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ObjectiveTo study seizures in patients hospitalised due to SARS-CoV-2 infection, and compare their severity with seizures in patients hospitalised due to other viral respiratory tract infections (RTIs).DesignObservational population-based cohort study.SettingNorthern Stockholm.PatientsPatients aged 1 month–18 years hospitalised due to SARS-CoV-2 with and without seizures, and patients of the same age hospitalised due to other viral RTIs with seizures, between 1 March 2020 and 30 June 2022.Main outcome measuresThe prevalence of seizures in hospitalised patients due to SARS-CoV-2, the evaluation of assumed predictors of seizures and the comparison of severity markers in patients with SARS-CoV-2 versus other RTIs.Results32 of 239 included patients (13.4%) admitted due to SARS-CoV-2 infection had seizures. Central nervous system (CNS) disease and the omicron period had significantly increased OR for seizures (OR: 5.12; CI: 2.06 to 12.72 and OR: 3.01; CI: 1.15 to 7.88, respectively). Seizures in patients with SARS-CoV-2 were more common in children older than 5 years (p=0.001), even in the absence of fever (p=0.007), as compared with other viral RTIs. The duration of hospitalisation was longer in patients with seizures due to other viral RTIs (p=0.023). There was no significant difference regarding severity markers of seizures between the two groups.ConclusionsCNS disease and the omicron period were risk factors for seizures in patients with SARS-CoV-2, who were older than patients with other RTIs. The severity of seizures was comparable between the two groups; hospitalisation was however longer in patients with other RTIs.

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Supplemental Digital Content is available in the text.

Increasing international migration has changed the epidemiology of tuberculosis (TB) in Europe. Little is published on clinical manifestations and epidemiology in children in this new era.

The decline of tuberculosis (TB) in the Swedish population since the middle of the 20th century resulted in decreased awareness of the disease. Increased migration from TB-endemic countries has resulted in new cases and risk of transmission. A day care provider was diagnosed with cavitary TB after being symptomatic for 5 months. We describe the contact tracing at the day care center, the clinical and radiographic findings, and treatment of the infected children.

There are few independent, population-based reports that estimate the risk of hospitalization of respiratory syncytial virus (RSV)-infected infants before and during the palivizumab era. We present figures from the greater Stockholm area during the three seasons after the introduction of palivizumab and relate them to data based on 1400 hospitalizations for RSV disease in the same population area during 1987 through 1998.

There have been few large reports of the treatment and outcome of neuroborreliosis in children.

To seek the possible epidemiologic relationship between the two dominant pediatric infectious agents, respiratory syncytial virus (RSV) and rotavirus, and to analyze the relationship of RSV to influenza virus infections and climate.

Aerobic and anaerobic fecal bacterial flora of normal newborn infants, of preterm newborn infants without other health problems and of five groups of newborn infants treated with combinations of benzylpenicillin, cloxacillin, flucloxacillin, ampicillin, cefuroxime, cefoxitin and gentamicin were compared. Preterm birth alone was associated with growth of Klebsiellawhich could be attributed to a higher rate of cesarean section in preterm than in term infants. All antibiotic regimens led to a pronounced suppression of anaerobic flora and overgrowth of Klebsiellabut not with other gram-negative aerobic bacteria. A slight colonization with Clostridium difficileand Clostridium perfringensoccurred. Disturbances of the intestinal microbial ecology can be expected in newborn infants after preterm birth by cesarean section and/or treatment with antibiotics, including some penicillins that are usually regarded as relatively harmless in this respect in adults.

At St. Göran's Children's Hospital (a tertiary center), we perform electron microscopy of feces in most cases of nosocomial gastroenteritis. From September 1987 through April 1992 we identified 32 episodes of calicivirus infection, 25 of which were nosocomial and, except for one outbreak, sporadic. Systematic study of the nosocomial outbreak of calcivirus gastroenteritis from November 1991 to January 1992, revealed calcivirus in the stools of 8 of 23 children with diarrhea and 0 of 10 without diarrhea. In 3 of 7 sampled after cessation of diarrhea, calicivirus excretion continued for 3 to 6 days. We found no calicivirus in 42 staff members or 9 members of infected patients' families. Nosocomial transmission of calicivirus can occur among infants.

During a 16-month study period at a children's hospital, 32 children developed nosocomial gastroenteritis caused by astroviruses. Twenty-five of these occurred during 2 epidemic outbreaks in medical and surgical infants' wards. From the community, 13 confirmed cases were admitted during the study period. Both community-acquired and nosocomial cases occurred during autumn, winter and early spring. The atack rates during outbreaks ranged between 7 and 62 and were highest among children with underlying gastrointestinal diseases. Diarrhea and vomiting were the most common clinical manifestations. The median duration of symptoms was 4 days and that of virus excretion was 5 days.

To describe the role of Norwalk-like virus in pediatric diarrhea, since relatively little is known about it in this age group.

81 cases of tuberculosis infection (17) and disease (64), seen between 1977 and 1995 at St Gööran's Children's hospital, Stockholm, Sweden are reviewed. The incidence of tuberculosis disease increased from 1 to 6/105children/y. The increase was due to immigration from high-prevalence countries, with an incidence of 20/105in a partly segregated suburb. Most of the children were foreign-born. Of the 31 0-4-y-old cases, 19 were born in Sweden, and 7 had received BCG vaccination. For Swedish-born children with Swedish-born parents, the incidence of tuberculosis disease remained stable at < 0.5. 50 patients were symptomatic when first seen (60% pulmonary tuberculosis, 8% miliary tuberculosis, 25%, cervical adenitis, 15% other extrapulmonary tuberculosis). There was 1 death, and in 2 children complicated tuberculosis courses. Side effects of drug therapy were seen in 5% of the children. In conclusion, tuberculosis remains an important differential diagnosis in children of immigrants from high-prevalence countries for at least 5 y after settlement in Sweden. The practice of delaying BCG vaccination of them until 6 months of age can be disputed.

Objective: To seek the possible epidemiologic relationship between the two dominant pediatric infectious agents, respiratory syncytial virus (RSV) and rotavirus, and to analyze the relationship of RSV to influenza virus infections and climate.

The aerobic and anaerobic intestinal microflora of 60 newborn infants in Addis Ababa was studied. As opposed to earlier published studies from Stockholm, there were no consistent changes of the microflora attributable to antibiotic treatment. The reason why antimicrobial agents caused quantitatively smaller changes of the intestinal microflora in newborn infants in Addis Ababa than in Stockholm is not known, but may be due to antimicrobial inactivation, or marked, continuous ingestion of bacteria. Colonisation by potentially pathogenic gram-negative bacteria was coupled to a low isolation rate of bifidobacterium, but not of lactobacillus. This is consistent with the hypothesis that bifidobacterium might convey some kind of resistance to colonisation by and overgrowth of gram-negative bacteria in newborn infants. Similar results have previously been obtained in Stockholm. In comparison to 45 healthy infants in Stockholm, the Ethiopian infants had more enterococcus and lactobacillus and less staphylococcus and bacteroides during the first 2 weeks of life. After that time, the only difference was more frequent colonisation by lactobacillus in Addis Ababa.

When the tuberculosis epidemic reached its peak in central Europe in the 1900s (not until the 2000s in sub-Saharan Africa), both contained and disseminated tuberculosis was mainly regarded as a childhood disease. From 1920, before the use of the Bacillus Calmette–Guérin (BCG) vaccine and the possibility of drug treatment, there was a drastic decline in the rate of tuberculosis incidence in the Western world. In 1970, the case rate had declined in Sweden from 500/100,000 individuals to 1/100,000 individuals. We recently studied childhood tuberculosis in the Stockholm area from 1971 to 2015. During this period the case rate had increased from 1/100,000 individuals to 8/100,000 individuals. A major contributing factor has been increased immigration and, more recently, from high incidence countries. While there are very few cases in Swedish children whose parents are also born in Sweden, the case rate is still high in foreign-born children, for example, 450/100,000 foreign-born Somali children. At the beginning of the past 45years, sentinel (infected in Sweden with no known source person) cases were a reality but they are rarely seen today. This may be attributed to better organization, contact tracing, screening, and early diagnosis in the adult population.

AIMS: To compare the aerobic and anaerobic intestinal microflora of newborn infants with and without antibiotic treatment and also to describe any relationships between presence of anaerobic bacteria and colonization by potentially pathogenic gramnegative aerobic bacteria.METHODS: Fresh faecal specimens were obtained from 61 infants in Addis Abeba and 21 infants in Stockholm. All infants were breastfed. The specimens were frozen for 0-20 days, thawed and transported in anaerobic athmosphere to the laboratory in Stockholm.RESULTS: In Stockholm, the dominating aerobe was S.epidermidis: and the dominating anaerobe was Bacteriodes fragilis. Bifidobacteria were only rarely isolated. In Addis Abeba E.coli and lactobacilli dominated. Antibiotic treatment produced no consistent change of the intestinal microflora of Addis Abeba infants, as opposed to the dramatic impact seen in Sweden. There was an inverse relationship between colonization by potentially pathogenic Gramnegative aerobic bacteria and occurrence of bifidobacteria but not of lactobacilli.CONCLUSIONS: The intestinal flora of breastfed newborn infants in Stockholm differs from what has previously been reported, whereas in Addis Abeba it is more “classical”. Bifidobacteria, but not lactobacilli, might produce some resistance to colonization by Gramnegative bacteria from the hospital environment.