New kid on the block: In the US, conjugated pneumococcoal vaccine became compulsory below 2 years of age in the year 2000. It has now been shown to reduce incidence of pneumococcal disease by 69% in under 2 year olds. There has also been reduction of disease in older children probably by herd immunity and reduction of transmission of disease. This 7 valent conjugated vaccine differs from the routinely used 21 valent unconjugated vaccine given to at risk people, as it is effective in infancy. With early reports of its success, the vaccine company, Wyeth is all charged to push its use in other countries. But the UK health department, cautious as usual is reviewing data to see whether it would not increase prevalence of other serotypes ( NEJM 2003;348:1737-46, eBMJ news 29 Nov 2003)

Defining disabilities: Antenatal diagnosis has opened up a Pandora's box of ethical questions. Lawyers are considering legal action against the hospital in the UK where a baby was aborted after 25 weeks because of a cleft lip. Abortion after 24 weeks is legally allowed only if the fetus has a substantial risk that it will be born seriously handicapped. Can a cleft lip be considered a serious handicap? Are we becoming intolerant of any disability? Many would have strong views including the Cleft Lip and Palate Association of UK. This case will trigger much needed debate to strengthen abortion laws (eBMJ news 29 Nov 2003).

A huge epidemic of dengue is being predicted next year in the South East Asia region. People studying disease patterns say that Dengue usually has 2 quiet years followed by a big epidemic. 1998 saw a pandemic in the western pacific region with 356,000 cases. The next 2 years the numbers dropped to 50,000. Again 2001 saw an upsurge with 132,000 cases. Hence health experts are crying themselves hoarse to ask countries to plan containment measures for this deadly disease. Since infected patients can transmit virus to susceptible mosquitoes, the disease is spreading beyond traditional strongholds like Laos, Vietnam and Thailand. Countries like Australia, Hong Kong and Macau are reporting the disease now ( BMJ news 13 December 2003).

Gouri Rao Passi,
Consultant, Department of Pediatrics,
Choithram Hospital & Research Center,
Indore 452 001, India.
Email: [email protected]