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5. Letter to the Editor

Author

Britton, Philip N, primary, Nayda, Claire, additional, Leung, Kin‐Chuen, additional, Colclough, Ailsa, additional, Shaw, Nadine, additional, and Kesson, Alison, additional

Published
2020
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9. Do facemasks protect against COVID‐19?

Author

Isaacs, David, primary, Britton, Philip, additional, Howard‐Jones, Annaleise, additional, Kesson, Alison, additional, Khatami, Ameneh, additional, Marais, Ben, additional, Nayda, Claire, additional, and Outhred, Alexander, additional

Published
2020
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18. Utility of early influenza diagnosis through point-of-care testing in children presenting to an emergency department

Author

Li-Kim-Moy, Jean, primary, Dastouri, Fereshteh, additional, Rashid, Harunor, additional, Khandaker, Gulam, additional, Kesson, Alison, additional, McCaskill, Mary, additional, Wood, Nicholas, additional, Jones, Cheryl, additional, Zurynski, Yvonne, additional, Macartney, Kristine, additional, Elliott, Elizabeth J, additional, and Booy, Robert, additional

Published
2016
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21. Recurrent fevers

Author

Isaacs, David, primary, Kesson, Alison, additional, Lester-Smith, David, additional, and Chaitow, Jeffrey, additional

Published
2012
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23. Comparing the use of, and considering the need for, lumbar puncture in children with influenza or other respiratory virus infections

Author

Khandaker, Gulam, primary, Heron, Leon, additional, Rashid, Harunor, additional, Li‐Kim‐Moy, Jean, additional, Lester‐Smith, David, additional, Kesson, Alison, additional, McCaskill, Mary, additional, Jones, Cheryl, additional, Zurynski, Yvonne, additional, Elliott, Elizabeth J., additional, Dwyer, Dominic E., additional, and Booy, Robert, additional

Published
2012
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31. Letters to the Editor

Author

Snelling, Tom, primary, Cripps, Terri, additional, Macartney, Kristine, additional, Dalton, Dianne, additional, Kesson, Alison, additional, and Isaacs, David, additional

Published
2007
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36. Comparing the use of, and considering the need for, lumbar puncture in children with influenza or other respiratory virus infections.

Author

Khandaker G, Heron L, Rashid H, Li-Kim-Moy J, Lester-Smith D, Kesson A, McCaskill M, Jones C, Zurynski Y, Elliott EJ, Dwyer DE, and Booy R

Subjects
Adolescent, Australia, Child, Child, Preschool, Diagnosis, Differential, Female, Humans, Infant, Infant, Newborn, Male, Retrospective Studies, Young Adult, Bacteremia diagnosis, Meningitis, Bacterial diagnosis, Respiratory Tract Infections diagnosis, Spinal Puncture statistics & numerical data, Virus Diseases diagnosis
Abstract

Background: The clinical presentation of influenza in infancy may be similar to serious bacterial infection and be investigated with invasive procedures like lumbar puncture (LP), despite very limited evidence that influenza occurs concomitantly with bacterial meningitis, perhaps because the diagnosis of influenza is very often not established when the decision to perform LP is being considered., Methods: A retrospective medical record review was undertaken in all children presenting to the Children's Hospital at Westmead, Sydney, Australia, in one winter season with laboratory-confirmed influenza or other respiratory virus infections (ORVIs) but excluding respiratory syncytial virus, to compare the use of, and reflect on the need for, the performance of invasive diagnostic procedures, principally LP, but also blood culture, in influenza and non-influenza cases. We also determined the rate of concomitant bacterial meningitis or bacteraemia., Findings: Of 294 children, 51% had laboratory-confirmed influenza and 49% had ORVIs such as parainfluenza viruses (34%) and adenoviruses (15%). Of those with influenza, 18% had a LP and 71% had a blood culture performed compared with 6·3% and 55·5% in the ORVI group (for both P<0·01). In multivariate analysis, diagnosis of influenza was a strong independent predictor of both LP (P=0·02) and blood culture (P=0·05) being performed, and, in comparison with ORVIs, influenza cases were almost three times more likely to have a LP performed on presentation to hospital. One child with influenza (0·9%) had bacteraemia and none had meningitis., Interpretation: Children with influenza were more likely to undergo LP on presentation to hospital compared with those presenting with ORVIs. If influenza is confirmed on admission by near-patient testing, clinicians may be reassured and less inclined to perform LP, although if meningitis is clinically suspected, the clinician should act accordingly. We found that the risk of bacterial meningitis and bacteraemia was very low in hospitalised children with influenza and ORVIs. A systematic review should be performed to investigate this across a large number of settings., (© 2012 John Wiley & Sons Ltd.)

Published
2013
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37. The impact of bacterial and viral co-infection in severe influenza.

Author

Blyth CC, Webb SA, Kok J, Dwyer DE, van Hal SJ, Foo H, Ginn AN, Kesson AM, Seppelt I, and Iredell JR

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Cohort Studies, Critical Care statistics & numerical data, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Pregnancy, Young Adult, Bacterial Infections complications, Coinfection epidemiology, Coinfection pathology, Influenza, Human epidemiology, Influenza, Human pathology
Abstract

Background: Many questions remain concerning the burden, risk factors and impact of bacterial and viral co-infection in patients with pandemic influenza admitted to the intensive care unit (ICU)., Objectives: To examine the burden, risk factors and impact of bacterial and viral co-infection in Australian patients with severe influenza., Patients/methods: A cohort study conducted in 14 ICUs was performed. Patients with proven influenza A during the 2009 influenza season were eligible for inclusion. Demographics, risk factors, clinical data, microbiological data, complications and outcomes were collected. Polymerase chain reaction for additional bacterial and viral respiratory pathogens was performed on stored respiratory samples., Results: Co-infection was identified in 23·3-26·9% of patients with severe influenza A infection: viral co-infection, 3·2-3·4% and bacterial co-infection, 20·5-24·7%. Staphylococcus aureus was the most frequent bacterial co-infection followed by Streptococcus pneumoniae and Haemophilus influenzae. Patients with co-infection were younger [mean difference in age = 8·46 years (95% CI: 0·18-16·74 years)], less likely to have significant co-morbidities (32·0% versus 66·2%, P = 0·004) and less frequently obese [mean difference in body mass index = 6·86 (95% CI: 1·77-11·96)] compared to those without co-infection., Conclusions:  Bacterial or viral co-infection complicated one in four patients admitted to ICU with severe influenza A infection. Despite the co-infected patients being younger and with fewer co-morbidities, no significant difference in outcomes was observed. It is likely that co-infection contributed to a need for ICU admission in those without other risk factors for severe influenza disease. Empiric antibiotics with staphylococcal activity should be strongly considered in all patients with severe influenza A infection., (© 2012 Blackwell Publishing Ltd.)

Published
2013
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38. Immunopathology of flavivirus infections.

Author

King NJ, Getts DR, Getts MT, Rana S, Shrestha B, and Kesson AM

Subjects
Animals, Antibody Formation, Central Nervous System immunology, Flavivirus immunology, Flavivirus pathogenicity, Flavivirus Infections transmission, Humans, Immunity, Cellular, Immunity, Innate, Mice, Viral Load, Central Nervous System virology, Flavivirus Infections immunology, Flavivirus Infections pathology
Abstract

With the recent emergence of the flavivirus, West Nile virus (WNV), in particular, the New York strain of Lineage I WNV in North America in 1999, there has been a significant increase in activity in neurotropic flavivirus research. These viruses cause encephalitis that can result in permanent neurological sequelae or death. Attempts to develop vaccines have made progress, but have been variably successful, despite considerable commercial underwriting. Thus, the discovery of ways and means to combat disease is no less urgent. As such, most recent work has been directed towards dissecting and understanding the pathogenesis of disease, as a way of informing possible approaches to abrogation or amelioration of illness. Whether inherent to flaviviruses or because humans are incidental, dead-end hosts, it is clear that these viruses interact with their human hosts in extremely complex ways. This occurs from the cellular level, at which infection must be established to produce disease, to its interaction with the adaptive immune response, which may result in its eradication, with or without immunopathological and consequent neurological sequelae. As human proximity to and contact with flavivirus insect vectors and amplifying hosts cannot practically be eliminated, our understanding of the pathogenesis of flavivirus-induced diseases, especially with regard to possible targets for treatment, is imperative.

Published
2007
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