ORCID Profile
0000-0001-6173-7768
Current Organisations
Royal Brisbane and Women's Hospital
,
University of Queensland
,
Queensland Children's Hospital
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Publisher: Informa UK Limited
Date: 05-04-2019
DOI: 10.1080/14760584.2019.1599286
Abstract: Biologic disease-modifying anti-rheumatic drugs (bDMARDS) are increasingly used in clinical practice for a variety of conditions. Due to concerns surrounding persistence of drug levels and resulting immunosuppression, current case reports recommend against live vaccine administration in the first year of life for an infant exposed to perinatal bDMARDS. As a result, this significantly impacts receipt of rotavirus vaccination, a vaccine recommended in many countries' national immunization program. Area covered: We have reviewed all available published literature to explore the effect of peripartum bDMARDS exposure on infant immune responses, safety of live vaccines, and vaccine efficacy in the first year of life. Expert opinion: We recommend that otherwise healthy newborns with a history of perinatal exposure to bDMARDS should receive rotavirus vaccinations as per the recommended schedule. Bacille Calmette et Guerin vaccine should be withheld in the first year of life. No additional booster doses of inactivated vaccines are required as they appear to mount adequate immune responses to the routine schedule.
Publisher: SAGE Publications
Date: 2020
Abstract: The condition known as 22q11 microdeletion syndrome has a broad phenotypic spectrum, with many affected in iduals experiencing mild-to-moderate immunodeficiency. Currently, there are significant variations in live vaccine practices and immunological testing prior to live vaccine administration due to safety concerns and limited established guidelines. Queensland Children’s Hospital (QCH) Child Development Unit, offers a state-wide 22q11 microdeletion clinic. This is a retrospective single-centre review, capturing the majority of children with 22q11 microdeletion in Queensland, Australia. We describe the live vaccination status of 134 children, age 0 to 18 years under our care between 2000 and 2018, adverse events following immunisation (AEFI) and the proportion of children who received additional pneumococcal coverage. An immunological investigation pathway prior to live vaccine administration is proposed. Of the 134 children, 124 were eligible for live vaccinations as per the Australian National Immunisation Program: 82% had received dose one of measles, mumps and rubella (MMR) vaccine, 77% had completed MMR dose two and 66% had completed varicella immunisation. There were no AEFI notifications reported. Of the total s le of children, 18% received a fourth dose of conjugate pneumococcal vaccine (Prevenar 7 or 13) and 16% received a dose of Pneumovax 23 from 4 years of age. Immunology workup practices were demonstrated to vary widely prior to live vaccine administration. Most patients’ immune profiles were consistent with mild-to-moderate immunodeficiency. We propose an immunological investigation and vaccination pathway with the aim of providing guidance and consistency to clinicians caring for children with 22q11 microdeletion.
Publisher: Australian Government Department of Health and Aged Care
Date: 20-10-2022
Abstract: The Australian Paediatric Surveillance Unit (APSU) has been conducting surveillance of rare communicable and non-communicable conditions in children since its inception in 1993. In this report, the results are described of surveillance of ten communicable diseases (and complications) for 2021, including the numbers of cases and incidence estimates demographics clinical features and management and short-term outcomes. The included diseases are: acute flaccid paralysis (AFP) congenital cytomegalovirus (CMV) neonatal herpes simplex virus (HSV) infection paediatric human immunodeficiency virus (HIV) infection perinatal exposure to HIV severe complications from influenza juvenile-onset respiratory papillomatosis (JoRRP) congenital rubella syndrome congenital varicella syndrome and neonatal varicella infection. In 2021, cases of JoRRP were reported to the APSU for the first time since 2017, indicating potential gaps in HPV vaccination. AFP surveillance by APSU again contributed to Australia achieving a minimum target incidence of one AFP case per 100,000 children aged 15 years. There were no cases of children with severe complications of influenza. No cases of varicella or congenital rubella were reported however, at-risk populations, especially young migrant and refugee women from countries without universal vaccination programs, need to be screened and prioritised for vaccination prior to pregnancy. Cases of perinatal exposure to HIV continue to increase however, the rate of mother-to-child-transmission remains at low levels due to the use of effective intervention strategies. Case numbers of congenital CMV and neonatal HSV remain steady in the absence of vaccines, prompting the need for greater awareness and education, with recent calls for target screening of at-risk infants for congenital CMV.
Publisher: Australian Government Department of Health
Date: 28-10-2021
Abstract: For 27 years, national prospective data on selected rare childhood diseases have been collected monthly by the Australian Paediatric Surveillance Unit (APSU) from paediatricians and other clinical specialists who report cases in children aged up to 16 years. We report here the annual results of APSU surveillance in 2020 for ten rare communicable diseases and complications of communicable diseases, namely: acute flaccid paralysis (AFP) congenital cytomegalovirus (CMV) infection neonatal herpes simplex virus (HSV) infection perinatal exposure to human immunodeficiency virus (HIV) paediatric HIV infection severe complications of seasonal influenza juvenile onset recurrent respiratory papillomatosis (JoRRP) congenital rubella syndrome congenital varicella syndrome and neonatal varicella infection. We describe the results for each disease in the context of the total period of study, including demographics, clinical characteristics, treatment and short-term outcomes. Despite challenges presented by the coronavirus disease 2019 (COVID-19) pandemic in 2020, more than 1,400 paediatricians reported regularly to the APSU and an overall monthly reporting rate of 90% was achieved. The minimum AFP target of 1 case per 100,000 children aged less than 15 years was achieved and there were few cases of vaccine-preventable diseases (JoRRP, rubella, varicella). However, high cases of congenital CMV, neonatal HSV and perinatal exposure to HIV persist. There were no severe complications of seasonal influenza reported for the first time in 13 years. This is consistent with other surveillance data reporting a decline of influenza and other communicable diseases in 2020, and likely reflects the wider effects of public health measures to reduce transmission of SARS-CoV-2 in the Australian community.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-11-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2020
Publisher: Wiley
Date: 25-09-2022
DOI: 10.1111/JPC.15752
Publisher: Wiley
Date: 05-05-2022
DOI: 10.1111/JPC.15992
Abstract: Herpes simplex CNS infection is a rare but important cause of neurological disability. Long term outcomes after HSV CNS infection in Australia have not yet been fully described. We sought to provide a comprehensive review of HSV CNS infection in children using a retrospective 13‐year evaluation of statewide laboratory and clinical records and a parent survey conducted at least one year after the initial infection. All positive PCR HSV 1 and 2 results from cerebrospinal fluid (CSF) or brain tissue were obtained from Queensland pathology providers for children aged 0–16 years between 1 January 2005 and 31 December 2017. Clinical data were obtained from patient records and longer‐term outcomes via parent survey at least 1 year after initial infection. Forty‐three children were identified over the 13‐year period, 17 (39.5%) neonates and 26 (60.4%) non‐neonates. The annual incidence for HSV CNS infection in Queensland children aged ≤16 years was 0.3/100 000 (95% confidence intervals (CIs): 0.2–0.4) with neonates at highest risk (incidence 2.5/100 000 live births, 95% CI: 1.5–3.9). HSV 1 was the predominant serotype in both neonates and non‐neonates (9/17, 52.9% neonates and 19/26, 73.1% non‐neonates). Seven (16.3%) children died, five (5/17, 29.4% neonates), directly attributable to HSV CNS infection (all neonates). Twenty‐five (58.1%) had neurological morbidity at discharge (9/17 neonates (52.9%) vs. 16/26 (61.5%) non‐neonates) and 20/27 (74.1%) reported long‐term neurological morbidity at follow‐up (5/9 neonates (55.6%) vs. 15/18 non‐neonates (83.3%)). Seven children (two neonates and four non‐neonates) with long‐term neurological sequelae had no neurological morbidity identified at discharge. Significant long‐term neurologic sequelae were seen in children with HSV CNS infection even in children with no neurological disability identified at discharge from hospital. Careful neurodevelopmental follow‐up of all children is recommended.
Publisher: Wiley
Date: 03-04-2019
DOI: 10.1111/JPC.14461
Abstract: The rat lungworm, Angiostrongylus cantonensis, is well established in eastern Australia, where it is the almost exclusive cause of human eosinophilic meningoencephalitis (EME). While neuroangiostrongyliasis can result in severe morbidity or death, its diagnosis requires a high index of clinical suspicion among medical practitioners. Prevention requires a high level of public awareness. We report two cases of EME in children from Queensland and summarise all reported Australian cases from the literature. We discuss the pathogenesis of neuroangiostrongyliasis, with particular reference to the timing of prophylaxis and treatment. A 5-year-old girl developed severe headache, eosinophilic meningitis and abnormal neuroimaging following a holiday to Bali. A 10-year-old boy with Rubinstein-Taybi syndrome, marked developmental delay and pica developed EME following ingestion of a snail, resulting in long-term morbidity. From 1971 to 2018, 28 Australian cases have been reported, with acquisition restricted to Southeast Queensland and New South Wales. Ages ranged from 10 months to 45 years most were male and most likely acquired infection from consuming unwashed lettuce or vegetables. The mortality rate was 18% most fatalities occurred in children <1 year old. Long-term neurological deficit was reported in 14% of cases and a full recovery in 57% of cases. Heightened medical and public awareness of the parasite is required to prevent infection and subsequent disease. A better understanding of the efficacy of prophylactic anthelmintic following ingestion or handling of molluscs and further studies of epidemiology of this parasite will inform and facilitate public health recommendations.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 28-12-2023
No related grants have been discovered for Angela Berkhout.