Publications by authors named "Maria Theodoridou"

138 Publications

The foundation of the Institute of Paediatric Virology on the island of Euboea, Greece (Review).

Exp Ther Med 2020 Dec 30;20(6):302. Epub 2020 Oct 30.

Institute of Paediatric Virology, Aliveri, 34500 Island of Euboea, Greece.

The Institute of Paediatric Virology, founded on October 2019 on the island of Euboea in Greece, introduces medical students, paediatric and neonatal trainees, postgraduate students, virologists, paediatric and allied health professionals to the bold, new, scientific field of paediatric virology. The institute is committed to medical education and is the sequel of the Paediatric Virology Study Group (PVSG), which was formed in 2007 in the United Kingdom by a group of young paediatric trainees and junior researchers. The main mission of the institute is to provide an educational e-platform on neonatal and paediatric viral infections, to facilitate scientific discussion between virologists and paediatric health professionals and to develop an international network aiming to the promotion of children's health by the prevention and treatment of viral infectious diseases. The foundation of the institute is dedicated to three children from a small fishing village at the south of the island of Euboea in Greece, who survived the 1918 Spanish flu pandemic.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2020.9432DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7668136PMC
December 2020

Paediatric virology and medical terminology.

Exp Ther Med 2020 Dec 30;20(6):301. Epub 2020 Oct 30.

Institute of Paediatric Virology, Aliveri, 34500 Island of Euboea, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2020.9431DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7668148PMC
December 2020

Viruses, vaccinations and RSV: Exploring terminology in paediatric virology.

Exp Ther Med 2020 Dec 30;20(6):300. Epub 2020 Oct 30.

Institute of Paediatric Virology, Aliveri, 34500 Island of Euboea, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2020.9430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7668151PMC
December 2020

COVID-19 and paediatric challenges: An interview with Professor of Paediatrics Vana Papaevangelou (University of Athens School of Medicine).

Exp Ther Med 2020 Dec 30;20(6):296. Epub 2020 Oct 30.

Institute of Paediatric Virology, Aliveri, 34500 Island of Euboea, Greece.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus, which causes coronavirus disease 2019 (COVID-19) and affects children less frequently than adults. According to Professor Vana Papaevangelou, Professor of Paediatrics at the University of Athens School of Medicine, children comprise only 2-6% of COVID-19 cases, worldwide, and they are not considered as super-spreaders of this infection. SARS-CoV-2 is transmitted through droplets, fomites, aerosol and fecal-oral route, while there is no strong evidence as yet, supporting transplacental transmission. Professor Papaevangelou highlights the epidemiological differences between seasonal influenza and COVID-19 and accepts that school closure had no direct impact since children are not the main transmitters of SARS-CoV-2. On the other hand, social distancing clearly limited the transmission of SARS-CoV-2, while quarantine seemed necessary during the first wave of this pandemic. She refers to antivirals, as well as other therapeutic agents able to diminish the immune response producing multisystem inflammatory syndrome, which is associated with increased mortality, and she notes that these agents were rarely used in children with COVID-19, while in most cases supportive treatment sufficed. She finishes with the ongoing scientific efforts for the development of an effective and safe vaccine against SARS-CoV-2 indicating that so far the most promising vaccine developments include vaccines that use viral vectors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2020.9426DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7668153PMC
December 2020

COVID-19 threat and the 1918 Spanish flu outbreak: The following day.

Exp Ther Med 2020 Dec 30;20(6):292. Epub 2020 Oct 30.

Institute of Paediatric Virology, Aliveri, 34500 Island of Euboea, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2020.9422DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7668147PMC
December 2020

Paediatric infectious diseases in Greece: Insights from a tertiary reference unit and perspectives for the future.

Exp Ther Med 2020 Dec 30;20(6):288. Epub 2020 Oct 30.

First Department of Paediatrics, University of Athens School of Medicine, 11527 Athens, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2020.9418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7668140PMC
December 2020

Knowledge, attitudes and practices about vaccine-preventable diseases and vaccinations of children among pregnant women in Greece.

Vaccine 2020 11 17;38(48):7654-7658. Epub 2020 Oct 17.

First Department of Obstetrics and Gynecology, University of Athens, Alexandra General Hospital, Athens, Greece.

Vaccine hesitancy has been recognized by the World Health Organization as one of ten threats to public health globally in 2019. Pregnant women constitute an extremely important group for the study of knowledge and attitudes towards pediatric vaccinations. This is a cross-sectional survey conducted in two maternity hospitals in Athens. A standardized questionnaire was used. A total of 814 pregnant women with a mean age of 33.1 years and a mean gestational age of 24.4 weeks were studied. Overall, 717 (89%) of 804 pregnant women reported that they intend to vaccinate their baby in accordance with the National Vaccination Program, 7 (1%) that they do not, while 80 (10%) reported that they have not decided yet. The women provided a mean of 11.4 correct replies out of 14 questions about vaccine-preventable diseases and vaccines (mean knowledge score: 81.5%). A pediatrician has been recognized as the source for information about vaccines in most cases (611/809, 75.5%), while in 215 (26.6%) the internet was also used. Overall, pregnant women trusted physicians about information for vaccines ("very much trusted" in 55.9% and "quite trusted" in 40% of cases). Lastly, 642 (81%) women agreed with the statement "vaccinations should be mandatory for school entry" while 70 (9%) women agreed with the statement "parents should have the right to refuse their children vaccinations". A multivariate analysis found that a gestational age of ≤20 weeks (OR = 2.33, CIs: 1.27-4.28, p-value = 0.006), having another child (OR = 4.44, CIs: 2.30-8.58, p-value < 0.001), a history of influenza vaccination (OR = 2.54, CIs = 1.37-4.71, p-value = 0.003), and a higher knowledge score about vaccine-preventable diseases and vaccines (OR = 1.33, CIs: 1.23-1.45, p-value < 0.001) were significantly associated with an increased probability to get their child vaccinated in accordance with the National Vaccination Program.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.vaccine.2020.10.003DOI Listing
November 2020

Update on current views and advances on RSV infection (Review).

Int J Mol Med 2020 Aug 15;46(2):509-520. Epub 2020 Jun 15.

Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece.

Respiratory syncytial virus (RSV) infection represents an excellent paradigm of precision medicine in modern paediatrics and several clinical trials are currently performed in the prevention and management of RSV infection. A new taxonomic terminology for RSV was recently adopted, while the diagnostic and omics techniques have revealed new modalities in the early identification of RSV infections and for better understanding of the disease pathogenesis. Coordinated clinical and research efforts constitute an important step in limiting RSV global predominance, improving epidemiological surveillance, and advancing neonatal and paediatric care. This review article presents the key messages of the plenary lectures, oral presentations and posters of the '5th workshop on paediatric virology' (Sparta, Greece, 12th October 2019) organized by the Paediatric Virology Study Group, focusing on recent advances in the epidemiology, pathogenesis, diagnosis, prognosis, clinical management and prevention of RSV infection in childhood.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/ijmm.2020.4641DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307844PMC
August 2020

Effectiveness of quadrivalent influenza vaccine in pregnant women and infants, 2018-2019.

Vaccine 2020 06 8;38(29):4625-4631. Epub 2020 May 8.

First Department of Gynecology and Obstetrics, National Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece.

Influenza is associated with an increased risk for serious illness, hospitalization and/or death in pregnant women and young infants. We prospectively studied the effectiveness of a quadrivalent inactivated influenza vaccine (QIV) in pregnant women and their infants during the 2018-2019 influenza season. A QIV was offered to pregnant women cared in a maternity hospital in Athens. Women were contacted weekly by telephone during the influenza season and PCR test was offered to women or infants who developed influenza-like illness (ILI). We studied 423 pregnant women and 446 infants. Unvaccinated pregnant women had a 7.5% probability to develop laboratory-confirmed influenza compared to 2.1% among vaccinated women (Odds ratio: 3.6; confidence intervals: 1.14-11.34, p-value = 0.029). Infants whose mothers were not vaccinated had a 7.9% probability to develop laboratory-confirmed influenza compared to 2.8% among infants of vaccinated mothers (Odds ratio = 2.849, confidence intervals: 0.892-9.102, p-value = 0.053). Cox regression analyses showed that QIV vaccination was significantly associated with a decreased probability for laboratory-confirmed influenza, ILI, healthcare seeking and hospitalization among pregnant women and a decreased probability for laboratory-confirmed influenza, healthcare seeking and prescription of antibiotics among infants. The effectiveness of QIV against laboratory-confirmed influenza was 72% among pregnant women and 64.5% among infants during the 2018-2019 influenza season. Vaccination of pregnant women with the QIV was associated with a lower risk for laboratory-confirmed influenza for them and their infants during the influenza season. Our findings strongly support the World Health Organization recommendations for vaccinating pregnant women against influenza.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.vaccine.2020.04.060DOI Listing
June 2020

Vaccination Programs for Adults in Europe, 2019.

Vaccines (Basel) 2020 Jan 20;8(1). Epub 2020 Jan 20.

Department for Interventions in Health Care Facilities, National Organization of Public Health, 15123 Athens, Greece.

Background: While all European countries implement vaccination programs for children, there are gaps in terms of vaccination programs for adults.

Methods: We studied the 2019 vaccination policies for adults in 42 European countries.

Results: Vaccination programs for adults were in place in all countries. However, there were considerable differences between countries in terms of number of vaccinations, target populations and frame of implementation (recommended or mandatory vaccinations). In particular the following vaccination policies were in place: influenza (42 countries), tetanus (31), diphtheria (30), pneumococcus (29), hepatitis B (20), pertussis (18), measles (14), human papilloma virus (14), meningococcus tetravalent A,C,W,Y (14), rubella (13), hepatitis A (11), mumps (11), poliomyelitis (10), herpes zoster (9), varicella (8), tick-born encephalitis (8), meningococcus B (6), rabies (6), type b (5), tuberculosis (3), typhoid fever (3), meningococcus C (2), and yellow fever (1). Seventeen countries implement mandatory vaccinations, mainly against diphtheria, tetanus and hepatitis B.

Conclusions: There are significant differences in vaccination programs for adults in Europe. Routine vaccination programs for adults need to be strengthened. A consensus-based vaccination program is needed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/vaccines8010034DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7157239PMC
January 2020

Vaccination coverage and immunity levels against vaccine-preventable diseases in male Air Force recruits in Greece.

Vaccine 2020 01 21;38(5):1181-1185. Epub 2019 Nov 21.

Medical Directorate, Hellenic Air Force General Staff, Athens, Greece.

Aim: Data about susceptibility rates in young adults are scarce. We estimated the complete vaccination rates, timeliness of vaccinations and susceptibility rates among male military recruits in Greece.

Methods: A standardized form was used to collect data. Immunity against measles, rubella, varicella, hepatitis A and hepatitis B was serologically estimated.

Results: We studied 385 recruits with a mean age of 23.5 years (range: 18.3-29.9 years). Complete vaccination rates were 94.3% for measles, 100% for rubella, 15% for varicella, 73.9% for hepatitis A and 96.5% for hepatitis B. Only 10.8% of participants were fully vaccinated against all five diseases. Timely vaccination was 47.2% for measles, 89.3% for rubella and 48.1% for hepatitis B. Recruits >23 years had a 1.5-fold increased probability for incomplete vaccinations compared to younger recruits. Laboratory-confirmed immunity rates were 80% against measles, 85.7% against rubella, 85.2% against varicella, 69.4% against hepatitis A and 77.1% against hepatitis B. It is estimated that approximately 388,696 persons aged 18-30 years are susceptible to measles, 277,640 persons to rubella, 287,736 persons to varicella, 595,664 persons to hepatitis A and 444,224 persons to hepatitis B in Greece.

Conclusion: Our study showed that young adults have significant immunity gaps against measles, rubella, varicella, hepatitis A and hepatitis B. Complete vaccination rates were suboptimal against hepatitis A and varicella. Strategies to access young adults and increase immunity rates through catch-up vaccination services should be investigated. A third dose of MMR vaccine should be considered for young adolescents in Greece.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.vaccine.2019.11.021DOI Listing
January 2020

Vaccination of healthcare personnel in Europe: Update to current policies.

Vaccine 2019 12 14;37(52):7576-7584. Epub 2019 Oct 14.

Director, Mayo Vaccine Research Group, Mayo Clinic, Rochester, MN, United States.

We investigated and compared current national vaccination policies for health-care personnel (HCP) in Europe with results from our previous survey. Data from 36 European countries were collected using the same methodology as in 2011. National policies for HCP immunization were in place in all countries. There were significant differences in terms of number of vaccinations, target HCP and healthcare settings, and implementation regulations (recommended or mandatory vaccinations). Vaccination policies against hepatitis B and seasonal influenza were present in 35 countries each. Policies for vaccination of HCP against measles, mumps, rubella and varicella existed in 28, 24, 25 and 19 countries, respectively; and against tetanus, diphtheria, pertussis and poliomyelitis in 21, 20, 19, and 18 countries, respectively. Recommendations for hepatitis A immunization existed in 17 countries, and against meningococcus B, meningococcus C, meningococcus A, C, W, Y, and tuberculosis in 10, 8, 17, and 7 countries, respectively. Mandatory vaccination policies were found in 13 countries and were a pre-requisite for employment in ten. Comparing the vaccination programs of the 30 European countries that participated in the 2011 survey, we found that more countries had national vaccination policies against measles, mumps, rubella, hepatitis A, diphtheria, tetanus, poliomyelitis, pertussis, meningococcus C and/or meningococcus A, C, W, Y; and more of these implemented mandatory vaccination policies for HCP. In conclusion, European countries now have more comprehensive national vaccination programs for HCP, however there are still gaps. Given the recent large outbreaks of vaccine-preventable diseases in Europe and the occupational risk for HCP, vaccination policies need to be expanded and strengthened in several European countries. Overall, vaccination policies for HCP in Europe should be periodically re-evaluated in order to provide optimal protection against vaccine-preventable diseases and infection control within healthcare facilities for HCP and patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.vaccine.2019.09.061DOI Listing
December 2019

Educational pathways in Paediatric Virology: Pros and cons.

Exp Ther Med 2019 Oct 28;18(4):3260-3262. Epub 2019 Aug 28.

Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2019.7955DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766579PMC
October 2019

Paediatric Virology and the indisputable value of prevention.

Exp Ther Med 2019 Oct 28;18(4):3257-3259. Epub 2019 Aug 28.

Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2019.7954DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766553PMC
October 2019

The wisdom and eudaimonia of Paediatrics: An interview with Professor George P. Chrousos, Professor of Paediatrics and Endocrinology at the University of Athens, Greece.

Exp Ther Med 2019 Oct 28;18(4):3217-3220. Epub 2019 Aug 28.

Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece.

Professor George P. Chrousos, Professor Emeritus of Paediatrics and Endocrinology at the University of Athens School of Medicine, in Athens, Greece, is the most distinguished Professor of Paediatrics in the modern history of Hellenic Paediatrics and among the 100 most prominent clinical investigators worldwide. According to Professor Chrousos, viruses frequently interact with the host endocrine signaling pathways, while stress triggers acutely an early inflammatory response termed 'neurogenic inflammation'. Soon after, however, stress suppresses innate immunity and causes a shift from T-helper 1- to T-helper 2- driven immunity. The natural history of the response to a viral infection is for immune and stress changes to take place in a highly coordinated process that results in the full return to the basal health state. He believes that over the past decades, our armamentarium against viruses has increased significantly as novel anti-viral agents, monoclonal antibodies and vaccines, have been and are continually being developed. Professor Chrousos declares that Paediatrics is a very broad scientific field, where paediatric trainees have many avenues to follow beyond clinical practice and into basic, preclinical, translational, clinical, applied, or epidemiologic research. He supports that researching and producing new knowledge to the benefit of humanity is a product of practicing Aristotle's ancient Greek virtues and a worthy cause of life's meaning. He completes our interview calling young paediatricians to 'listen to their minds and hearts' to select a life course that would lead them to acquire personal wisdom and eudaimonia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2019.7945DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766582PMC
October 2019

Paediatric virology and human papillomaviruses: An update.

Exp Ther Med 2019 Jun 22;17(6):4337-4343. Epub 2019 Apr 22.

Department of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece.

Almost 10 years ago, in October, 2008, the scientist who reported for the first time the association between human papillomaviruses (HPV) and cervical cancer, was awarded with the Nobel prize. In the years that followed, Professor Harald zur Hausen actively supported the value of the HPV vaccination in the prevention of different types of cancer and highlighted the necessity of its introduction in both girls and boys. However, to date, in the majority of countries, HPV vaccination among male adolescents has not been implemented into the national vaccination schemes, while in several countries, including Greece, the participation rate to HPV vaccination among female adolescents still remains low. Recent data indicate that catch-up HPV vaccination among young women has been extremely useful and has exhibited a significant effect in decreasing the prevalence of HPV. While the marketed current HPV vaccines prevent anogenital HPV infection, their impact on the natural history of oral HPV and their efficacy in preventing HPV-related head and neck carcinomas need to be further investigated. Juvenile onset recurrent respiratory papillomatosis, as well as HPV-associated conjunctival papillomas continue to be observed in childhood and their clinical management involves different therapeutic approaches with controversial outcomes. This review article provides an overview of recent views and advances on HPV infections and prevention in childhood that were presented at the '4th Workshop on Paediatric Virology' on Saturday September 22, 2018 in Athens, Greece.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2019.7516DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6507507PMC
June 2019

A paediatric influenza update 100 years after the Skyros island Spanish flu outbreak.

Exp Ther Med 2019 Jun 22;17(6):4327-4336. Epub 2019 Apr 22.

Department of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece.

This year marks the 100th anniversary of the 1918 Spanish flu outbreak on the Greek Aegean Sea island of Skyros, which devastated its population in less than 30 days. According to Constantinos Faltaits's annals published in 1919, the influenza attack on the island of Skyros commenced acutely 'like a thunderbolt' on the 27th of October, 1918 and was exceptionally severe and fatal. At that time, the viral cause of the influenza had not been detected, while the total number of victims of the Spanish flu outbreak has been estimated to have surpassed 50 million, worldwide. Almost one century after this Aegean Sea island's tragedy, the '4th Workshop on Paediatric Virology', organised on the 22nd of September, 2018 in Athens, Greece, was dedicated to the 100 years of the 'Spanish' flu pandemic. This review article highlights the plenary and key lectures presented at the workshop on the recent advances on the epidemiology, clinical management and prevention of influenza in childhood.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2019.7515DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6507498PMC
June 2019

Vaccination of healthcare workers: is mandatory vaccination needed?

Expert Rev Vaccines 2019 01 10;18(1):5-13. Epub 2018 Dec 10.

d First Department of Pediatrics , National and Kapodistrian University of Athens , Athens , Greece.

Introduction: Vaccinations of healthcare workers (HCWs) aim to directly protect them from occupational acquisition of vaccine-preventable diseases (VPDs) and to indirectly protect their patients and the essential healthcare infrastructure. However, outbreaks due to VPDs continue to challenge healthcare facilities and HCWs are frequently traced as sources of VPDs to vulnerable patients. In addition, HCWs were disproportionately affected during the current measles outbreak in Europe. Areas covered: We reviewed the recent published information about HCWs vaccinations with a focus on mandatory vaccination policies. Expert commentary: Although many countries have vaccination programs specifically for HCWs, their vaccination coverage remains suboptimal and a significant proportion of them remains susceptible to VPDs. The increasing vaccination hesitancy among HCWs is of concern, given their role as trusted sources of information about vaccines. Mandatory vaccinations for HCWs are implemented for specific VPDs in few countries. Mandatory influenza vaccination of HCWs was introduced in the United States a decade ago with excellent results. Mandatory vaccinations for VPDs that may cause significant morbidity and mortality should be considered. Issues of mistrust and misconceptions about vaccinations should also be addressed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/14760584.2019.1552141DOI Listing
January 2019

Does Europe need paediatric virologists?

Exp Ther Med 2018 Sep 31;16(3):2783-2784. Epub 2018 Jul 31.

Department of Clinical Virology, School of Medicine, University of Crete, Heraklion 71003, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2018.6548DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122481PMC
September 2018

The 1918 Spanish flu outbreak that devastated a Greek island underlines past lessons that must never be forgotten.

Acta Paediatr 2018 11 19;107(11):2034. Epub 2018 Apr 19.

Department of Clinical Virology, University of Crete School of Medicine, Heraklion, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/apa.14351DOI Listing
November 2018

Paediatric Virology and its interaction between basic science and clinical practice (Review).

Int J Mol Med 2018 Mar 4;41(3):1165-1176. Epub 2018 Jan 4.

Department of Clinical Virology, School of Medicine, University of Crete, Heraklion 71003, Greece.

The 3rd Workshop on Paediatric Virology, which took place on October 7th, 2017 in Athens, Greece, highlighted the role of breast feeding in the prevention of viral infections during the first years of life. Moreover, it focused on the long-term outcomes of respiratory syncytial virus and rhinovirus infections in prematurely born infants and emphasised the necessity for the development of relevant preventative strategies. Other topics that were covered included the vaccination policy in relation to the migration crisis, mother‑to‑child transmission of hepatitis B and C viruses, vaccination against human papilloma viruses in boys and advances on intranasal live‑attenuated vaccination against influenza. Emphasis was also given to the role of probiotics in the management of viral infections in childhood, the potential association between viral infections and the pathogenesis of asthma, fetal and neonatal brain imaging and the paediatric intensive care of children with central nervous system viral infections. Moreover, an interesting overview of the viral causes of perinatal mortality in ancient Greece was given, where recent archaeological findings from the Athenian Agora's bone well were presented. Finally, different continuing medical educational options in Paediatric Virology were analysed and evaluated. The present review provides an update of the key topics discussed during the workshop.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/ijmm.2018.3364DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819919PMC
March 2018

Vaccinations and Malaria Chemoprophylaxis of Adolescents Traveling From Greece to International Destinations: A Nine-Year Prospective Study.

Pediatr Infect Dis J 2018 05;37(5):e132-e135

First Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece.

Background: There are few publications focusing on vaccination and malaria chemoprophylaxis in adolescent travelers. We assessed pretravel vaccinations and malaria chemoprophylaxis of adolescents 12-18 years old traveling from Greece to international destinations.

Methods: We prospectively studied 239 adolescents 12-18 years old during 2008-2016. A standard questionnaire was used to collect data.

Results: Adolescents sought pretravel services at a mean of 24.1 days before departure. Their main destinations were sub-Saharan Africa (79 adolescents; 33.1%), Latin America (56; 23.5%) and North America (26; 10.9%). Almost half (46.1%) of them planned to stay abroad for at least 3 months. Sixteen (7.4%) adolescents planned to visit friends and relatives. The yellow fever vaccine and the typhoid vaccine were the most frequently administered vaccines (74.1% and 20.5%, respectively), while the hepatitis A vaccine and the tetanus-diphtheria vaccine accounted for most routine vaccinations (18% and 14.2%, respectively). The rabies and the typhoid fever vaccines were administered inadequately to adolescents traveling to endemic areas. Malaria chemoprophylaxis should have been prescribed in many cases traveling to sub-Saharan Africa and the Indian subcontinent.

Conclusions: Only a small number of adolescents from Greece traveling abroad seek pretravel counseling. We found significant gaps in typhoid fever and rabies vaccinations of adolescents traveling to endemic areas. We also found gaps in prescription of malaria chemoprophylaxis for those traveling to high-risk areas. There is a need to develop communication strategies to access adolescent travelers and improve appropriate vaccination and use of malaria chemoprophylaxis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/INF.0000000000001782DOI Listing
May 2018

Consumption of antibiotics by children in Greece: a cross-sectional study.

Int J Pediatr Adolesc Med 2017 Sep 23;4(3):108-111. Epub 2017 Jun 23.

First Department of Pediatrics, University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece.

Background: Greece is among the European countries with the highest consumption of antibiotics.

Objectives: To study the rates and characteristics of consumption of antibiotics in the community by children in Greece.

Methods: Questionnaire-based study of parents of hospitalized children.

Results: A total of 549 children were studied; 247 (45%) received at least one course of antibiotics the previous year (mean number of antibiotic courses the past year: 1.9), including 427 (91.8%) following examination by a pediatrician, 6 (1.3%) following phone consultation, 2 (0.4%) following suggestion by a pharmacist and 2 (0.4%) as self-medication. Prevalent reasons for antibiotic consumption were acute otitis media (AOM) (27.3%), pharyngotonsillitiss (25.4%), and bronchitis (17.8%). Amoxicillin-clavulanate was the prevalent antibiotic for pharyngotonsillitis, urinary tract infection (UTI) and skin infection (30.5%, 35.7% and 36.4% of cases, respectively), amoxicillin for AOM and pneumonia (32.3% and 36.4% of cases, respectively), and clarithromycin for bronchitis (27.7%). We found 84.3%, 81.9%, 64.3%, 63.7%, and 50% of parents reporting treatment consisted with the national guidelines for AOM, pneumonia, UTI, skin infection, and pharyngotonsillitis, respectively. In the multivariate analysis, an age of 1-5 years and asthma were significantly associated with a higher probability for antibiotic consumption.

Conclusions: Antibiotic consumption of children in Greece is mainly driven by pediatricians. Continuing medical education is expected to further improve antibiotic prescription practices by pediatricians.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijpam.2017.04.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372488PMC
September 2017

Preparedness of adolescents departing from Athens International Airport to Africa or Asia: A five-year airport-based prospective study.

Travel Med Infect Dis 2018 Jan - Feb;21:69-73. Epub 2017 Aug 1.

University of Athens First Department of Pediatrics, "Aghia Sophia" Children's Hospital, Athens, Greece.

Background: The number of adolescents who travel has increased. We estimated the preparedness of adolescents (12-18 years) departing from Athens to Africa and Asia.

Methods: An airport-based survey was conducted from 2011 to 2015.

Results: Sixty-eight adolescents participated; 27/68 (40%) had the Greek nationality. Their main destinations were the Indian subcontinent (37%) and South-East Asia (32%). Most adolescents planned to stay for <1 month (69%) or for 1-3 months (22%). Their main purpose for travel was to visit friends and relatives (VFRs) (60%). Compared to non-VFR adolescents, VFRs more frequently travelled to sub-Saharan Africa and Southeast Asia, stayed in local residences and for longer periods. Twenty-one (31%) adolescents sought pre-travel counseling (in 57% of cases 8-14 days before departure). Having the Greek nationality was the only significant factor associated with an increased probability for seeking pre-travel counseling. Vaccination against rabies, typhoid fever, Japanese encephalitis and meningococcus was highly inadequate for adolescents travelling to endemic areas. Significant gaps in malaria chemoprophylaxis were found in those travelling to the Indian subcontinent.

Conclusions: Less than one third of adolescents travelling to Africa and Asia seek counseling. There is a need to access adolescent travellers in Greece and improve pre-travel vaccinations and malaria chemoprophylaxis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.tmaid.2017.07.011DOI Listing
May 2018

The impact of access to immunization information on vaccine acceptance in three countries.

PLoS One 2017 3;12(8):e0180759. Epub 2017 Aug 3.

Vaccine Education Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America.

Introduction: Vaccine acceptance is a critical component of sustainable immunization programs, yet rates of vaccine hesitancy are rising. Increased access to misinformation through media and anti-vaccine advocacy is an important contributor to hesitancy in the United States and other high-income nations with robust immunization programs. Little is known about the content and effect of information sources on attitudes toward vaccination in settings with rapidly changing or unstable immunization programs.

Objective: The objective of this study was to explore knowledge and attitudes regarding vaccines and vaccine-preventable diseases among caregivers and immunization providers in Botswana, the Dominican Republic, and Greece and examine how access to information impacts reported vaccine acceptance.

Methods: We conducted 37 focus groups and 14 semi-structured interviews with 96 providers and 153 caregivers in Botswana, the Dominican Republic, and Greece. Focus groups were conducted in Setswana, English, Spanish, or Greek; digitally recorded; and transcribed. Transcripts were translated into English, coded in qualitative data analysis software (NVivo 10, QSR International, Melbourne, Australia), and analyzed for common themes.

Results: Dominant themes in all three countries included identification of health care providers or medical literature as the primary source of vaccine information, yet participants reported insufficient communication about vaccines was available. Comments about level of trust in the health care system and government contrasted between sites, with the highest level of trust reported in Botswana but lower levels of trust in Greece.

Conclusions: In Botswana, the Dominican Republic, and Greece, participants expressed reliance on health care providers for information and demonstrated a need for more communication about vaccines. Trust in the government and health care system influenced vaccine acceptance differently in each country, demonstrating the need for country-specific data that focus on vaccine acceptance to fully understand which drivers can be leveraged to improve implementation of immunization programs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0180759PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5542683PMC
September 2017

Antimicrobial resistance and the current refugee crisis.

J Glob Antimicrob Resist 2017 09 1;10:75-79. Epub 2017 Jul 1.

First Department of Medicine, Medical School, University of Athens, Athens, Greece.

In the past few years, Europe has experienced an enormous influx of refugees and migrants owing to the ongoing civil war in Syria as well as conflicts, violence and instability in other Asian and African countries. Available data suggest that refugees carry a significant burden of multidrug-resistant (MDR) organisms, which is attributed to the rising antimicrobial resistance (AMR) rates in their countries of origin, both in healthcare settings and in the community. Transmission of MDR pathogens among refugees is facilitated by the collapsed housing, hygiene and healthcare infrastructures in several communities as well as poor hygiene conditions during their trip to destination countries. These findings highlight the fact that refugees may serve as vehicles of AMR mechanisms from their countries of origin along the immigration route. Following risk assessment, routine microbiological screening for MDR organism carriage of refugees and migrants as well as effective infection control measures should be considered upon admission. This will on the one hand address the possibility of dissemination of novel AMR mechanisms in non- or low-endemic countries and on the other will ensure safety for all patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jgar.2017.03.013DOI Listing
September 2017

Paediatric Virology: A rapidly increasing educational challenge.

Exp Ther Med 2017 Feb 23;13(2):364-377. Epub 2016 Dec 23.

Department of Clinical Virology, School of Medicine, University of Crete, Heraklion 71003, Greece.

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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2016.3997DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5348700PMC
February 2017

The development of the Paediatric Virology Study Group: Ten years in the making.

Exp Ther Med 2017 Feb 23;13(2):363. Epub 2016 Dec 23.

Department of Clinical Virology, School of Medicine, University of Crete, Heraklion 71003, Greece.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2016.3998DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347900PMC
February 2017

Study of Greek children and youths with cystic fibrosis identifies immunisation gaps and delays.

Acta Paediatr 2017 Feb 29;106(2):288-291. Epub 2016 Nov 29.

First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece.

Aim: Data about immunisation rates in cystic fibrosis (CF) patients are scarce. We estimated the rates and timeliness of immunisations in CF patients aged 0.55-22 years.

Methods: We studied 122 subjects at a hospital in Greece in 2014. A standard questionnaire was used to collect data and parents' opinions about immunisations.

Results: The complete immunisation rates were 92.6% for diphtheria-tetanus-acellular pertussis-inactivated poliomyelitis-Haemophilus influenzae (DTaP-IPV-Hib), 96.7% for hepatitis A, 97.4% for hepatitis B, 97.4% for measles-mumps-rubella, 85.1% for the varicella zoster virus, 85.1% for the meningococcus C conjugate, 84.3% for the pneumococcus conjugate and 58.9% for the bacillus Calmette-Guérin vaccine. Immunisation rates in youths were 64.4% for DTaP-IPV, 26.8% for the tetravalent meningococcus conjugate vaccine and 54.1% for the human papilloma virus vaccine. In addition, 30.1% received the 23-valent pneumococcal polysaccharide vaccine and 45.6% received annual influenza vaccines. Complete, up-to-date immunisation rates fell from 61.4% at 12 months of age to 14.5% at six and 12 years. All vaccines experienced delays. Most parents believed vaccines were necessary to protect their child's health.

Conclusion: Our study of children with CF found immunisation gaps with no catch-up immunisations and these need to be administered at follow-up visits.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/apa.13663DOI Listing
February 2017