Currently, more than 30,200,000 COVID-19 cases have been diagnosed in Germany alone. However, data regarding prevalence of COVID-19 in children, both in Germany and internationally, are sparse. We ...sought to evaluate the number of infected children by measuring IgG antibodies. Oropharyngeal swabs were collected between December 2020 and August 2021 to measure SARS-CoV-2, and capillary blood for the detection of SARS-CoV-2 antibodies (by rapid test NADAL® and filter paper test Euroimmun® ELISA); venous blood was taken for validation (Roche® ECLIA and recomLine Blot) in 365 German children aged 3-16 years from 30 schools and preschools. We used multiple serological tests because the filter paper test Euroimmun® ELISA performs better in terms of sensitivity and specificity than the rapid test NADAL®. The Roche® ECLIA test is used to detect SARS-CoV-2 spike protein, and the recomLine Blot test is used to rule out the possibility of infection by seasonal SARS-viruses and to test for specific SARS-CoV-2 proteins (NP, RBD and S1). In addition, one parent each (n = 336), and 4-5 teachers/caregivers (n = 90) per institution were tested for IgG antibodies from capillary blood samples. The total study duration was 4 months per child, including the first follow-up after 2 months and the second after 4 months. Of 364 children tested at baseline, 3.6% (n = 13) were positive for SARS-CoV-2 IgG antibodies using Euroimmun® ELISA. Seven children reported previously testing positive for SARS-CoV-2; each of these was confirmed by the Roche® Anti-SARS-CoV-2-ECLIA (antibody to spike protein 1) test. SARS-CoV-2 IgG antibodies persisted over a 4-month period, but levels decreased significantly (p = 0.004) within this timeframe. The median IgG values were 192.0 BAU/ml 127.2; 288.2, 123.6 BAU/ml 76.6; 187.7 and 89.9 BAU/ml 57.4; 144.2 at baseline, 2 months and 4 months after baseline, respectively. During the study period, no child tested positive for SARS-CoV-2 by oropharyngeal swab. A total of 4.3% of all parents and 3.7% of teachers/caregivers tested positive for IgG antibodies by Euroimmun® ELISA at baseline. We noted a rather low seroprevalence in children despite an under-reporting of SARS-CoV-2 infections. Measurement of IgG antibodies derived from capillary blood appears to be a valid tool to detect asymptomatic infections in children. However, no asymptomatic active infection was detected during the study period of 4 months in the whole cohort. Further data on SARS-CoV-2 infections in children are needed, especially in the group of <5-year-olds, as there is currently no licensed vaccine for this age group in Germany. The Robert Koch Institute's Standing Commission on Vaccination (STIKO) recommended COVID-19 vaccination for 12-17 and 5-11 year olds in August 2021 and May 2022 respectively.
Introduction
Here we report our results of a multi-center, open cohort study (“COVID-Kids-Bavaria”) investigating the distribution of acute SARS-CoV-2 infections among children and staff in 99 ...daycare facilities and 48 elementary schools in Bavaria, Germany.
Materials and Methods
Overall, 2,568 children (1,337 school children, 1,231 preschool children) and 1,288 adults (466 teachers, 822 daycare staff) consented to participate in the study and were randomly tested in three consecutive phases (September/October 2020, November/December 2020, March 2021). In total, 7,062 throat swabs were analyzed for SARS-CoV-2 by commercial RT-PCR kits.
Results
In phase I, only one daycare worker tested positive. In phase II, SARS-CoV-2 was detected in three daycare workers, two preschool children, and seven school children. In phase III, no sample tested positive. This corresponds to a positive test rate of 0.05% in phase I, 0.4% in phase II and 0% in phase III. Correlation of a positive PCR test result with the local-7-day incidence values showed a strong association of a 7-day-incidence of more than 100/100,000 as compared to <100/100,000 (OR = 10.3 1.5–438,
p
< 0.005). After phase III, antibody testing was offered to 713 study participants in elementary schools. A seroprevalence rate of 7.7% (students) and 4.5% (teachers) was determined.
Discussion
During the initial waves of the SARS-CoV-2 pandemic, the risk of a positive SARS-CoV-2 result correlated positively with the local 7-day incidence. Hence, the occurrence of SARS-CoV-2 infections were reflected in schools and daycare facilities. An increased risk of SARS-CoV-2 transmission in the setting of daycare and elementary schooling was unlikely.
Allergies and vaccination: a myth demystified Ankermann, Tobias; Spindler, Thomas; Gerstlauer, Michael ...
Allergo journal international,
11/2018, Letnik:
27, Številka:
7
Journal Article
Recenzirano
Odprti dostop
Background
Vaccinations are among the commonest and most successful medical measures. Due to the drop in the incidence of vaccine-preventable diseases, rare side effects such as allergic reactions ...are coming more to the fore. In addition, vaccinations are often associated with the rising prevalence of allergic sensitization and allergic disease. The myth that “vaccinations cause allergies” is being circulated. This article presents the available evidence on the effect of vaccinations on the prevalence of atopic manifestations (sensitization, asthma, allergic rhinitis, food allergy) and atopic dermatitis. Based on position papers, recommendations are given on the approach to vaccinations in children with allergic disease and/or atopic dermatitis as well as on the approach in patients with anaphylactic reactions to vaccines.
Methods
A literature search in PubMed and in the reference lists of the identified articles was conducted.
Results
There is no evidence that vaccinations increase the risk of specific allergic sensitization or the manifestation of allergic diseases either in high-risk patients (atopy, positive family history) or in patients with no family history of atopy. Vaccinations do not cause allergies! According to experts, atopic children can be vaccinated under standard conditions without a mandatory follow-up observation period. Allergy testing should be performed following allergic reactions to vaccines or vaccine components. Follow-up vaccinations after anaphylactic reactions to vaccines or vaccine components should be performed under monitoring conditions by physicians experienced in the recognition and treatment of anaphylactic reactions.
Conclusion
Standard vaccinations do not increase the risk for manifesting allergic disease or specific sensitization to environmental allergens. If individual protection is desired, and taking into account the particular risks and provisos, children with allergic disease and anaphylactic reactions to vaccines can also be vaccinated.
Zusammenfassung
Allergische Rhinokonjunktivitis und allergisches Asthma bronchiale gehören zu den häufigsten chronischen Erkrankungen im Kindesalter. Neben Pharmakotherapie und Strategien zur ...Allergenmeidung steht mit der Allergen-Immuntherapie (AIT) ein kausaler Therapieansatz zur Verfügung. Es kann eine Reihe von Erfolgsfaktoren für eine wirksame Therapie identifiziert werden. Außer einem klinisch gut belegten Zusammenhang zwischen Symptomen und Allergenexposition durch eindeutige Anamnese oder Provokationstestung gehört dazu eine bei Therapiebeginn etablierte Management-Strategie zur Sicherung der Adhärenz über den 3‑jährigen Behandlungszeitraum. Das Wissen um mögliche Kontraindikationen und trainierte Abläufe für das Vorgehen bei insgesamt sehr seltenen anaphylaktischen Nebenwirkungen sind notwendig. Eine besondere Herausforderung stellt die sich unter dem Einfluss der Therapieallergene-Verordnung verändernde Produktlandschaft dar.
Allergen immunotherapy (AIT) is the only causal therapy for allergic diseases and therefore particularly important. Allergen preparations have been classified as medicinal products since 1989 ...(Directive 89/342/EEC) and were taken over into Directive 2001/83/EC in 2001. In addition, in 2008 the Therapy Allergen Ordinance (TAO) came into force to stricter regulate the exception for named patient products (NPP) by exclusion of common therapy allergens from the exception to be marketed as NPP. The TAO regulates the requirements for testing safety and efficacy for these common therapy allergens. Due to the long transitional provisions, the last deadlines for solving clinical shortcomings will end in 2026. The advantage of this regulation is that the market for common allergens has been cleared of products without proof of efficacy, and new preparations with an optimal dose range are developed through dose-finding studies. The demand for long-term pediatric studies has been outlined by the standard Pediatric Investigation Plan (PIP) on allergen products from the Pediatric Committee of the EMA (PDCO). This is particularly problematic, as it is foreseeable that recruitment of patients will be limited and ethical problems arise from the prolonged use of placebo. Furthermore, many newly approved preparations will not be used in pediatrics for the foreseeable future, as no marketing authorization has yet been granted for this age group. This will result in a serious supply gap for children.
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