The aim of vaccination is immunisation of the child against diseases to prevent mortality and morbidity from specific infections. Adequate immunization coverage is the prerequisite for creating herd immunity. The maintenance of these levels of population immunity requires continuous vigilance and changes to immunisation schedule in response to changing circumstances. Changes have been made over the years to optimise the immunisation of poliomyelitis, measles, mumps, rubella, and varicella. The introduction of hemophilus influenza type B vaccine and pneumococcal vaccine has reduced the incidence of these infections. Vaccination against human papillomavirus infection is being expanded to protect against cervical neoplasia in females and also anal intraepithelial neoplasia in both genders. Childhood exanthems due to viral and bacterial infections, as well as immunological causes continue to be important and the ability to recognise them is necessary.

Asthma ; drug therapy ; epidemiology ; physiopathology ; prevention & control ; Humans ; Pediatrics ; Singapore ; epidemiology

Asia is a populous and diverse region and potentially an important source of information on food allergy. This review aims to summarize the current literature on food allergy from this region, comparing it with western populations. A PubMed search using strategies "Food allergy AND Asia", "Food anaphylaxis AND Asia", and "Food allergy AND each Asian country" was made. Overall, 53 articles, published between 2005 and 2012, mainly written in English were reviewed. The overall prevalence of food allergy in Asia is somewhat comparable to the West. However, the types of food allergy differ in order of relevance. Shellfish is the most common food allergen from Asia, in part due to the abundance of seafood in this region. It is unique as symptoms vary widely from oral symptoms to anaphylaxis for the same individual. Data suggest that house dust mite tropomysin may be a primary sensitizer. In contrast, peanut prevalence in Asia is extremely low compared to the West for reasons not yet understood. Among young children and infants, egg and cow's milk allergy are the two most common food allergies, with prevalence data comparable to western populations. Differences also exist within Asia. Wheat allergy, though uncommon in most Asian countries, is the most common cause of anaphylaxis in Japan and Korea, and is increasing in Thailand. Current food allergy data from Asia highlights important differences between East and West, and within the Asian region. Further work is needed to provide insight on the environmental risk factors accounting for these differences.
Anaphylaxis ; Arachis ; Asia ; Asian Continental Ancestry Group ; Child ; Epidemiology ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Infant ; Japan ; Korea ; Milk Hypersensitivity ; Ovum ; Prevalence ; Pyroglyphidae ; Risk Factors ; Seafood ; Shellfish ; Thailand ; Wheat Hypersensitivity

Food allergies and atopic diseases are on the rise worldwide. There have been several published practice guidelines on the primary prevention of these diseases. One aspect of these guidelines is the recommendations on infant nutrition, as food allergen exposure and other nutritional factors may influence allergen sensitization. This article aims to review the current international recommendations on infant diet and weaning practices in the primary allergy prevention of infants. The conclusions drawn are as follows: (1) Breastfeeding is considered the gold standard for infant nutrition, especially since exclusive breastfeeding confers some protection against the development of allergic diseases. However, large cohort studies have not been carried out in Asian populations. (2) Maternal avoidance of allergenic food substances during pregnancy and lactation has not been proven to reduce the risk of allergies and is not recommended as a primary prevention strategy. (3) Hydrolyzed formulas have not been shown to have an advantage over breastfeeding, although they have some protective value against atopic eczema in at risk infants when compared to regular cows milk based infant formula. (4) Soy formula is also not recommended for prevention of atopic diseases. (5) Weaning to semisolids should be undertaken between the ages of 4 to 6 months as weaning before the age of 4 months is associated with increased of allergy symptoms. (6) The age for introduction of certain highly allergenic foods have been arrived at empirically and included in some guidelines. These comprise the initiation of dairy products at 12 months, eggs at 24 months, and peanuts, nuts and fish at 36 months.
Arachis ; Asian Continental Ancestry Group ; Breast Feeding ; Cohort Studies ; Dairy Products ; Dermatitis, Atopic ; Diet ; Eggs ; Female ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Imidazoles ; Infant ; Infant Formula ; Lactation ; Milk ; Nitro Compounds ; Nuts ; Ovum ; Pregnancy ; Primary Prevention ; Weaning

Crustacean shellfish allergy is an important cause of food allergy and anaphylaxis in Asia. The major allergen in shellfish allergy is tropomyosin, a pan-allergen that is also found in house dust mites and cockroaches. Tropomyosins from house dust mites (HDMs) have a high sequence homology to shellfish tropomyosins, and cross-reactivity between HDM and shrimp tropomyosins has been demonstrated. Exposure to inhaled tropomyosins from house dust mites has been postulated to be the primary sensitizer for shellfish allergy, in a reaction analogous to the oral allergy (inhalant-food) syndrome. This notion is supported by indirect data from the effects of HDM immunotherapy on shellfish allergy, and strong correlations of shellfish and HDM sensitization. HDM immunotherapy has been reported to induce both shrimp allergy in non-allergic patients and shrimp tolerance in shrimp-allergic patients. Epidemiological surveys have also demonstrated a strong correlation between shellfish and HDM sensitization in both hospital-based and community-based studies. Unexposed populations have also been shown to develop sensitization-shellfish sensitization in orthodox Jews with no history of shellfish consumption was associated with HDM sensitization. Reciprocally, HDM sensitization in an Icelandic population living in a HDM-free environment was associated with shrimp sensitization. In vitro IgE inhibition studies on sera in shrimp-allergic Spanish patients indicate that mites are the primary sensitizer in shrimp-allergic patients living in humid and warm climates. Current data supports the hypothesis that tropomyosin is the link between HDM and shellfish allergies. The role of tropomyosin in HDM and shellfish allergies is a fertile field for investigation as it may provide novel immunotherapeutic strategies for shellfish allergy.
Anaphylaxis ; Asia ; Climate ; Cockroaches ; Dust* ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Iceland ; Immunoglobulin E ; Immunotherapy ; Jews ; Mites ; Pyroglyphidae* ; Sequence Homology ; Shellfish* ; Tropomyosin*

INTRODUCTIONThe world's first rotavirus vaccine, Rotashield or RRV-TV, was registered in the US in 1998, but withdrawn within a year because of an observed association with intussusception (IS). Surveillance for IS has consequently become important in safety monitoring of new-generation rotavirus vaccines during development. Post-marketing surveillance is also important, and requires the availability of local baseline epidemiology data on IS.

MATERIALS AND METHODSAn eight-year study of IS in children under 2 years of age in Singapore was performed by retrospective review of admissions to KK Women's and Children's Hospital, the main paediatric hospital, from 1997 to 2001, followed by prospective surveillance of all hospitals from 2001 to 2004, using the case definition of the Brighton Collaboration Intussusception Working Group.

RESULTSThe average IS incidence was 60 per 100,000 in under-ones, and 32 per 100,000 in under-twos, with a downward trend between 1999 and 2004. Ninety-two per cent of subjects were aged below one year, with 51% aged 6 months to 11 months. The mean age at which IS occurred increased from 6.4 months to 12.5 months over the study period. The male-to-female ratio was 1.3:1. No trend in IS numbers was observed over different months of the year.

CONCLUSIONIS in Singapore shows no seasonality, but has demonstrated a trend of decreasing incidence in recent years. While highest in the first year of life, the risk of IS is increasing in the second year of life. Males have a slightly higher risk.

Child, Preschool ; Female ; Humans ; Immunization Programs ; Incidence ; Infant ; Infant, Newborn ; Intussusception ; chemically induced ; epidemiology ; Male ; Prospective Studies ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Rotavirus ; immunology ; Rotavirus Infections ; prevention & control ; Rotavirus Vaccines ; adverse effects ; Singapore ; epidemiology ; Vaccination ; adverse effects

Rhinitis is a disease of the upper airway characterized by runny and/or blocked nose and/or sneezing. Though not viewed as a life threatening condition, it is also recognized to impose significant burden to the quality of life of sufferers and their caretakers and imposes an economic cost to society. Through a PubMed online search of the literature from 2006 to September 2011, this paper aims to review the published literature on rhinitis in young children below the age of 6 years. It is apparent from epidemiology studies that rhinitis in this age group is a relatively common problem. The condition has a heterogenous etiology with classification into allergic and non-allergic rhinitis. Respiratory viral infections may play a role in the pathogenesis of long standing rhinitis, but definitive studies are still lacking. Treatment guidelines for management are lacking for this age group, and is a significant unmet need. Although the consensus is that co-morbidities including otitis media with effusion, adenoidal hypertrophy and asthma, are important considerations of management of these children. Pharmacotherapy is limited for young children especially for those below the age of 2 years. This review underscores the lack of understanding of rhinitis in early childhood and therefore the need for further research in this area.
Adenoids ; Asthma ; Child ; Classification ; Consensus ; Drug Therapy ; Epidemiology ; Humans ; Hypertrophy ; Nose ; Otitis Media with Effusion ; Prevalence ; Quality of Life ; Rhinitis ; Risk Factors ; Sneezing

In the original publication, we created a mistake in typing the name. Thus it was spelled as Antony Hadjojo when submitted to the publisher. We request for a correction of the author name into Antony Hardjojo.
Child ; Humans ; Publications ; Rhinitis

No abstract available.
Asia ; Hypersensitivity

The literature supports the notion that carbohydrate epitopes, on their own, do not contribute significantly to the induction of allergic reactions. They bind weakly to IgE antibodies and have been termed as cross reactive carbohydrate determinants. These epitopes cause confusion in in vitro IgE testing through nonspecific cross-reactivity. Coincident with the rising trends in food allergy prevalence, there has recently been reports of anaphylaxis induced by carbohydrate epitopes. There are two distinct groups, each with unique characteristics and geographical distribution. Anaphylaxis and acute allergic reactions related to the carbohydrate galactose-α-1,3-galactose (α-Gal) epitope that are present in the monoclonal antibody, cetuximab and red meat have been described in the United States and Europe populations where tick bites have been found to be the primary sensitizer. Another carbohydrate inducing anaphylaxis is galacto-oligosaccharides in commercial milk formula which has been described in the several Asian populations including Singapore. The latter is unique in that the allergen is a pure carbohydrate. We summarize the current literature on carbohydrate-induced food allergy, and evaluate the two new groups of carbohydrate allergy that have defied previous findings on carbohydrates and their role.
Allergens ; Anaphylaxis ; Antibodies ; Asian Continental Ancestry Group ; Carbohydrates ; Cetuximab ; Cross Reactions ; Epitopes ; Europe ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Immunoglobulin E ; In Vitro Techniques ; Milk ; Oligosaccharides ; Prevalence ; Red Meat ; Singapore ; Tick Bites ; United States