Vaccines

Pediatricians around the countryare being bombardedwith questions about avianflu. This brief review of thecurrent status of the avian fluoutbreak and its treatment and preventionprovides the informationyou will need to answer the mostpressing patient questions.

This 12-month-old girl presented with a diffuse rash that was first noticed by the child's day-care provider a day earlier. A fever (temperature of 39.4°C [103°F]) subsequently developed.

In the Photoclinic item titled "Vaccine-Induced Herpes Zoster," by Julie L. Cantatore-Francis, MD, and Yelva Lynfield, MD (Consultant For Pediatricians, June 2005, pages 290 and 291), the dosage of acyclovir was incorrectly printed as 80 mg/d divided into 4 doses. The correct dosage is 80 mg/kg/d divided into 4 doses. We apologize for the error.

An otherwise healthy 22-month-old was referred for evaluation of a pruritic rash on her buttocks and right leg of 5 days' duration. Her mother reported that the rash had begun as red bumps and blisters on the buttocks that subsequently spread to the right leg.

With the significant decline in disease caused by Haemophilus influenzae type b and Streptococcus pneumoniae achieved through vaccination, Neisseria meningitidis has moved to the forefront. Its emergence as the most important cause of bacterial meningitis challenges the pediatrician to prevent and control this terrible disease. Meningococcal disease can be easily misdiagnosed. It may present with different clinical manifestations, and its signs and symptoms may mimic those of common viral illnesses, such as influenza. The onset and progression of meningococcal disease are rapid. Although the rate of disease is highest in infants, morbidity and mortality rates for this disease are highest in adolescents and young adults, despite the existence of effective therapies.1