Letter: Sterilization of children under 16 years of age.

PIP: This is an official response by the British Paediatric Association t o a discussion paper prepared by the Dept. of Health and Social Security . Sterilization in children falls into 2 groups: 1) those for whom ster ilization is unavoidable in the course of treatment of a serious medical condition, and (2) sterilization of children with a severe mental handicap to avoid pregnancy. In the 1st case a 2nd opinion should be sought if at all possible, but in some cases of cancer when the decision must be made at operation, this is not always feasible. In genetic conditions the presence of the condition alone cannot justify sterilization. A full consultation involving medical social workers, psychologists, and others should be sought. In no case should a parent be able to secure a daughter's sterilization because it is feared she may become promiscuous. Whenever possible sterilization should be postponed until age of consent. In cases of severe mental handicap there should be procedures which safeguard the interest of the person regardless of age. The Association opposes a central registry, as well as ethical committees. If consensus cannot be reached a Ward of the Court Procedure should be followed.^ieng

Letter: Sterilisation of children under 16.

PIP: In response to a recent Dept. of Health and Social Security paper on sterilization of children under 16, the British Paediatric Association states its opinion. Sterilization is recommended for 2 groups: 1) those for whom sterilization is unavoidable in the course of treatment of a serious medical condition (such as cancer of the pelvic organs), and 2) those with severe mental handicap in which pregnancy is not desired. In the 1st case the decision should be made by the doctor in charge, in con sultation with others if at all possible. In the 2nd a decision should not be made by a single doctor but by other medical personnel, social workers, and the like. Genetic conditions alone do not indicate sterilization under the age of 16 and in no instance should a parent secure a daughter's sterilization because it is feared the child may become promiscuous. Wherever possible, sterilization should be postponed until the age of consent. The Paediatric Association is not in favor of a central registry or any form of notification, and decisions should not be delegated to ethical committees. If consensus cannot be reached, a ward of court procedure should be followed.^ieng

Virus cross-infection in paediatric wards.

In a survey of virus cross-infection in paediatric wards there were 15 cross-infections due to respiratory syncytial (R.S.) virus and 16 due to influenza A, both during a four-month period, and 19 due to parainfluenza viruses over two years. The illnesses produced by these infections acquired in hospital ranged from a slight cold to severe pneumonia: in 17 of the 50 cases the illness involved the lower respiratory tract. A measure of cross-infection frequency in the form of a "cross-infection rate" has been devised, and it is suggested that this can be used to assess the influence of factors such as ward design and admission policy on the frequency of cross-infection.

Respiratory syncytial virus in hospital cross-infection.

During an epidemic of respiratory syncytial (R.S.) virus in Newcastle upon Tyne 13 children developed R.S. virus infections while in hospital with other conditions. R.S. virus infection was also noted in four members of the staff. In two of the hospital wards outbreaks developed. All children infected with R.S. virus developed symptoms. The symptoms varied with age; two children aged 2 months or less developed colds, as did five children over 1 year of age. One child of 15 months with Werdnig-Hoffman disease, though suffering from a cold, later developed pulmonary collapse. All five children aged 3 to 8 months developed bronchiolitis. The effectiveness of special nursing in cubicles was probably diminished because adults with mild colds were excreting virus. The dangers of R.S. virus infection to other children in the ward, especially those with congenital heart disease, is emphasized.