1 mg/ml) remained stable when stored at refrigerator conditions f

1 mg/ml) remained stable when stored at refrigerator conditions for 7 days including the storage at room temperature for 8 h. Donepezil was stable in plasma samples when stored at room temperature for 19 h. Donepezil was found to be stable for three freeze and thaw cycles. Donepezil was stable and did not show any degradation when stored in the freezer for 96 days. Donepezil in the processed samples was stable for 82 h when stored in the auto sampler at 10 °C. The method characteristics are represented in Table 2. We described here the development of a new, selective, precise and accurate method for the quantification of

donepezil in human plasma using Liquid Chromatography Mass Spectrometric method with the simple liquid–liquid extraction technique using the less volume of plasma and is suitable for application to a pharmacokinetic, bioequivalence and drug interaction studies for the estimation of donepezil from plasma. see more The limit of quantification of the method was set to 50 pg/ml considering the dosage of donepezil

administered and PD-0332991 clinical trial it is determined not only by detection technique but also by the effective clean-up of sample and thus improving the signal to noise ratio. The method reported here uses a simple and effective extraction technique with good and reproducible recovery. All authors have none to declare. Authors are thankful to JPR Solutions for providing the support during publication. “
“Wound healing is a complex issue involving many sequential steps in the restoration of the skin to its normal state.1 Wound healing process is delayed by the free radicals present in the wound. The free radicals act by causing lipid peroxidation, enzymatic degradation & DNA breakage. Moreover the exposure of the wound to the external environment worsens the phases of wound healing since it is prone to the microbial attack. There is a substantial evidence of the role of antioxidants acting against the free radicals by scavenging Etomidate them.2 Natural extracts like Centella asiatica, Terminalia arjuna are renowned for their

antioxidant properties. 3 They possess the active constituents such as quinones, iridoids, triterpenoid derivatives, coumarins, flavonoids and isoflavonoids which play an important role in wound healing. 4, 5 and 6 The applicability of these extracts as such, is a point to be considered as inappropriate concentration may lead to subtherapeutic or undesired effects. At this juncture the need of a suitable delivery system for this extracts is inevitable. In this research an attempt was made to impregnate these extracts in a collagen matrix (a natural polymer) which acts as a base or platform by providing the physical support and ensuring the slow release of the extract. 12 and 14 Further, collagen is interlinked with the wound healing property by the virtue of its nature. Other advantages of the usage of collagen include its biodegradability & biocompatibility.

Epidemiological studies accounting for multiple colonization can

Epidemiological studies accounting for multiple colonization can provide a more precise picture of the serotypes colonizing the nasopharynx, which can then be tested in developing animal models. This approach may help

predict the virulence potential of these serotypes for their inclusion in pneumococcal vaccines even before they become major disease agents in humans. This work was supported by projects GRACE (contract LSHM-CT-2005-518226) and PNEUMOPATH (contract HEALTH-F3-2009-222983) from the European Commission and project PTDC/SAU-ESA/65048/2006 from Fundação para a Ciência Selleckchem PLX3397 e Tecnologia (FCT). N.F. was supported by FCT grant SFRH/BD/30103/2006. selleck products We gratefully acknowledge the directors, staff, parents and children at the participating day care centers. We thank R. Mato, I. Santos-Sanches, A. Brito-Avô, J. Saldanha, S. Nunes, N. Sousa, C. Simas, A. Gonçalves and P. Gonzaga for participating in studies that led to the isolation and initial characterization of the pneumococcal collection

described here. We would like to thank A. Tomasz for help with the study design, interpretation of the results and revision of the manuscript and F. Pinto for discussions on statistical analysis. “
“Extensive experimental and clinical data that reinforce the key roles of new blood vessel formation in tumor development, progression, and metastasis [1] has converted inhibition

of neo-angiogenesis, and in particular of the Vascular Endothelial Growth Factor (VEGF)–VEGF receptors system, into an active cancer therapeutic mafosfamide platform. Biological and synthetic inhibitors of angiogenesis approved as drugs or in advanced study exert their therapeutic effect at four different key steps of the VEGF pro-angiogenic cascade. Rapamicin [2], [3] and [4], COX-2 inhibitors [2], [3] and [4], and thalidomide [2], [3] and [4] decrease VEGF production by tumor cells. Bevacizumab, the humanized recombinant antibody against VEGF-A [5], and aflibercept [6] and [7] prevent circulating VEGF from interacting with its receptors. Antibodies as IMC-1121b [8] directly block access to monomeric VEGF receptor 2 in the cell surface of endothelial cells. Finally, small synthetic drugs as Sorafenib tosylate and Sunitinib malate [9] interfere with the intracellular VEGF receptor signaling pathways in endothelial and tumor cells. We have recently developed a therapeutic cancer vaccine candidate (hereafter denominated CIGB-247) with recombinant modified human VEGF produced in E. coli as antigen, combined with a potent adjuvant formed by very small sized proteoliposomes (VSSP) derived from the Neisseria meningitidis outer membrane [10].

Unlike

simulation, the peer-assisted learning model does

Unlike

simulation, the peer-assisted learning model does not require additional equipment and therefore may be more economically viable for health services and education providers. The results demonstrate that students were not concerned by delivering feedback to a peer or receiving it from a peer, but placed higher value on the feedback delivered by the clinical educator. This finding of learners attributing more value to feedback provided Epigenetics Compound Library mouse by experts compared with feedback from peers is consistent with feedback studies in higher education.26 If peer-assisted learning tasks could be made more valuable for students, this might play an important role in shifting the traditional view of supervision and feedback from one being led solely by the clinical educator, to one that is also shared among learners. Physiotherapy clinical educators have previously reported that time spent directly teaching students is burdensome,27 and that having students in the workplace takes time away from non-clinical tasks such as administration and quality assurance activities.28 Peer-assisted learning works on BIBF-1120 the assumption that learners are intrinsically motivated, can act in a collaborative manner and do not require the clinical educator to direct all of their

learning.19 This notion of reduced reliance on the clinical educator was demonstrated in the results where, in the peer-assisted learning model, clinical educators spent significantly less time on direct teaching and more time on non-student-related quality assurance activities. Interestingly, the reduction in the burden of direct teaching did not lead to greater satisfaction with the peer-assisted learning model. This may be because the introduction of the peer-assisted learning model represented a change in ideology and practice, and may have challenged clinical

educators’ traditional and more familiar practices. A previous study reported that peer learning processes challenge expectations of the educator’s roles and responsibilities, and require a different understanding of ways to approach teaching and learning.19 This may also explain why, despite else there being no difference in the average number of patients seen or the student performance outcomes, clinical educators reported less satisfaction with the time available for client service and their ability to observe and gauge students’ clinical abilities in the peer-assisted learning model. The implementation of the peer-assisted learning model as part of a research trial also involved additional data collection and administration, which may have added to the burden for both educators and students and contributed to dissatisfaction. The data collection was required for the outcomes of the trial, but would not be part of usual practice when implementing a peer-assisted learning model.

CASTS contributed to analysis and interpretation of the data; Mda

CASTS contributed to analysis and interpretation of the data; MdaGLCT contributed to interpretation of the data; SR did the initial analysis of the data; SMAM contributed to prepare the data to analysis; JPGL contributed with the design of the study and interpretation BGJ398 of the data; MLB contributed

with the design of the study, analysis and interpretation of the data. All the authors contributed to edit the paper. The manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. The order of authors listed in the manuscript has been approved by all of us. All authors have given due consideration to the protection of intellectual property associated with this work and that there are no impediments to publication, including the timing of publication, with respect to intellectual property. In so doing the authors confirm that they have followed the regulations of their institutions concerning intellectual property. This study was approved by the Committee of Institute of Collective Health, Federal University of Bahia (Protocol 017-08/CEP/ISC-2008), by four local ethics committees. Consent to participate was obtained from selleck compound all the hospitals. Carers of participating children signed written an informed consent form. This work was supported by Health Surveillance of Ministry of Health of Brazil who collaborated

in recruitment of sites but no role in study design, in collection, analysis, interpretation of data, in the writing of the report or in the decision of submit the article for publication. We recognize the contribution of the ROTAVAC Group which includes all the professionals enrolled in the rotavirus AD Surveillance System who participated in the conduction of the study: Alessandra Araújo Siqueira, Greice Madeleine, Rejane Maria de Souza Alves, Viviane Martins, Marli Costa, Ernani Renoir, Eduardo

do Carmo Hage (Health Surveillance of Ministry of Health, Brasilia, Brazil); Alexandre Madi Fialho, Rosane Santos Maria de Assis (Regional Reference Laboratory, FIOCRUZ, Rio de Janeiro, Brazil); Rita Cássia Compagnoli Carmona (Regional Reference Laboratory, Adolfo Lutz, Sao Paulo, Brazil); Joana D’Arc Pereira Mascarenhas, Luana da Silva Soares (National Reference Laboratory/Evandro Chagas, Belém, Brazil); Acácia MTMR9 Perolina Resende Setton, Adelaide da Silva Nascimento, Ana Gabriela de Andrade Carreira, Ângela Maria Rodrigues Ferreira, Fabíula Maria de Almeida de Holanda Tormenta, Janete Xavier dos Santos, Teonília Loula Dourado, Mara Espíndola Cardoso Araújo, Marco Aurelio de Oliveira Goes, Maria Elisa Paula de Oliveira, Marília Reichelt Barbosa, Maria Cristina Toledo Coelho, Sandra Cristina Deboni (AD Surveillance System of the States and Municipalities, Brazil); Ivana R. S. Varella, Elenice Brandão Cunha, Emerson Henklain Ferruzz, Marícia de Macedo Mory Kuroki, Maria de Fátima Rezende Dória Pinto, Maria Roseilda B.

He has been treated in the past for enlarged cysts with a percuta

He has been treated in the past for enlarged cysts with a percutaneous drainage of 1.2 L fluid in May 2007, followed by a seminal vesicle cyst laparoscopic decortication in December 2009. He had been stable and followed with PI3K inhibitor computed tomographic (CT) scans of the pelvis over time. On presentation to the emergency department, his initial evaluation was significant only for discomfort associated with sharp 8/10 lower abdominal and perineal pain. Vital signs were stable and within normal limits, his physical examination was benign and urinalysis, complete blood count, and basic metabolic panel were all within normal limits. This prompted a CT scan of

his pelvis with intravenous contrast, which revealed a recurrent left seminal vesicle cyst as well as the development of a new large extraperitoneal fluid collection measuring 11.6 cm × 5.0 cm, suspicious for a hematoma. This can be visualized in Figure 1,

with an arrow depicting contrast extravasation suggestive of active hemorrhage from a cystic vessel. Despite normal stable vital signs, adequate pain control, and normal laboratory work, he was admitted for observation with serial laboratory draws. By hospital day 2, he was still doing well but his hemoglobin and hematocrit levels decreased steadily. With CT evidence of active bleeding in the setting of persistently decreasing blood counts, interventional radiology department was consulted for definitive management of his hemorrhagic BEZ235 cost seminal vesicle cyst. The interventional radiologist performed a percutaneous embolization through a left internal iliac angiogram using Gelfoam slurry and 500-700 μm Embospheres. Digital subtraction angiography was performed, which demonstrated ectatic vessels outlining the enlarged left seminal vesicle as demonstrated in Figure 2A. The inferior seminal vesicle artery followed by the left seminal vesicle artery were

isolated with subsequent placement of Gelfoam and Embospheres. Nonvisualization of contributory vessels to the from left seminal vesicle was appreciated after Gelfoam embolization and can be seen in Figure 2B, suggesting successful embolization. The patient was kept overnight for observation and reassessment of complete blood counts. By postoperative day 1, he was asymptomatic with increasing hemoglobin and hematocrit values and was discharged in good condition with routine follow-up. The patient at 1-week follow-up described difficulty voiding and defecating, which was attributed to mass effect on the colon and bladder from the hematoma. Despite these symptoms, the patient’s blood counts remained stable. The patient remained stable hematologically without further hemorrhagic events. The patient had follow-up CT scans 1 year and 2 years after the procedure that demonstrated regression in size. In conclusion, seminal vesicle cysts are a very rare phenomenon, and clinically significant hemorrhagic seminal vesicle cysts are even less common.

A p-value <0 05 was considered as statistically significant All

A p-value <0.05 was considered as statistically significant. All statistical analysis was performed by SAS software version 9.1.3 (SAS Institute, Cary, NC, USA). For planning the study, we assumed that approximately 20% of enrolled AGE cases might get detected as RV positive and it was based on earlier outpatient setting studies in India [15] and [16]. With this expected proportion of rotavirus positivity, 500 was the targeted (PP) population for enrolling AGE subjects. It was planned that each region would provide complete data of at least 100

subjects. We initiated the study at a total of 10 sites with two sites located in each geographical region (i.e., north, south, east, west, and center) of India. These sites started enrolling subjects from December 2011. Due to inadequate enrollment from one site and region as a whole, in northern region, we initiated enrollment at an additional site Z-VAD-FMK solubility dmso in July 2012, taking Carfilzomib nmr the total number of sites to 11. Enrollment at the new site and existing site in the region was competitive. We screened a total of 616 children for eligibility for participation in this study (Fig. 1). We found 98.2% (605/616) eligible subjects and enrolled them

in the study. The study collected stool samples from all subjects (n = 605). Site staff contacted the parent/guardian of all subjects (n = 605) by telephone for data collection after Day 7 and Day 14, for collecting information for all Day 1–Day 7 and Day 8–Day 14, respectively. Out of 552 subjects in PP population, three sites in

north India had 109 (16 + 59 + 34) subjects; two sites each in south, east, west, and center of India had 99 (47 + 52), 113 (55 + 58), 111 (58 + 53), 120 (45 + 75) subjects, respectively. From majority of the subjects (89.7% [495/552]) stool samples were collected within 2 days of enrollment. EIA testing was possible for samples of 91.2% (552/605) subjects’ stool samples. EIA testing could not be performed for stool samples of 8.8% (53/605) subjects for reasons such as insufficient quantity of samples (n = 46), samples not labeled (n = 4), and inappropriate enrollment (disease symptoms occurred >3 days prior to enrollment as opposed to protocol requirement) (n = 3). In addition to laboratory results (for EIA), complete per protocol data was available for these 552 subjects and they formed the PP population. The demographic characteristics are presented in Table 1. Mean (±SD) age of subjects was 17.0 (±12.6) months. RV positive subjects were younger compared to RV negative subjects (mean age ± SD was 14.8 ± 10.1 months vs. 17.6 ± 13.2 months); this difference was not statistically significant. The distribution of cases by age revealed statistically significant (p = 0.0081) proportion of RV positive cases in ≤24 months age group.

Culture supernatants were then assayed for murine cytokines by EL

Culture supernatants were then assayed for murine cytokines by ELISA using specific kits (BD Biosciences) or by multiplex ELISA biomarker assays (Aushon BioSystems, Billerica, MA, USA). Cytokine levels determined in the cultures from LNs of PBS-immunized animals were used as the initial time-point (0 h). Similarly, systemic cytokine levels in pooled or individual serum

samples drawn from www.selleckchem.com/products/azd9291.html vaccinated animals via terminal bleeds at different time intervals after inoculation were measured by ELISA. Cytokine levels from the sera of PBS-immunized animals were considered as the initial time-point (0 h). All experiments on cytokine measurement in vivo were run two or three times yielding similar results for each experimental group. At different time-points after injection with SVP, free TLR agonist or PBS, mice were sacrificed,

draining popliteal lymph nodes harvested and digested for 30 min at 37 °C in 400 U/mL collagenase type 4 (Worthington, Lakewood, NJ, USA). Single cell suspensions were prepared by forcing digested lymph nodes through a 70-µm nylon filter membrane, then washed in PBS containing 2% FBS and counted using a Countess® cell counter (Life Technologies, Carlsbad, CA, USA). Cells were stained pairwise with antibodies against the following mouse surface cell molecules: B220 and CD11c, PAK6 CD3 and CD49b, F4/80 and Gr1 (BD Biosciences, CA, USA). The gating logic was as follows: plasmacytoid selleck products dendritic cells (CD11c+, B220+), myeloid dendritic cells (CD11c+, B220-), B cells (CD11c-, B220+), granulocytes (GR-1+, F4/80-), macrophages (GR-1-, F4/80+), NK T cells (CD49b+, CD3+), NK cells (CD49b+, CD3-), and T cells (CD49b-, CD3+). Similarly, SIINFEKL-loaded pentamers (Proimmune, Oxford, UK), were used along with anti-mouse CD8 and CD19 (to gate out non-specific pentamer binding).

Cell samples were then washed and immediately analyzed by flow cytometry. Data were analyzed with FlowJo software (Tree Star Inc., Ashland, OR, USA). TLR7/8 (R848) and TLR9 (CpG ODN 1826; mouse-specific B-type CpG ODN) agonists were encapsulated in synthetic polymer nanoparticles and tested for their ability to induce cytokines in vitro. R848 was chemically conjugated to PLGA and used for SVP formulation as PLGA-R848, and CpG ODN was passively entrapped into SVP as described in Section 2. Natural oligonucleotide sequences contain a phosphodiester (PO) backbone, which is susceptible to rapid hydrolytic cleavage by nucleases in vivo. Nuclease-resistant CpG sequences with a phosphorothioate (PS) backbone have been shown to have superior activity to PO-CpG in vivo. Both PS and PO forms of the immunostimulatory CpG ODN 1826 sequence (PS-CpG 1826 and PO-CpG 1826) were evaluated.

VP7(T13) is an immuno-dominant orbivirus-species/serogroup-specif

VP7(T13) is an immuno-dominant orbivirus-species/serogroup-specific antigen [51], [60] and [61]. Antibodies to VP7 can neutralise the infectivity of BTV core-particles, but do not significantly neutralise intact virus particles [62]. The incorporation of baculovirus-expressed VP7 in previously reported vaccination studies using VP2 and VP5, also failed to enhance NAb

responses in sheep [43]. However, vaccination with BTV-VP7 has been shown to induce a partially-protective Ipatasertib price cytotoxic T-cell response that may reduce viraemia [63]. Capripoxvirus expressing VP7 was shown to confer cross-protection [51]. Although vaccination with baculovirus-expressed BTV core-like-particles (CLP – containing VP3 and VP7) did not prevent clinical signs of the disease, it did reduce their severity [44]. The addition of expressed VP7 to vaccination antigens (with VP5Δ1–100 and soluble domains of VP2) failed to increase neutralising antibody titres (against BTV-4) and failed to protect IFNAR−/− mice from lethal challenge with BTV-8. Regardless of the antigen combination which we see more used, there was no protection from the heterologous BTV-8 lethal challenge. These results show that the response to immunisations is serotype-specific and that VP2 is the main protective component in the three combinations of antigens. The results presented show that soluble BTV-VP2 domains and VP5 can be expressed in

bacteria, suggesting that they adopt a native conformation/fold in this system. The aim of this study was to assess bacterially-derived BTV structural-proteins as candidates for a DIVA-compatible subunit-vaccination-strategy, using Balb/c mice and the well-established BTV animal-model, IFNAR−/− mice. DIVA-compatible BTV vaccines could be based on a subset of the viral proteins, with detection of antibodies to the remaining protein(s) as surveillance markers for previous infections. Our results demonstrate potential for a bacterial-expressed BTV-subunit DIVA vaccine, based principally

on VP2 and VP5. The exclusion of VP7, which does not seem to influence protection, provides a mean for DIVA. The two expressed VP2 domains, VP2D1 and VP2D2 whatever combined on equimolar basis, generated high titres of neutralising antibodies with similar titres in both Balb/c and IFNAR−/−. Although a transient viraemia was observed in mice immunised with VP2D1 + VP2D2, post-challenge with BTV-4, this was rapidly cleared and they survived without signs of infection throughout the experiment. This indicates that soluble bacterial-expressed antigens are protective and do not require more complex eukaryotic expression systems. The use of bacterial-expressed protein antigens, could provide a safe and scalable alternative to live-attenuated BTV vaccines. Bacterial expression could represent an alternative to inactivated vaccines, particularly if viruses prove to be difficult to propagate in cell culture (like BTV-25 [7]).

WECS might be beneficial for the prevention of

cancer met

WECS might be beneficial for the prevention of

cancer metastasis as an adjuvant agent in cancer chemotherapy, and it also reduces the adverse effects of chemotherapeutic agents. In in vivo studies, Kubo et al. investigated the antimetastatic activity of WECS using INCB024360 clinical trial a mouse model injected with B16-F0 mouse melanoma (B16-F0) cells into the spleen. WECS (50 mg/kg/day for 20 days after cancer inoculation) administered intraperitoneally significantly reduced the number of metastatic surface nodules of B16-F0 cells in the liver of C57BL/6Cr mice, and significantly prolonged their survival. Furthermore, they examined the effect of WECS on the hepatocyte growth factor (HGF)-accelerated invasion of B16-F0 cells using a chemo-invasion assay in vitro. WECS (1 μg/mL) was shown to significantly reduce HGF-accelerated B16-F0 cell

invasion (12). Moreover, Kubo et al. investigated the effect of WECS on tissue inhibitor of metalloproteinase (TIMP)-1 secretion from B16-F0 cells Selleckchem Inhibitor Library in order to identify clues to the mechanism underlying the anti-invasive action of WECS. As a result, WECS (1 μg/mL) significantly increased the secretion of TIMP-1 from B16-F0 cells (13). These results suggest that WECS has an antimetastatic action through inhibiting the invasiveness of cancer cells by accelerating the secretion of TIMP-1 from cells. In in vivo studies, the anticancer effect of orally administered cordycepin was examined in C57BL/6Cr mice inoculated with B16-BL6 cells. B16-BL6 (1 × 106) cells were inoculated subcutaneously into the right footpad of mice. At two weeks after the cell inoculation, the enlarged primary cancer lump was weighed. Cordycepin (15 mg/kg per day), administered orally to the mice for two weeks from the date of cancer inoculation, significantly Fossariinae reduced the wet weight of the primary cancer by 36% compared to that of the untreated control

mice, without any loss of body weight or systemic toxicity (14). These results show that orally administered cordycepin inhibits melanoma cell growth in mice with no side effects. In in vivo studies, Sato et al. investigated the anti-metastatic activity of cordycepin using a mouse model injected with B16-F0 cells into the spleen. Cordycepin was administered intraperitoneally daily at a dose of 0, 0.5, or 5.0 mg/kg for 19 days after cancer inoculation. All C57BL/6Cr mice inoculated with B16-F0 cells died due to liver metastasis via the portal vein from the spleen. Cordycepin at 0.5 and 5.0 mg/kg resulted in significantly longer survival times than those observed in control mice (15). Kubo et al. investigated the effect of cordycepin on TIMP-1 secretion from B16-F0 cells in order to identify clues to the mechanism underlying the anti-invasive action of cordycepin. Cordycepin was shown to significantly accelerate the release of TIMP-1 from cells (13). Jeong et al.

It is also likely that the overall incidence rates in our current

It is also likely that the overall incidence rates in our current study have been inflated by the increased numbers of influenza admissions during the A(H1N1)pdm09 pandemic period during 2009/10. Our current rates are also higher than those of another recent Hong Kong study [7], but lower than those of an earlier report by the same group (Table 4) [3]. However, the burden of disease alters in relation to both the vaccine coverage in these children and the protection learn more elicited by

the vaccines that covered the circulating virus strain types of the respective seasons. We were unable to differentiate between cases infected with vaccine-covered or non-vaccine-covered strains as not all patients had their virus

isolates characterised. However, based on the data provided by the National Influenza Reference Laboratory (personal communications), the trivalent vaccine strains matched with our circulating strains in 2005 and 2010; and incomplete match occurred with Dorsomorphin order influenza A H3 strains for 2006 and 2011. For 2007 and 2009, the influenza A H1N1 strains were not matched while influenza B strains were not matched in 2008. However, data suggested the uptake rate among infants 6–23 months was low at 8.5% during the 2005/6 flu season [8], but the introduction of governmental subsidies to influenza vaccination for aged 6–59 months since 2008 may have improved vaccine uptake. Pregnant women are a high risk group that can benefit from seasonal influenza vaccination and recent studies have suggested that their infants will

also enjoy some degree of protection [9], [10], [11], [12], [13], [14], [15] and [16]. The vaccination uptake rate among pregnant women in Hong Kong is low in general, and ranged between 1.7 and 4.9% from various studies reported during this period [17], [18] and [19]. Should a vaccination programme targeting pregnant women also reduce the high influenza incidence of hospitalisation Etomidate in infants aged 2 months to below 6 months, it is likely that vaccine uptake would increase and cost-effectiveness of the programme would be enhanced. In contrast to high influenza hospitalisation rate in infants aged 2 months to below 6 months was the low rate in infants below two months of age (627 per 100,000). This low rate was despite the high absolute numbers of infants admitted during the first two months of life (Table 1). A US study has shown that infants below 3 months of age are more likely to present with fever alone than children aged 3 months to below 24 months of age, and although they generally do well and have a shorter duration of hospital stay, they are more likely to be admitted [20]. This analysis shows the potential of combining laboratory surveillance and passive discharge diagnosis surveillance to monitor disease burden of vaccine-preventable pathogens [1] and [2].