Infectious Diseases

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Concerned about the logistics of vaccinating patients this flu season, now that even healthy children younger than 2 years are to be immunized? Worried about reimbursement? For a practical approach to vaccinating against influenza--without putting a financial strain on your practice--read on.

Most infectious disease researchers believe that a pandemic of influenza--like the Spanish flu pandemic of 1918 and 1919 that killed 50 million people--is inevitable. That fear has gained new urgency with the resurgence in Asia of avian influenza.

It has been difficult to determine the impact of influenza infection on infants and young children, because annual outbreaks of respiratory syncytial virus infection often overlap influenza outbreaks. But careful epidemiologic tests, combined with accurate, simple-to-perform viral diagnostic studies, have now clearly demonstrated that young children--particularly those younger than 2 years--are hospitalized because of influenza at a rate that equals or exceeds the influenza hospitalization rate for the elderly.

A 6-year-old girl and an 11-year-old boy each presented for evaluation of an erythematous, pruritic, papular rash that developed after swimming in a Wisconsin lake.

Complaints of pain in an ear prompted the mother of a 4-year-old boy to seek medical consultation for her son. The external ear was red, swollen, and warm. This appearance is typical of erysipelas caused by group A β-hemolytic streptococci.