groups, Mutant Variants, and Vaccination Strategies

2021 ◽  
Author(s):  
Jyotirmoy Roy ◽  
Samuel Heath ◽  
Doraiswami Ramkrishna ◽  
Shiyan Wang
Keyword(s):  
United States ◽  
Large Fraction ◽  
Age Groups ◽  
The United States ◽  
Vaccination Strategies ◽  
Health Authorities ◽  
Mutant Variant ◽  
High Infection ◽  
Control And Prevention ◽  
Vaccine Distribution

The in-depth understanding of the dynamics of COVID-19 transmission among different age groups is of great interest for governments and health authorities so that strategies can be devised to reduce the pandemic's detrimental effects. We developed the SIRDV-Virulence epidemiological model based on a population balance equation to study the effect of mutants of the virus and the effect of vaccination strategies on mitigating the transmission among the population in the United States. Based on the available data from the Centers for Disease Control and Prevention (CDC), we obtain the key parameters governing the dynamic evolution of the spread of the COVID-19 pandemic. In the context studied, the results show that a large fraction of infected cases comes from the adult and children populations in the presence of a mutant variant of COVID-19 with high infection rates. We further investigate the optimum vaccine distribution strategy among different age groups. Given the current situation in the United States, the results show that prioritizing children and adult vaccinations over that of seniors can contain the spread of the active cases, thereby preventing the healthcare system from being overwhelmed and minimizing subsequent deaths. The model suggests that the only option to curb the effects of this pandemic is to reduce the population of unvaccinated individuals. A higher fraction of 'Anti/Non-vaxxers' can lead to the resurgence of the pandemic.

An Overview of Acute Flaccid Myelitis

2021 ◽  
Vol 20 ◽  
Author(s):  
Aseem Setia ◽  
Jasween Bhatia ◽  
Sankha Bhattacharya
Keyword(s):  
United States ◽  
Signs And Symptoms ◽  
The United States ◽  
Sudden Onset ◽  
Clinical Findings ◽  
The Body ◽  
Difficult Situation ◽  
Acute Flaccid Myelitis ◽  
Control And Prevention ◽  
Diagnostic Approaches

: Acute Flaccid Myelitis is defined by the presence of Acute Flaccid Paralysis (AFP) and a spinal cord lesion on magnetic resonance imaging that is primarily limited to the grey matter. AFM is a difficult situation to deal with when you have a neurologic illness. According to the Centers for Disease Control and Prevention (CDC), a large number of cases were discovered in the United States in 2014, with 90% of cases occurring in children. Although the exact cause of AFM is unknown, mounting evidence suggests a link between AFM and enterovirus D68 (EV-D68). In 2014, an outbreak of AFM was discovered in the United States. The condition was initially linked to polioviruses; however, it was later found that the viruses were caused by non-polioviruses Enteroviruses D-68 (EV-D68). The number of cases has increased since 2014, and the disease has been declared pandemic in the United States. The sudden onset of muscle weakness, usually in an arm or leg, as well as pain throughout the body, the patient's facial expression changing to one of weakness, and shortness of breath, ingesting, and speaking are all common symptoms in patients suffering from neurologic disease. This article includes graphic and histograms representations of reported AFM incidents and criteria for causality, epidemiology, various diagnostic approaches, signs and symptoms, and various investigational guidelines. It also includes key statements about recent AFM disease clinical findings.

scholarly journals Initial economic damage from the COVID-19 pandemic in the United States is more widespread across ages and geographies than initial mortality impacts

2020 ◽  
Vol 117 (45) ◽  
pp. 27934-27939 ◽  
Author(s):  
Maria Polyakova ◽  
Geoffrey Kocks ◽  
Victoria Udalova ◽  
Amy Finkelstein
Keyword(s):  
United States ◽  
New York ◽  
Excess Mortality ◽  
Age Groups ◽  
The United States ◽  
Economic Damage ◽  
Monthly Data ◽  
Policy Responses ◽  
All Cause Mortality ◽  
Control And Prevention

The economic and mortality impacts of the COVID-19 pandemic have been widely discussed, but there is limited evidence on their relationship across demographic and geographic groups. We use publicly available monthly data from January 2011 through April 2020 on all-cause death counts from the Centers for Disease Control and Prevention and employment from the Current Population Survey to estimate excess all-cause mortality and employment displacement in April 2020 in the United States. We report results nationally and separately by state and by age group. Nationally, excess all-cause mortality was 2.4 per 10,000 individuals (about 30% higher than reported COVID deaths in April) and employment displacement was 9.9 per 100 individuals. Across age groups 25 y and older, excess mortality was negatively correlated with economic damage; excess mortality was largest among the oldest (individuals 85 y and over: 39.0 per 10,000), while employment displacement was largest among the youngest (individuals 25 to 44 y: 11.6 per 100 individuals). Across states, employment displacement was positively correlated with excess mortality (correlation = 0.29). However, mortality was highly concentrated geographically, with the top two states (New York and New Jersey) each experiencing over 10 excess deaths per 10,000 and accounting for about half of national excess mortality. By contrast, employment displacement was more geographically spread, with the states with the largest point estimates (Nevada and Michigan) each experiencing over 16 percentage points employment displacement but accounting for only 7% of the national displacement. These results suggest that policy responses may differentially affect generations and geographies.

Shifting the Paradigm in HIV Prevention and Treatment Service Delivery Toward Differentiated Care for Youth

2019 ◽  
Author(s):  
Vincent Guilamo-Ramos ◽  
Marco Thimm-Kaiser ◽  
Adam Benzekri ◽  
Donna Futterman
Keyword(s):  
United States ◽  
Hiv Prevention ◽  
Service Delivery ◽  
The United States ◽  
Hiv Care ◽  
Health Concern ◽  
Service Needs ◽  
Minority Adolescents ◽  
Prevention And Treatment ◽  
Differentiated Care

Despite significant progress in the fight against HIV/AIDS in the United States, HIV prevention and treatment disparities among key populations remain a national public health concern. While new HIV diagnoses are increasing among people under age 30—in particular among racial, ethnic, and sexual minority adolescents and young adults (AYA)—dominant prevention and treatment paradigms too often inadequately consider the unique HIV service needs of AYA. To address this gap, we characterize persistent and largely overlooked AYA disparities across the HIV prevention and treatment continuum, identify AYA-specific limitations in extant resources for improving HIV service delivery in the United States, and propose a novel AYA-centered differentiated care framework adapted to the unique ecological and developmental factors shaping engagement, adherence, and retention in HIV services among AYA. Shifting the paradigm for AYA to differentiated HIV care is a promising approach that warrants implementation and evaluation as part of reinforced national efforts to end the HIV epidemic in the United States by 2030.

scholarly journals Incidence of Benign Meningiomas in the United States: Current and Future Trends

2021 ◽  
Author(s):  
Sonia Bhala ◽  
Douglas R Stewart ◽  
Victoria Kennerley ◽  
Valentina I Petkov ◽  
Philip S Rosenberg ◽  
...  
Keyword(s):  
United States ◽  
Age Groups ◽  
Cancer Registries ◽  
Health Impact ◽  
The United States ◽  
Birth Cohorts ◽  
Benign Meningioma ◽  
Case Count ◽  
Future Burden ◽  
Rate Ratios

Abstract Background Benign meningiomas are the most frequently reported central nervous system tumors in the United States (US), with increasing incidence in past decades. However, the future trajectory of this neoplasm remains unclear. Methods We analyzed benign meningioma incidence of cases identified by any means (eg, radiographically with or without microscopic confirmation) in US Surveillance Epidemiology and End Results (SEER) cancer registries among 35–84-year-olds during 2004–2017 by sex and race/ethnicity using age-period-cohort (APC) models. We employed APC forecasting models to glean insights regarding the etiology, distribution, and anticipated future (2018–2027) public health impact of this neoplasm. Results In all groups, meningioma incidence overall increased through 2010, then stabilized. Temporal declines were statistically significant overall and in most groups. JoinPoint analysis of cohort rate-ratios identified substantial acceleration in White men born after 1963 (from 1.1% to 3.2% per birth year); cohort rate-ratios were stable or increasing in all groups and all birth cohorts. We forecast that meningioma incidence through 2027 will remain stable or decrease among 55–84-year-olds but remain similar to current levels among 35–54-year-olds. Total meningioma burden in 2027 is expected to be approximately 30,470 cases, similar to the expected case count of 27,830 in 2018. Conclusions Between 2004–2017, overall incidence of benign meningioma increased and then stabilized or declined. For 2018–2027, our forecast is incidence will remain generally stable in younger age groups but decrease in older age groups. Nonetheless, the total future burden will remain similar to current levels because the population is aging.

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