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Introduction: Varicella is a highly contagious infection that can lead to serious complications, particularly in high-risk groups; however, it is vaccine preventable. Disease awareness and understanding of the disease burden can strongly influence vaccine coverage. This review provides insight into the current epidemiology and the importance of varicella from both public health and economic perspectives across the Asia-Pacific (APAC) region. Areas covered: A systematic literature review was conducted to identify studies on the incidence, seroprevalence, fatality rate and complication rate of varicella. Economic burden studies were also captured. Altogether, 125 studies were identified across the region; these were supplemented by government reports (gray data). Reported vaccine coverage varied from 2.8% to 97%; a key influencing factor was inclusion of the varicella vaccine in national immunization programs. In general, varicella incidence in the unvaccinated population was highest in children ≤5 years old and seroprevalence increased with age. Economic analyses highlighted the cost-saving potential of vaccination programs, especially from a societal perspective. Expert opinion: Varicella-related data varied greatly across the APAC region, highlighting the need to better understand the burden of varicella in this area, and particularly identified the need for better surveillance and reporting.

Varicella or chickenpox is a highly contagious disease with a high secondary attack rate. Almost 30% of Indian adolescents lack protective antibodies against varicella, emphasizing the need of routine varicella immunization. The Oka VZV is a well-established, safe and efficacious vaccine strain that is highly immunogenic and produces lifelong protective immunity. The present multicentric, open label, randomized, controlled Phase II/III study, compared the Bio Pox™ (indigenous investigational vaccine) with a licensed vaccine, Varivax™, for its safety and immunogenicity profile in 252 healthy subjects in the age group of 1–12 y (cohort I: 6–12 years, II:1–6 years) in 3 tertiary medical institutions. Antibodies were measured by VZV Glycoprotein Enzyme Linked Immunoassay (IgG ELISA) kit. Seroconversion percentage in children having pre-vaccination anti VZV IgG titer

Bullous mastocytosis (BM) is a rare variant of diffuse cutaneous mastocytosis where there is disorderly infiltration of the skin by mast cells. We report a 4-month-old male infant with this rare disease who presented with wrinkled tough skin and generalized multiple bullous lesions. Diagnosis was done by serum tryptase level and histopathological examination. The patient responded well to oral corticosteroid and antihistaminic therapy. Although a congenital disorder, timely diagnosis and treatment can be potentially rewarding in patients with BM.

Introduction: Antibiotic resistance is an increasing global problem which hampers appropriate treatment of Urinary Tract Infection (UTI) in paediatric population, rendering the developing kidneys vulnerable for scarring and long-term complications. The present study stressed upon the most severely affected patients who required hospitalisation for treatment of UTI. Authors conducted this study observing the higher degree of drug resistance in patients admitted to general paediatric ward lately, suffering from UTI. Aim: To observe different clinical presentations of paediatric patients hospitalised with UTI. Authors also intended to identify locally prevalent community acquired bacterial uropathogens of clinical importance and note the sensitivity and resistance patterns of the isolated organisms against different antibiotics. Materials and Methods: This prospective observational pilot study was conducted at the Institute of Child Health, Kolkata, a tertiary care paediatric referral hospital. A total of 950 urine samples (single sample per patient) were collected from hospitalised children (from neonatal age group, upto 12 years) with suspected UTI/sepsis, between October 2014 to April 2016. Of 132 culture positive samples, 35 were excluded as per exclusion criteria, and 97 isolates had antimicrobial sensitivity performed on them. Clinical presentation was documented. Statistical analysis was done using the Chi-Square test. Results: The most common clinical presentations were fever, pain abdomen and anorexia. The most common isolates were Escherichia coli 59/97 (60.82%), followed by Enterococcus spp. 19/97 (19.59%) and Klebsiella pneumoniae 9/97 (9.28%). The majority of E. coli (n=59) isolates showed resistance against all Cephalosporins: 49-52 (83.1-88.1%), meropenem: 39 (66.1%), cotrimoxazole: 42 (71.1%), amoxycillin-clavulanic acid: 55 (93.2%) and quinolones: 50-51 (84.8-86.4%). Most Enterococcus spp. (n=19) isolates were resistant to amikacin: 17 (89.5%). Overall, a large proportion, 79/97 (81.4%) of uropathogens isolated showed Multidrug-Resistance (MDR). Conclusion: The alarming rates of resistance of uropathogens to commonly used antibiotics calls for review of empiric treatment guidelines and emphasises the need for preventing antibiotic misuse in day-to-day practice.