Pediatric Annals

editorial 

Infectious Topics

Stanford T Shulman, MD

Abstract

The hardcore New York Yankees fan, Leonard R. Krilov, MD, is the Guest Editor of this issue, as well as the July issue, of Pediatric Annals (see his column with baseball cards, page 300). As I write this, the Yankees are mired in last place (yesi) and my Detroit Tigers are in first place (yes!). I know that the former won't last and pray that the latter will. But Lenny has done an excellent job of organizing these issues and recruiting a great lineup of luminaries in infectious diseases.

The development and licensure of new vaccines and the continuing changes in the vaccine schedule challenge all of us to keep up to date. The two articles by Penelope H. Dennehy, MD, and by Erin M. Bennett, MD, and Joseph B. Domachowske, MD, provide excellent reviews of the influenza, varicella, and new rotavirus vaccines, as well as the additions to the adolescent vaccine schedule, including conjugate meningococcal, human papillomavirus, and the booster acellular pertussis vaccine. It is particularly important to structure pediatric office schedules to facilitate administering the adolescent vaccines in particular, as the opportunity to vaccinate against pertussis and meningococcal infection in this highrisk group, as well as prevention of an important cancer of young women, must not be overlooked.

The controversial issue of the role in children (if any) for fluoroquinolones (ciprofloxacin, levofloxacin, etc.) is reviewed very nicely by Thomas S. Murray, MD, PhD, and Robert S. Baltimore, MD. Like most pediatric infectious disease consultants, I certainly do not hesitate to use these agents off-label in special circumstances when they appear to be the best option. The authors highlight, however, the cogent arguments against routine prescribing of this class of antibiotics, especially the potential for emergence of quinolone-resistant respiratory flora with indiscriminate usage.

Paul J. Lee, MD, and Dr. Krilov provide a primer on infectious disease issues that relate to the pediatric international traveler and highlight common infections incurred and/or brought home, like malaria and traveler's diarrhea, and preventive strategies, including specific vaccines. Finally, Robert J. Leggiadro, MD, discusses issues related to potential bioterrorism threats as they apply to children. He provides a review of the Category A (high-risk) agents, including anthrax, smallpox, plague, tularemia, botulism, and viral hemorrhagic fevers. Of course, although we all hope that we will never have to become intimately involved with any of these potential threats, some general knowledge about these topics could be useful.…

The hardcore New York Yankees fan, Leonard R. Krilov, MD, is the Guest Editor of this issue, as well as the July issue, of Pediatric Annals (see his column with baseball cards, page 300). As I write this, the Yankees are mired in last place (yesi) and my Detroit Tigers are in first place (yes!). I know that the former won't last and pray that the latter will. But Lenny has done an excellent job of organizing these issues and recruiting a great lineup of luminaries in infectious diseases.

The development and licensure of new vaccines and the continuing changes in the vaccine schedule challenge all of us to keep up to date. The two articles by Penelope H. Dennehy, MD, and by Erin M. Bennett, MD, and Joseph B. Domachowske, MD, provide excellent reviews of the influenza, varicella, and new rotavirus vaccines, as well as the additions to the adolescent vaccine schedule, including conjugate meningococcal, human papillomavirus, and the booster acellular pertussis vaccine. It is particularly important to structure pediatric office schedules to facilitate administering the adolescent vaccines in particular, as the opportunity to vaccinate against pertussis and meningococcal infection in this highrisk group, as well as prevention of an important cancer of young women, must not be overlooked.

The controversial issue of the role in children (if any) for fluoroquinolones (ciprofloxacin, levofloxacin, etc.) is reviewed very nicely by Thomas S. Murray, MD, PhD, and Robert S. Baltimore, MD. Like most pediatric infectious disease consultants, I certainly do not hesitate to use these agents off-label in special circumstances when they appear to be the best option. The authors highlight, however, the cogent arguments against routine prescribing of this class of antibiotics, especially the potential for emergence of quinolone-resistant respiratory flora with indiscriminate usage.

Paul J. Lee, MD, and Dr. Krilov provide a primer on infectious disease issues that relate to the pediatric international traveler and highlight common infections incurred and/or brought home, like malaria and traveler's diarrhea, and preventive strategies, including specific vaccines. Finally, Robert J. Leggiadro, MD, discusses issues related to potential bioterrorism threats as they apply to children. He provides a review of the Category A (high-risk) agents, including anthrax, smallpox, plague, tularemia, botulism, and viral hemorrhagic fevers. Of course, although we all hope that we will never have to become intimately involved with any of these potential threats, some general knowledge about these topics could be useful.

The stamps here focus on Robert Koch and Louis Pasteur, both of whom were the founders of bacteriology and the developers of some of the earliest vaccines. Koch (18431910), working in isolation as a general physician, in 1876 discovered the bacillus of anthrax, one of the potential bioterrorism agents discussed in this issue. Pasteur (18221895) developed and successfully tested an anthrax vaccine in cows and goats in a classic controlled experiment in 1881. Koch is most famous for his Nobel Prize-winning discovery of the tubercle bacillus in 1882, while Pasteur, of course, developed the rabies vaccine in 1885 and made many other important contributions. The large souvenir sheet from Madagascar shows Pasteur studying spontaneous generation, developing, and administering his rabies vaccine. The latter is incorrect as Pasteur, a non-physician, did not administer the vaccine but rather relied upon Jacques- Joseph Grancher (1843-1907), one of the founders of French pediatrics. Koch is shown on the 1982 Cuba stamp (see page 297) (along with Mycobacterium tuberculosis, the "red snappers") and on the stamp from Gambia.

10.3928/0090-4481-20070601-01

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