Editorial

This special issue of Paediatrics and International Child Health is dedicated to advancing knowledge and care of emerging infectious diseases. Emerging infections are defined as infectious diseases of increasing incidence, either overall or in new areas or new population groups [1]. These conditions can result from changes in the offending micro-organisms that prompt them to become resistant to antimicrobial therapy or to gain the capacity to infect different species.

Two years ago, when editor-in-chief Brian Coulter and I started discussing this special thematic issue of Paediatrics and International Child Health, we were glad that the Ebola and Zika outbreaks were calming. We had no clue what major infection would emerge next, yet we knew that discussing emerging infections would help prepare us to provide preventive and therapeutic care to benefit future children around the world, whatever new challenges they would face. Now, as this issue has been planned, written and published, the world has learned new terms such as ‘COVID-19ʹ, and the people of this planet have grown accustomed to daily news headlines about ‘lockdowns’ and ‘super-spreaders’.

It is a pleasure to offer this special issue to you, our readers. We are glad that, through early online publication, some of the material published here now has already been available to and accessed by many people around the planet, and that the review papers in this issue pull together helpful information about just what clinicians and researchers around the world need to know. We are glad, too, that the science keeps advancing and that these papers can serve as a foundation upon which knowledge and practice may continue to grow.

The COVID-19 pandemic has made it clear that travel is associated with the spread of infection and that we humans find it very unpleasant to limit our travel. Beth Dawson-Hahn and her colleagues in Washington and Minnesota provide excellent North American and global perspectives on the importance of migrants and, especially, travellers in the spread and emergence of infectious diseases. Realising that many or even most physicians feel uncomfortable or unprepared to provide pre-travel and post-migration care, the authors provide readers with helpful approaches and superb references to improve the care of travelling children in order to mitigate the emergence of diseases in new areas.

Devika Dixit along with colleagues in Canada and in north-eastern Democratic Republic of Congo give us a current review of paediatric Ebola virus disease. With past and current first-hand knowledge of dealing with Ebola in children in Africa, they provide good explanations of its epidemiology, clinical manifestations and management in paediatric patients. They place special emphasis on the topic of persistent viral infection and its implications for breastfeeding. Wisely, they also deal with psychosocial factors and the stigma related to Ebola virus infection.

It has been 5 years since mosquito-born Zika virus disease rampaged through South America, and we have learned a lot (but still not enough) about it as it affects pre-born and paediatric patients. Antonio de Cunha and his colleagues in Brazil have been caring for Zika-affected children and following their progress for years. In this issue, his colleague Marlos Melo Martins and co-authors review the epidemiology, management and prevention of Zika. They use follow-up data to show that the manifestations of congenital Zika syndrome extend far beyond ‘just’ severe microcephaly.

Nipunie Rajapakse of the United States’ Mayo Clinic and Canadian Devika Dixit worked together to give an extensive, updated and evolving review of human and novel Coronavirus infections in children. Fortunately, this paper has already been available online for more than 6 months. Nonetheless, the data are still correct, and the messages remain relevant. Their comprehensive review is very helpful, even as vaccines are emerging onto the global platform. As editors, we especially appreciate the scientific integrity and thoroughness with which this paper was written. This is especially helpful when a literature review revealed that dozens of other papers written early during the COVID-19 pandemic had to be withdrawn or retracted [2]. Readers can trust the material in Paediatrics and International Child Health, and readers should always read the medical literature carefully.

Updating us with new data about COVID-19 in children, Dinagul Bayeshevaa and colleagues provide a helpful case series review of 650 children in Kazakhstan who were recruited from all 17 regions of the country, and this is the first such study from Central Asia. The epidemiological, clinical and radiological features are outlined.

Similarly, Muni Kilani and colleagues describe 61 SARS-CoV-2-infected children in Jordan. Serial RT-PCR was undertaken 7 days after the first test and on alternate days until discharge, and it was found that PCR positivity could persist for more than a month.

Marlos Melo Martins and colleagues in Brazil have provided an excellent literature review of the up-to-date clinical findings of SARS-CoV-2 infection in children. Readers will probably be very interested in their description of the multisystem inflammatory syndrome which has emerged as a paediatric concern during the evolving pandemic and in their in-depth review of neonatal COVID-19.

Finally, Leslie Enane and John Christenson of Indiana University in the United States review emerging antimicrobial resistance among important infectious pathogens. They focus on tuberculosis, HIV and Gram-negative bacteria—infections which are still responsible for most of the infection-related deaths in the world. They wisely point to specific clinician and healthcare system interventions that can stem the rise in antimicrobial resistance. At a practical level, every reader can benefit from this call to daily implementation of antimicrobial stewardship. On a global level, ‘the emergence of a multidrug-resistant organism in one part of the world threatens the entire international community and must be treated as a global public health emergency.’ [3]

A year and a half ago, no-one would have imagined the havoc wreaked all over the planet by COVID-19. Similarly, we cannot predict what will happen in future years, but the information and perspectives in this special issue of Paediatrics and International Child Health can help readers as they care for patients today and as they prevent future health problems. Enjoy!