Allergen immunotherapy and respiratory infections in children: an encouraging experience.

BACKGROUND: Allergic inflammation may promote respiratory infections (RI). House dust mite (HDM) sensitization is common in childhood. Allergen immunotherapy may cure allergy as it restores a physiological immune and clinical tolerance toward the causal allergen and exerts anti-inflammatory activity. This study retrospectively investigated whether 3 year high-dose HDM-sublingual immunotherapy (SLIT) could affect respiratory infections in children with allergic rhinitis. METHODS: Globally, 33 HDM allergic children (18 males, mean age 9.3 years) were subdivided in 2 groups: 20 treated with symptomatic drugs alone (group 1) and 13 by high-dose SLIT, titrated in mcg of major allergens (group 2) for 3 years. RESULTS: SLIT-treated children had significantly (P=0.01) less RI episodes (3.6) than symptomatically-treated children (5.4). In addition, SLIT-treated children had less fever (P<0.01) and took fewer medications, such as antibiotics (P<0.05) and fever-reducers (P<0.01), than symptomatically-treated children. CONCLUSIONS: This preliminary study suggests that high-dose 3-year SLIT might lessen RI in allergic children.

Peer teaching at recess and improvement of disc-throwing skills by children in kindergarten through grade 3.

This study examined the effect of peer teaching at recess on improving disc-throwing skills for kindergartners to children in Grade 3. 167 boys and girls were instructed in basic disc-throwing skills, backhand and forehand throwing techniques, and peer teaching. The practice group (n = 73) was encouraged to practice with a disc using peer teaching for at least 10 min. during recess for 10 days. The control group (n = 94) took part in other activities without a disc. Two-way analysis of variance with repeated measures gave significant interaction of groups and tests for girls in Grade 3 as well as significant main effects between tests in kindergarten boys and Grade 2 boys and girls. This study suggests that peer teaching for disc-throwing skills is useful for girls in Grade 3 and may be more effective for girls than boys.

Influenza vaccination coverage among children with high-risk medical conditions.

We evaluated influenza vaccination coverage in children with chronic disease at high risk of influenza complications, and the need for methods to increase parents' and pediatricians' knowledge of influenza and its prevention. The 5286 children aged less than 14 years attending our Emergency Department on Wednesdays and Sundays between 1 January and 30 April 2003 included 274 (5.2%) high-risk patients. The use of influenza vaccine during the previous three seasons had been very low, but significantly increased in the last season (2000-2001, 5.1%; 2001-2002, 12.9%; 2002-2003, 26.3%; p<0.001). The children with asthma or cardiac disease showed the lowest vaccination rates; their parents and primary care pediatricians had only a marginal knowledge of influenza and the benefits of its prevention. In conclusion, the delivery of influenza vaccine to children with chronic disease at high risk of influenza complications is completely inadequate, and major efforts are urgently needed to increase parents' and pediatricians' knowledge of its importance.

Theoretic coverage of heptavalent pneumococcal conjugate vaccine in the prevention of community-acquired pneumonia in children in Italy.

In order to evaluate the theoretic coverage of the heptavalent conjugate vaccine against community-acquired pneumonia (CAP) during the first years of life, the anti-capsular IgG antibodies to the nine more common pneumococcal serotypes (1, 4, 5, 6B, 9V, 14, 18C, 19F, 23F) were quantitated in 196 affected children aged 2-5 years by means of enzyme-linked immunosorbent assays of acute and convalescent serum samples. Acute Streptococcus pneumoniae infection associated with the nine tested serotypes was diagnosed in 57 children (29.1%). Serological data indicated that 16.8% of CAPs were caused by serotypes included in the heptavalent conjugate vaccine. This study confirms the significant role of S. pneumoniae in pediatric CAP, and highlights the importance of pneumococcal conjugate vaccines in preventing it during the first years of life.