Parts of the country with requirements that adolescents be vaccinated against human papillomavirus (HPV) before entering school had higher HPV vaccination rates compared to nearby areas without such policies, a recent study in JAMA Pediatrics found. The findings suggest that school-entry requirements can help increase HPV vaccination coverage in the U.S., where these rates remain less than optimal.

A recent report shows that penicillin-resistant and ciprofloxacin-resistant meningococci are now present in the United States, findings that promoted the Centers for Disease Control and Prevention (CDC) to issue a June 18 health advisory to clinicians and public health officials.

Several PIDS members have been recognized by the Society for Pediatric Research (SPR) and the American Pediatric Society (APS) for their important contributions to the field of pediatrics.

TVH App iconAs part of the PIDS Vaccine Education from Practice to Training Program, we are pleased to announce the release of the new 2020 The Vaccine Handbook App (TVHApp). TVHApp is FREE and contains the 9th edition of The Vaccine Handbook. A Practical Guide for Clinicians (“The Purple Book”) and links to numerous valuable educational resources.

Antibiotic Use and Outcomes in Children in the Emergency Department with Suspected Pneumonia.

Community-acquired pneumonia (CAP) is a common infection for which antibiotics are frequently prescribed in the inpatient and outpatient setting. Pneumonia due to respiratory viruses is more common than bacterial infections in both settings. The 2011 IDSA and PIDS Pediatric CAP guidelines recommend against routinely obtaining chest radiography and prescribing antibiotics for children with CAP not requiring hospitalization. A large randomized trial in Africa demonstrated only minimal benefit from antibiotics but these results do not translate well in high-resource settings. This study examined the effect of antibiotics on a cohort of patients presenting to the Emergency Department with CAP not requiring hospitalization.

Following the killing of George Floyd by a police officer in Minneapolis and widespread protests around the country, several health care organizations, including PIDS, have come forward to call out the impact of systemic racism on public health and to press for change. Shared widely via social media and reported by media outlets such as CNN, Newsweek, and The Hill, several of the groups’ statements noted that the ongoing COVID-19 pandemic has disproportionately affected African Americans, underscoring long-standing structural inequities in the nation’s health care system.

The PIDS Pediatric Committee on Antimicrobial Stewardship (PCAS) supports best practices for developing, monitoring, and implementing ASPs in institutions caring for children. PCAS’ annual charges and goals include:

(1) Maintaining an up-to-date ASP Toolkit on the PIDS website to provide helpful resources for improving the use of antibiotics in children cared for in all healthcare settings. In January 2019 PCAS collaborated with AAP and Healthcare without Harm to develop the Pediatric Antibiotic Stewardship Program Toolkit, housed on the PIDS website. Given how rapidly the field of antimicrobial stewardship advances, PCAS is ensuring the Toolkit remains up-to-date and relevant by revising it annually. We anticipate the updated content being published in the upcoming 1-2 months.

The Journal of the Pediatric Infectious Diseases Society is accepting manuscripts for its special issue “COVID-19: A Focus on Pediatrics”.

May has been an active month for PIDS on social media, highlighted by a robust, positive response, both from our membership and the general public, to our position statement on the health impacts of systemic racism and the George Floyd protests nationwide.

Freedom from infections for all children. That’s always been the vision of the Pediatric Infectious Diseases Society. But from this day forward, we must also acknowledge that structural racism is more harmful to the health and well-being of children than infectious diseases, including COVID-19.

Dear Prospective Fellowship Applicant,

Thank you for your interest in pediatric infectious diseases, an incredibly diverse and rewarding specialty. As evidenced by the ongoing COVID-19 pandemic, pediatric infectious diseases physicians have never been more important nor their duties more diverse. This pandemic has highlighted the wide array of career paths available to a pediatric infectious diseases’ specialist; everything from clinical care, disaster planning, infection prevention and control, antimicrobial and diagnostic stewardship, immunology, microbial pathogenesis, vaccine development, epidemiology and public health, public relations, and social determinants of health. We need you to join this exciting profession and we are committed to helping you find your particular niche within it.

The PIDS Foundation is pleased to announce the 2020 call for applications for the ASP Fellowship Award.  The goal of this award is to support the development of future researchers in pediatric antimicrobial stewardship by providing mentorship to complete a scholarly research project in a timely manner during fellowship or residency.  Fostering trainees who have an interest in ASP is important for continuous improvement in patient safety and ensures the continued efficacy of antibiotics.

Past awardees indicated the value of the ASP Fellowship Award.  “Being awarded the PIDS ASP Fellowship Award at the start of my 2nd year of fellowship served not only to solidify that interest, but afforded me the incredible opportunity to personally connect with and learn from leaders in the field of AS” said Dr. Candance (CeCe) Johnson, Columbia University.  “The award provided the means for me to pursue an exploration of the use of AS strategies in an understudied healthcare setting (pediatric post-acute care facilities); even more it also supplied me with tools and resources that served to strengthen my foundational knowledge of AS and with invaluable connections that have continued to keep me abreast of the latest developments in the world of stewardship.”

Dr. Sophie Katz, Vanderbilt University, said “receiving the ASP Fellowship Award was a great opportunity as it allowed mentorship from anywhere around the globe.”  “It was also helpful to have the accomplishment on my CV,” added Dr. Katz.

Applicants may propose any type of study focusing on antimicrobial stewardship. The project should be able to be completed in one year, and the award will provide travel funds for awardees to present their work at the annual Pediatric Antimicrobial Stewardship Conference in St. Louis.  Applicants wishing to discuss a project proposal pre-submission may email This email address is being protected from spambots. You need JavaScript enabled to view it..
 The application deadline for the 2020 ASP Fellowship Award cycle is Thursday, July 2nd.  Submission and other details can be viewed by clicking here.  For questions, please email Christy Phillips at This email address is being protected from spambots. You need JavaScript enabled to view it..

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So… how are you doing? I understand the answer may not be straightforward. The SARS-CoV-2 pandemic has created exceptional challenges over the last several months. Please let me know how the Society can offer you support during this time and I pledge to you that we will try.

I thought this letter would be a good opportunity to highlight some of the important work done by our members relative to the pandemic.

  1. What’s in a name?
    • Europe/UK: Paediatric Multisystem Inflammatory Syndrome temporally associated with SARS-CoV-2 infection (PMIS-TS or PIMS)
    • United States: Multi-system Inflammatory Syndrome in Children (MIS-C)
  2. Whatever you call it, in both Europe and US, there has been a temporal association of MIS-C cases being reported to occur approximately 4 weeks after the start of documented SARS-CoV-2 transmission in communities. Whether MIS-C is caused by the virus, a post-viral immune response, or other etiology is currently unknown.
  3. Time (and a comprehensive evaluation to understand immunopathogenesis!) will provide further evidence to inform whether MIS-C is indeed one condition or a manifestation of a disease spectrum, as yet not fully characterized. Currently, there are interim MIS-C case definitions to guide clinicians:
  4. While the clinical findings in MIS-C overlap with several other syndromes including toxic shock syndrome, Kawasaki disease (incomplete, KD shock), macrophage activation syndrome/hemophagocytic lymphohistiocytosis, and cytokine release syndrome, MIS-C appears to be a distinct syndrome. Similarities and differences were highlighted throughout the call.
  5. Children with MIS-C that require hospitalization have varied symptoms at presentation – these symptoms are distinct from those seen in acute, severe COVID-19. Patients with MIS-C have fever and GI symptoms (abdominal pain, diarrhea) consistently reported. The majority of reported patients (≥ 65%) with MIS-C progress to shock, which may be cardiogenic, distributive, hypovolemic, or some combination of the three. All patients develop ≥ 1 organ dysfunction – most frequently with myocardial impairment suggesting a cardiac injury similar to myocarditis; renal/AKI, GI/hepatitis, hematologic, CNS/neurologic, etc. Notably, few patients have respiratory symptoms and the need for mechanical ventilation is more often to support cardiac function or facilitate procedures than a primary pulmonary process.
  6. Initial labs in patients with MIS-C are notable for neutrophilia, lymphopenia, thrombocytopenia, and over-exuberant immune profile including markedly elevated CRP, PCT, d-dimer, ferritin, and IL-6. Markers of cardiac injury or dysfunction including troponin and BNP are abnormal. Concurrent infections are rare. Few patients have detection of SARS-CoV-2 PCR (nasopharyngeal and stool) at presentation, but most patients do have detectable antibodies (multiple platforms used)
  7. Echocardiographic findings early on often demonstrate impaired left ventricular function of variable severity as well as coronary artery dilations and rarely, coronary artery aneurysms. Serial echocardiography and follow up with cardiology should be ensured
  8. The optimal management of MIS-C beyond intensive care support to reverse shock is unknown and best practices are evolving. Many centers consider use of IVIG, including in in patients who satisfy 2017 AHA KD criteria; some centers also prescribe other immunomodulators (corticosteroids, anakinra, infliximab, and less frequently tocilizumab) in patients with ongoing inflammation. ID physicians are strongly encouraged (as always) to participate in multi-disciplinary discussions with local institutional experts in intensive care, rheumatology, cardiology, hematology, etc to develop best management plans for individual patients.
  9. Understanding the immunopathogenesis of MIS-C will allow us to provide targeted therapies. There are research efforts ongoing and clinicians are encouraged to contribute to the advancement of the science.
  10. Unknowns: a lot! MIS-C needs thoughtful, systematic study, and ongoing, multi-disciplinary collaboration. #WeAreID (pedsID, that is!)

No doubt we have all been consumed with COVID 19 over these past many weeks. It is almost hard to recall life and work before this predicable, and yet still surprising pandemic overtook them. But there was indeed activity BC*

The burden of COVID-19 in children has been small compared with adults; children under 18 years of age comprising <2% of all cases. Recently, a syndrome resembling Kawasaki Disease (KD) has been described in children with current or recent infection with SARS-CoV-2. Since then, additional cases have been identified, including 15 patients reported to the New York City Department of Health. As a result, the CDC recently distributed a health advisory through the Health Alert Network for Healthcare providers to report similar cases to their local, state, or territorial health department. These two articles, published online in the past two weeks, describe clusters of cases of a hyperinflammatory syndrome (Kawasaki-like) in South East England and the Lombardy region of Italy.