title: Immunizations, neonatal hyperbilirubinemia and animal-induced injuries.
abstract: OBJECTIVE
  To report recent research findings and new recommendations on immunizations, neonatal hyperbilirubinemia, and animal-induced injuries.
  
  
  RESULTS
  Vaccines against rotavirus and human papilloma virus have entered clinical use. Varicella outbreaks among previously vaccinated children have prompted the recommendation for a two-dose varicella vaccine series. Broader coverage for influenza vaccination is now recommended in the US and Canada. Diagnosis and treatment of neonatal hyperbilirubinemia uses population and hour-based norms for total serum bilirubin and assessment of risk factors. Delayed cord clamping is not apparently a risk factor for jaundice but warrants more study. Universal predischarge screening shows promise but is not yet officially recommended. New treatments for hyperbilirubinemia are being evaluated. Dogs are the chief cause of animal bites in children and the largest reservoir for rabies worldwide. In North America and Europe, cats and wild animals cause most human rabies. Postexposure prophylaxis should follow region-appropriate guidelines.
  
  
  CONCLUSIONS
  New vaccines are available against rotavirus and human papilloma virus. Changes have been made to official immunization recommendations. Appropriate vaccine use can reduce the pediatric disease burden further. Hyperbilirubinemia is the subject of ongoing study, which may lead to improved diagnosis and treatment protocols and reduce the incidence of acute bilirubin encephalopathy. The best tool for rabies prevention after an animal bite is prompt postexposure prophylaxis.
authors.affiliation: Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA. henry.h.bernstein@hitchcock.org
authors.forename: Sean R
authors.initials: SR
authors.lastname: Bennett
authors.forename: Beth
authors.initials: B
authors.lastname: Brennan
authors.forename: Henry H
authors.initials: HH
authors.lastname: Bernstein
mesh_terms: D000818:Animals; D001663:Bilirubin / Q000097:blood; D001733:Bites and Stings; D019433:Chickenpox Vaccine; D004285:Dogs; D006506:Hepatitis A / Q000517:prevention & control; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D007115:Immunization Schedule; D007231:Infant, Newborn; D007251:Influenza, Human / Q000517:prevention & control; D008589:Meningococcal Infections / Q000517:prevention & control; D010567:Pertussis Vaccine; D010789:Phototherapy; D012400:Rotavirus Infections / Q000517:prevention & control; D022243:Rotavirus Vaccines; D014761:Viral Hepatitis Vaccines; D014765:Viral Vaccines / Q000008:administration & dosage*
chemical_list: D019433:Chickenpox Vaccine; D010567:Pertussis Vaccine; D022243:Rotavirus Vaccines; D014761:Viral Hepatitis Vaccines; D014765:Viral Vaccines; D001663:Bilirubin