Paediatric Virology: A rapidly increasing educational challenge

Abstract

The '2nd Workshop on Paediatric Virology', which took place on Saturday the 8th of October 2016 in Athens, Greece, provided an overview on recent views and advances on Paediatric Virology. Emphasis was given to HIV-1 management in Greece, a country under continuous financial crisis, hepatitis B vaccination in Africa, treatment options for hepatitis C virus in childhood, Zika virus in pregnancy and infancy, the burden of influenza on childhood, hand-foot-mouth disease and myocarditis associated with Coxsackie viruses. Other general topics covered included a critical evaluation of Paediatric Accident and Emergency viral infections, multimodality imaging of viral infections in children, surgical approaches of otolaryngologists to complex viral infections, new advances in the diagnosis and treatment of viral conjunctivitis and novel molecular diagnostic methods for HPV in childhood. A brief historical overview of the anti-vaccination movement was also provided, as well as presentations on the educational challenge of Paediatric Virology as a new subspecialty of Paediatrics. This review highlights selected lectures and discussions of the workshop.

Keywords: AIDS; Coxsackie viruses; ENT; HIV-1; HPV; MRI; Paediatric Virology; Zika virus; conjunctivitis; hepatitis B; hepatitis C; influenza; viral infections.

Figure 1.

Paediatric cases of HIV-1 infection by transmission group reported in Greece by 31/12/2014 - adapted from Hellenic Centre for Disease Control and Prevention (HCDCP) (11).

Figure 2.

HCV treatment choices in children: To treat or not to treat children for HCV? - adapted from Wirth et al (30).

Figure 3.

Post-varicella vasculitis and stroke: a 3-year-old boy presented with acute onset of left upper arm weakness and facial nerve palsy; there was a recent previous history of ‘gastroenteritis’. MRI performed on emergency admission revealed an extensive area of abnormal signal intensity at the region of the right basal ganglia on axial fluid attenuation inversion recovery (FLAIR) image (arrow in panel a), which presented restricted diffusion on diffusion weighted imaging (DWI) sequence (arrow in panel b) in keeping with acute ischaemic infarct. Absence of flow void on magnetic resonance angiography (MRA) was confirmed in the proximal part of the right anterior cerebral artery (ACA) (single arrow in c) and along the right middle cerebral artery (MCA) (double arrow in panel c).

Figure 4.

Total number of specimens tested for influenza viruses and positive specimens for each influenza subtype during 2015–2016 in Greece-adapted from Hellenic Centre for Disease Control and Prevention (HCDCP) (71).