Monday 13 July 2020

Does the Measles, Mumps and Rubella (MMR) Vaccine Enhance One or More Specific Functions in Children and Can it Help against this Novel Paediatric Inflammatory Multisystem Syndrome? by Carl Dowling in Open Access Journal of Biogeneric science and Research


Introduction
On 31st December 2019, the World Health Organisation (WHO) was informed of a novel virus known as Covid-19. This virus originated from Wuhan, China, where it rapidly started to spread to different parts of the world and become a global pandemic. Covid-19 mainly affected elderly and vulnerable adults. However, In April 2020 children started to present with a rare dangerous reaction which was unknown to healthcare providers. The novel syndrome seen in children has now been named Paediatric Inflammatory Multisystem Syndrome (PIMS). Some experts say that this new syndrome seen in children is related to Covid-19 and resembles Kawasaki Disease (KD) and Toxic Shock Syndrome (TSS). According to the Centers for Disease control and Prevention [1] it is recommended that all children receive two doses of the measles, mumps and rubella (MMR) vaccine. This editorial will be analysing key concepts from variable research collected through different studies, in order to gain a better understanding of the MMR Vaccine and if it has any benefit in a child’s immune response when fighting against this new novel PIMS.

What is Covid-19?

According to the WHO [2] Covid-19 is a viral infectious disease which causes Severe Acute Respiratory Syndrome. Ferretti [3] states that the virus can be transmitted through exhaled droplets and contamination of surfaces. According to Singal [4] symptoms of Covid-19 include fever, sore throat, cough followed by breathing difficulties. Furthermore, Singal [4] explains that symptoms of Covid-19 in neonates, infants and children are significantly milder than they are in adults. Roser [5] states that as of May 14th 2020 there are (4,477,573) reported cases which includes (299,958) reported deaths, with 2.2% of those deaths being related to children aged 0-17 years of age. Verdoni [6] that in children, the respiratory involvement in Covid-19 takes on a more benign course. According to Mehta [7] stated that Covid-19 carried a 3.7% mortality rate compared to less than 1% mortality rate from influenza. Furthermore, Mehta [7] mentions that Covid-19ncan cause cytokine storms within the body, and that it is advantageous to identify and treat they hyper inflammation using existing approved therapies where possible, in order to reduce the rise in mortality.
What is Paediatric Inflammatory Multisystem Syndrome?

According to Herman [8] approximately a month after the first surge of Covid-19 cases in New York, where at that time at least 50 children developed a Multisystem Inflammatory Syndrome, suggesting it is a post infectious immune response related to Covid-19. The European Centre for Disease Prevention and Control [1] stated that a total of 230 suspected cases of this novel PIMS associated with Covid-19 has been reported within Europe with ages ranging between 0-19 years of age. Riphaean [9] explains that symptoms of this PIMS in children include fever, rash, conjunctivitis, peripheral oedema, extremity pain, abdominal pain, gastrointestinal symptoms and cardiac problems. Verdoni [6] States that there is evidence which proposes that tissue damage from Covid-19 is mediated by the innate immunity, however, this novel PIMS causes a similar reaction when compared to Covid-19 as cytokine storms are caused from macrophage activation. According to Ford [10] these new cases of the novel PIMS have common overlapping features of TSS and KD. In Riphaean [9] study, 8 children were admitted into the Paediatric Intensive care Unit (PICU), none of them had any underlying health issues and all were tested negative for Covid-19, however, all children had known family exposure to Covid-19. 6 were of Afro-Caribbean descent and 5 were boys. Furthermore, in Riphaean [9] study, it mentions that the children were given intravenous (IV) Immunoglobulin 2g/kg in first 24 hours of arrival in PICU followed by aspirin if needed. Shekerdemian [11] conducted a study in Italy on this novel PIMS and found that children in group 2 were older than those who are typically seen with KD, had a higher rate of cardiac involvement and macrophage activation syndrome (MAS). Furthermore, Shekerdemian [11] states that all children made a full recovery, however, all patients received immunoglobulin, but 80% required further treatment with steroids.


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