Zika virus (ZIKV) is the causative agent of a viral infection that causes neurological complications in newborns and adults worldwide. Its wide transmission route and alarming spread rates are of great concern to the scientific community. Numerous trials have been conducted to develop treatment options for ZIKV infection. This review highlights the latest developments in the fields of vaccinology and pharmaceuticals developments for ZIKV infection. A systematic and comprehensive approach was used to gather relevant and up-to-date data so that inferences could be made about the gaps in therapeutic development. The results indicate that several therapeutic interventions are being tested against ZIKV infection, such as DNA vaccines, subunit vaccines, live-attenuated vaccines, virus-vector-based vaccines, inactivated vaccines, virus-like particles, and mRNA-based vaccines. In addition, approved anti-ZIKV drugs that can reduce the global burden are discussed. Although many vaccine candidates for ZIKV are at different stages of development, none of them have received Food and Drug Authority approval for use up to now. The issue of side effects associated with these drugs in vulnerable newborns and pregnant women is a major obstacle in the therapeutic pathway.

Objective: To investigate the importance of immunization in preventing measles infection and to determine the most useful laboratory tests for confirmation of measles.

Methods: This study included pediatric cases evaluated with a presumed diagnosis of measles between December 2022 and June 2023, at Marmara University Pendik Training and Research Hospital. The effects of vaccination status and underlying disease on the clinical course, treatments, and complications were evaluated.

Results: In total, 117 patients were enrolled in the study with a median age of 80 months (IQR: 32.5-125.0). Twelve patients with contact history were asymptomatic and had an underlying disorder, and intravenous immunoglobulin was given to them for post-exposure prophylaxis. Fifty-one patients had confirmed measles diagnosis. Ribavirin treatment was given to three patients (a newborn, a girl with rhabdomyosarcoma, and a healthy boy) with respiratory distress. Seventy-eight percent of confirmed measles cases were unvaccinated, and all hospitalized cases were unvaccinated or under-vaccinated. Four full-vaccinated children had confirmed measles infection. Measles PCR from nasopharyngeal swabs was negative in all of them, and their diagnosis was established with anti-measles IgM positivity.

Conclusions: The measles vaccine is the most effective way to protect from measles and measles-related complications. Although measles can also occur in fully vaccinated patients, the disease is milder than in unvaccinated patients. Using ELISA and RT-PCR tests together may be beneficial in patients with high clinical suspicion for early diagnosis.

Objective: To investigate the prevalence and risk factors associated with long COVID symptoms among children and adolescents who have recovered from COVID-19.

Methods: This study applied a cross-sectional approach within community settings in a southern province of Vietnam. A structured questionnaire featuring socio-demographic information and common long COVID symptoms was employed. Phi correlation coefficients assessed associations among pairs of long COVID symptoms. Additionally, multivariable logistic regression models were performed to investigate the risk factors of long COVID in recovered COVID-19 children and adolescents.

Results: Among 422 participants, 39.3% reported long COVID symptoms, with a prevalence of 45.2% (SD=0.5) in children and 22.2% (SD=0.4) in adolescents. Common symptoms reported were cough 34.6% (SD=0.5), fatigue 20.6% (SD=0.4), shortness of breath 10.9% (SD=0.3), and lack of appetite 6.6% (SD=0.3). Concerning risk factors of long COVID, a higher risk was observed among demographic groups, including girls (OR 1.25, 95% Cl 1.15-1.37; P<0.001, reference: boys), children compared to adolescents (OR 1.24, 95% CI 1.12-1.37; P<0.001), overweight individuals (OR 1.14, 95% CI 1.02-1.27; P=0.018, reference: healthy weight), and participants without any COVID-19 vaccination (OR 1.36, 95% CI 1.20-1.54; P<0.001), or have received only one single dose (OR 1.35, 95% CI 1.10-1.64; P=0.004) compared to those who have received two doses. Besides, patients with a COVID-19 treatment duration exceeding two weeks also had a higher risk of long COVID (OR 1.32, 95% CI 1.09-1.60; P=0.003) than those who recovered less than seven days.

Conclusions: The insights from this study provide crucial guidance for predicting the factors associated with the occurrence of long COVID in pediatric patients, contributing to strategic interventions aimed at mitigating the long COVID risks among children and adolescents in Vietnam.

Objective: To determine the risk factors of mortality among hospitalized COVID-19 patients.

Methods: This retrospective study used hospitalization records collected by the Indonesia Health Social Security Administrator Agency (Badan Penyelenggara Jaminan Sosial Kesehatan-BPJS Kesehatan). A total of 38277 eligible patients with confirmed COVID-19 were analyzed. The dependent variable of the study was the discharge status (death or recovery) of COVID-19. Independent variables were history of morbidity and disease-related occurrence, type of room health facilities, length of stay and demographic variables (sex, age). The analyses use bivariate and multivariate logistic regression to determine the dominating variable associated with all these variables.

Results: Of the 38 277 inpatients with PCR-confirmed COVID-19, 31051 (81.1%) were discharged and 7226 (18.9%) died. Risk of death was positively associated with older age (aOR 5.74, 95% CI 4.20-7.87 for 19-64 years old; aOR 13.75, 95% CI 9.99-18.92 for 65 years above), male sex (aOR 1.13, 95% CI 1.07-1.19), treated in ICU without ventilator (aOR 5.84, 95% CI 5.41-6.30) and had comorbid respiratory diseases (aOR 5.39, 95% CI 4.93-5.90), but negatively associated with hospital stay of 15 days or longer (aOR 0.39, 95% CI 0.36-0.43).

Conclusions: COVID-19 related death during hospitalization was associated with duration and type of treatment, and existing medical condition among the inpatient individuals during COVID-19 pandemic in DKI Jakarta. The findings of the study suggest importance of appropriate and timely medical intervention and care.

Rationale: Acute pain is a medical emergency that requires prompt abdominal evaluation and management. Dengue, a mosquito-borne arboviral infection, can lead to complications such as acute abdominal pain.

Patient concerns: A 72-year-old hypertensive female presented with high-grade intermittent fever with chills and rigors for four days. She was diagnosed with dengue fever (NS1Ag-reactive) the day before admission. A contrast-enhanced computed tomography of the abdomen showed a hematoma along the rectus sheath which was managed conservatively as per surgical opinion.

Diagnosis: Dengue hemorrhagic fever with rectus sheath hematoma.

Interventions: Blood transfusion and fluid therapy.

Outcomes: Ten days after discharge, the patient reproted no pain in the right iliac fossa and the size of the hematoma was significantly reduced.

Lessons: Although it is rarely seen as a cause of acute abdomen, complaints of adnominal pain should never be ignored in critical or convalescent phase of dengue fever. Radiological investigations should be promptly conducted as hematoma is often difficult to be diagnosed clinically. Delay in diagnosis of rectus sheath hematoma can be fatal.