Recap of 2005: new threats, old enemies and more ways to fight the good fight

December 2005

New threats, such as avian influenza, and old enemies, like polio and rabies, dominated the pages of Infectious Diseases in Children in 2005.

The year was full of good and bad news. Because I’m inherently an optimist, let’s talk about the good news first. Vaccines for adolescents made the pages this year with the approval of two diphtheria-tetanus-acellular pertussis (Tdap) vaccines and a new meningococcal vaccine. These new vaccines make it more prudent for adolescents to visit your office. Public health officials hope that pediatricians use this visit to not only vaccinate, but to assess the overall health of young people, including their psychological well-being. It can be a great opportunity to discuss sex, drugs and other temptations.

The new Tdap vaccines (Boostrix, GlaxoSmithKline; Adacel, Sanofi Pasteur) are recommended for adolescents aged 10 to 18 years old. Eventually, though, they may wind up being the “tetanus” shot that emergency room doctors give to anyone who comes in with a wound. The reason: pertussis in adolescents and adults can cause serious illness in infants too young to be vaccinated.

The human papillomavirus (HPV) vaccine was good news. Researchers found Gardasil (Merck) to be almost 100% effective in preventing precancerous lesions from HPV-16 and -18. Its approval is expected next year. HPV infections are rampant around the world, and the vaccine’s acceptance may depend on whether parents view it as an anti-cancer vaccine or a vaccine against a sexually transmitted disease. We hope you can make the case for preventing these diseases in adolescents.

The approval of meningococcal C vaccine (MCV4; Menacta, Sanofi Pasteur) was also good news. However, reports of six cases of Guillain-Barré syndrome (GBS) have tempered the news somewhat. Public health officials are investigating whether this is related to the vaccine or just normal cases for this disease. To date, Sanofi Pasteur has distributed 2.8 million doses of MCV4, and there were no reports of GBS in prelicensure studies that included 7,000 doses of vaccine.

Other news included the approval of a measles-mumps-rubella-varicella (MMRV; ProQuad, Merck) vaccine, which will reduce the number of shots that infants receive by one, and new recommendations for the hepatitis A vaccine, which is now universally recommended for infants. Until this change, the hepatitis A vaccine was only given to high-risk children and those living in endemic areas of the country. The remarkable difference the vaccine made in those areas lead to the universal recommendation.

Rubella moved one step closer to being eliminated throughout the world, and polio took one step backward in its elimination effort. Health officials are probing five cases of polio that occurred among an Amish community in Minnesota. Only one case has resulted in disease in an immunocompromised child. Health officials, however, do not know where that child was exposed and are trying to find the source.

Avian influenza dominated the pages this year, and will probably dominate the pages next year. Although the hype may lead you to think this is just a media event, one influenza expert said that the migratory patterns of Asian water fowl has gripped his attention as birds have never done in the past. In other words, a pandemic is very possible and it is wise for the world to pay attention, prepare and work to prevent one.

Methicillin-resistant Staphylococcus aureus (MRSA) continues to make headlines too, as it moved from the hospital to the community and back again. A while back, the IDSA called on Congress to implement strategies to encourage development of new and better antibiotics. Antibiotics, which are only given for a short period, just are not the moneymakers that shareholders demand. If something is not done to encourage the development of new antibiotics, we could return to an era when doctors cannot treat infections.

Finally, an odd little story from Wisconsin. A teenager who contracted rabies and who did not receive post-exposure prophylaxis survived the disease – a first in medical history. The survivor’s physician finally revealed the formula that saved her life.

How did our stories make our top 10 list? Our editorial board voted. It was very democratic, but not very scientific. We hope you enjoy our recap of the year’s news, and we look forward to another exciting year in infectious diseases and pediatrics. Have a happy holiday and wonderful New Year.