Atoms
The flaking lilac wardrobe hadn’t been opened for what must have been decades. Even in her upper nonagenarian vintage, she fiercely guarded any entry to the rooms above ground level Her prerogative, of course, the creaky timber underpinning the banistered steps a warning sign to her should anyone be so bold as to try. So, it was only when it came to sorting her possessions after she moved on, that this cache, amongst others, were brought to light for the first time since Eisenhower was in his pomp. Most of the figures in the yellowing wedding album were discernible. Many, of course, had now died too, but one figure, even with the closest scrutiny baffled them all. A man of medium height and build, neatly attired in ‘slacks’ whose gaze seemed permanently fixed on her, even in those in which her (long since departed) husband appeared. Something, somewhere along...
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Glycerol intoxication: slush ice drinks and toxicosurveillance
Brothwell et al present their description and investigation of a novel paediatric glycerol intoxication syndrome associated with the consumption of slush ice drinks.1 The authors’ findings are highly relevant in and of themselves; additionally, they highlight the critical importance of multidisciplinary cooperation and active toxicosurveillance. Brothwell et al identified this novel syndrome, which mimics known inborn errors of metabolism, through existing regional referral networks for specialty metabolic care. Within a relatively short period of time, they were able to identify a putative culprit exposure and cooperate with UK poison centre infrastructure and governmental authorities to distribute updated medical guidance for clinicians and families. This rapid evidence-based response highlights the critical role that poison centres can play in detecting and mitigating outbreaks of dangerous xenobiotic exposure.2 It is important to note, however, that it is very challenging to demonstrate a true causal link between a xenobiotic...
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Falling enthusiasm for paediatrics in South Korea: it couldnt happen here. Could it?
In 2020, across the world there were an estimated 65 million healthcare workers, including 13 million doctors.1 Despite this seemingly huge workforce, roughly equal in size to the total population of the UK, the world’s population is currently 7.8 billion and there is an international shortage of healthcare staff, which in Europe alone is estimated at 1.8 million.2 The WHO estimates that the global shortfall of healthcare staff will be 10 million by 2030.3 Inevitably, shortfalls have affected paediatricians, and the paper by Young June Choe and Kee-Hyoung Lee describes a precipitous fall in the number of paediatric trainees in South Korea.4 Other countries have also reported worrying trends where they struggle to recruit paediatricians into their healthcare organisations.5 The UK paediatric community and wider child health workforce cannot consider itself immune to these global workforce challenges. This editorial explores the challenges to recruitment...
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Varicella: is it time for a global vaccination programme?
Varicella, known as chickenpox, is caused by the varicella zoster virus (VZV), with an estimated 84 million cases annually. It primarily affects children, for most of whom it is a self-limiting illness. However, there are an estimated 950 000 disability-adjusted life years attributed to VZV annually, disproportionately affecting lower-income settings. Children with impaired immunity and neonates are particularly at risk for severe varicella. Epidemiology varies between tropical and temperate regions with infections occurring at an earlier age in temperate climates. Varicella is a vaccine-preventable disease and over 40 countries have a universal one-dose or two-dose paediatric immunisation programme, either administered alone or combined with the measles, mumps and rubella vaccination (MMRV). The UK’s Joint Committee on Vaccination and Immunisation recommended the introduction of MMRV in November 2024. The vaccine, whether monovalent or MMRV, is effective in reducing varicella cases and hospital admissions, and two-dose regimens have further reduced breakthrough infections of shingles, a recognised concern in varicella vaccination programmes. Long-term data on shingles incidence in later life are not yet available and may be mitigated through paired universal shingles vaccination programmes for adults. Cost-effectiveness studies in high-resource settings support vaccination due to reduced hospitalisations and societal costs, such as missed caregiver employment. However, more research is needed for lower-resource regions to determine whether universal vaccination is feasible and cost-effective. While global varicella elimination is unlikely without sterilising immunity, vaccination can significantly reduce the disease burden, depending on regional epidemiology and available resources.
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