Monthly pediatrics bulletin — October 13, 2026
This issue covers October 7 through October 13, 2026 (the previous issue was published on October 6). It was a thin week for clinical trials: there was no news in neonatology, and several items come from conference abstracts or manufacturer releases, which is flagged in each case. Five items from the preceding weeks that had not appeared in earlier issues are also included, with their dates stated; one of them (September 11) carries the "Outside the period" label. Eleven items in total.
Neonatology
No news in this issue. The story on the hepatitis B birth dose is in the vaccines section.
Infectious diseases, vaccines, and emergency care
1. Measles: PAHO raises the risk of spread in the Americas to "very high"
[Epidemiological alert] [Americas — PAHO/WHO]
PAHO's risk assessment, dated October 8 and released October 9, updates the August 5 assessment ahead of several religious mass gatherings in South America. Between January 4 and October 3, 2026, 17 countries and territories confirmed 55,792 cases and 77 deaths, a 4.8-fold increase over the same period of 2025. Guatemala (34,355 cases, 50 deaths), Mexico (13,595 and 23), the United States (3,887 and 2), Peru (2,553 and 1), and Canada (1,121, no deaths) account for 99.5% of cases; the remaining death occurred in Bolivia. In Guatemala, 67.6% of cases had no history of vaccination. Regional coverage in 2025 was 88% for the first dose and 85% for the second (95% is needed), and about 1.6 million children received no dose.
Why it matters: the Dominican Republic does not appear in the situation report, but it receives travelers from all five of the most affected countries; PAHO recommends one dose for anyone aged 6 months or older without evidence of vaccination before travel or mass gatherings, ideally two weeks in advance. This is a good moment to review records in clinic.
https://www.paho.org/sites/default/files/2026/10/pahomeaslessitrep13eng.pdf
2. Hepatitis B birth dose: the University of Southern Denmark approves the Guinea-Bissau trial
[Publication — ethics decision on a trial, no results] [Guinea-Bissau / Denmark / United States]
According to coverage published between October 9 and 11, Jakob Grauslund, dean of the faculty of health sciences at the University of Southern Denmark, approved the Bandim Health Project trial following an independent ethical assessment by the university's research ethics committee. The design randomizes about 14,000 newborns: half would receive the hepatitis B birth dose and half would follow the current national schedule, which starts at 6 weeks. The US CDC is funding it with $1.6 million. Guinea-Bissau's ethics committee approved a revised protocol this summer, but final government authorization has not been granted and the study cannot begin without it; the country plans to introduce the birth dose in 2028.
Why it matters: this is not a result but a decision about a design that WHO questioned on February 13 ("resource constraints cannot be used to justify withholding proven care in a research study involving people"); the recommendation to vaccinate within the first 24 hours is unchanged, and none of this should alter Dominican practice.
https://www.medicaldaily.com/hepatitis-b-birth-dose-trial-guinea-bissau-approval-479835
3. AAP renews its call to ban raw milk sales and adds H5N1 as a risk
[Guideline — AAP policy statement] [United States]
The statement "Consumption of Unpasteurized (Raw) Milk and Milk Products by Pregnant People and Children" was published online October 5 (November issue of Pediatrics) and updates the 2014 statement, reaffirmed in 2025. It calls for a ban on the sale and distribution of raw milk and raw dairy products, including raw cheeses, and for young children and pregnant or breastfeeding people to avoid them. Figures cited: nearly half of illnesses from raw dairy occur in people under 20; listeriosis incidence in pregnancy is estimated at 12 to 14 times that of the general population; during the 2024 US dairy outbreak, H5N1 was detected in nearly one-quarter of raw milk samples from affected areas, and the virus may remain detectable for up to 5 weeks in refrigerated raw milk.
Why it matters: no human H5N1 infection from drinking raw milk has been confirmed, so that risk is theoretical for now; the rest (Listeria, Salmonella, E. coli, Brucella) is well documented and applies directly to the unpasteurized artisanal cheeses eaten in the Dominican Republic. Published two days before this issue's period.
4. E-bike injuries in minors: fractures predominate
[Conference — AAP National Conference 2026, abstract] [United States]
Analysis of NEISS data from 2005 to 2024 in patients aged 17 or younger, presented at the AAP conference in San Diego (October 2 to 6; press release October 2). Fracture was the most common e-bike injury (27%), whereas contusions or abrasions were most common for conventional bicycles (24%) and gas-powered cycles (27%); the head was injured in 20% of e-bike cases (16.6% for gas-powered cycles and 15.8% for bicycles). Admission rates were 6.6% for e-bikes, 5% for bicycles, and 10% for gas-powered cycles.
Why it matters: the e-bike sample is only 305 cases (one fatal), versus 134,426 bicycle and 1,721 gas-powered cycle cases; the abstract reports no statistical comparisons and has not been peer reviewed. It supports helmet and supervision counseling, relevant given the spread of electric scooters and motorbikes in Santo Domingo, but it does not quantify risk. Presented before this issue's period.
General pediatrics, development, nutrition, and adolescence
5. PrEggNut: higher egg and peanut intake in pregnancy and lactation did not prevent infant allergy
[Clinical trial] [Australia]
Randomized trial in four Australian cities (Adelaide, Melbourne, Perth, and Sydney), published September 17 in N Engl J Med (2026;395:1090-1099). It randomized 2,137 women at less than 23 weeks' gestation whose infants had at least two first-degree relatives with allergic disease (1,070 to high intake and 1,067 to standard intake). High intake (at least 6 eggs and 60 peanuts per week) was compared with standard intake (no more than 3 eggs and 30 peanuts) from enrollment through 4 months of breastfeeding. IgE-mediated egg or peanut allergy at 1 year, in the intention-to-treat analysis, was 7.8% versus 8.4% (adjusted RR 0.93; 95% CI 0.69–1.26; P = .65); the outcome was determined directly in 1,917 of 2,130 eligible infants, and the rest were imputed. Peanut allergy was 2.6% in both groups. Serious adverse events (3.6% versus 3.8%) and egg or peanut anaphylaxis (0.5% versus 0.9%) did not differ, nor did eczema or sensitization.
Why it matters: the result is neutral, but observed prevalence was half the 16% assumed in the power calculation, and the interval does not exclude a 30% relative reduction; given the nature of the intervention, participants knew their diet. There is no basis for advising pregnant women to eat more egg or peanut for this purpose, nor to avoid them; early introduction in the infant remains the strategy with evidence. Published before this issue's period.
https://doi.org/10.1056/NEJMoa2605659
6. Dupilumab and the atopic march: fewer new diagnoses of asthma, rhinitis, and food allergy than with systemic corticosteroids
[Conference — Fall Clinical Dermatology Conference, poster] [United States]
Retrospective claims analysis (Inovalon database, more than 150 health plans) presented at the October 8–11 meeting in Las Vegas: 2,897 children with atopic dermatitis starting dupilumab, propensity-matched 1:1 to 2,897 treated with systemic corticosteroids. The outcome was a new diagnosis of food allergy, asthma, allergic rhinitis, or eosinophilic esophagitis, with follow-up of up to 2 years in children under 6 and up to 3 years in older children. Hazard ratios: 0.67 (95% CI 0.52–0.86) under 2 years; 0.48 (0.40–0.56) at 2 to 5 years (231 versus 423 events among 1,055 per group); 0.66 (0.52–0.84) at 6 to 11 years; and 0.64 (0.52–0.79) at 12 to 17 years.
Why it matters: this is a non-peer-reviewed poster, observational and based on billing codes; the comparator (systemic corticosteroids, which are not standard treatment for atopic dermatitis) selects a different kind of patient, and in the sensitivity analysis the 6-to-11 group lost significance (HR 0.71; 95% CI 0.48–1.05). The coverage does not state the funding, but the authors include Regeneron staff, and Regeneron makes the drug with Sanofi. It generates a hypothesis and does not justify prescribing dupilumab to "prevent" asthma; cost also limits access in the Dominican Republic.
7. Roflumilast cream 0.05% in infants aged 3 to under 24 months with atopic dermatitis
[Industry] [United States]
On October 9, at the EADV congress, Arcutis presented data from the open-label phase 2 INTEGUMENT-INFANT study: 101 infants received once-daily roflumilast cream 0.05%, with no vehicle arm, and 96 completed 4 weeks. vIGA-AD success (clear or almost clear with at least a 2-grade improvement) was reached by 34.4% of completers, and 46.6% of 88 assessed had at least a 25% improvement in itch within 10 minutes, by caregiver report. According to the company, there were no serious adverse events, and at least 97.9% had no application-site irritation. The cream is approved in the United States for ages 2 to 5; the FDA accepted the application for infants from 3 months on July 8, with a target action date of February 23, 2027.
Why it matters: this is an open-label, single-arm, 4-week study reported by the manufacturer; without a vehicle arm, response cannot be separated from the natural fluctuation of the disease (vehicle reached 10.7% in the controlled trial in ages 2 to 5). It does not change practice; emollients and low-potency topical corticosteroids remain the foundation.
8. Adolescent suicidal ideation: the trend reversed around 2009
[Conference — AAP National Conference 2026, abstract] [United States]
Joinpoint analysis of national Youth Risk Behavior Surveillance System data (high school students, 1991 to 2021), presented at the AAP conference (press release October 2). Suicidal ideation fell 3.61% per year from 1991 to 2009 and rose 3.66% per year from 2009 to 2021; suicide attempts rose 3.42% per year after 2009 (P = .032). Persistent sadness or hopelessness rose 1.71% per year from 2009 to 2017 and 7.67% per year from 2017 to 2021; insufficient sleep increased from 2013 and obesity from 2011.
Why it matters: this is a non-peer-reviewed abstract with no sample size reported, and an ecological analysis that cannot attribute causes (smartphones, social media, sleep); the data are from the United States and end in 2021. It supports routine screening for depression and suicide risk at adolescent visits, which does not depend on this study. Presented before this issue's period.
Pediatric surgery and subspecialties
9. Hypospadias: caudal versus penile block and urethrocutaneous fistula
[Clinical trial] [United States] [Outside the period: September 11]
Randomized non-inferiority trial at 16 Pediatric Regional Anesthesia Network centers (Regional Anesthesia & Pain Medicine, online September 11) in children aged 2 years or younger undergoing primary single-stage repair of distal or midshaft hypospadias. A total of 161 children completed follow-up. Urethrocutaneous fistula at 3 months occurred in 8.9% with caudal block and 7.3% with penile block (RR 0.98; 95% CI 0.35–2.76; P = .9). The caudal group needed less intraoperative and rescue opioid, with lower pain scores in recovery; proximal meatal position was the independent risk factor for fistula.
Why it matters: it answers with a trial a concern raised by retrospective series linking caudal block to more fistulas, but it stopped early because of incomplete enrollment and loss to follow-up, and the confidence interval is too wide to rule out clinically relevant differences. For now it does not require abandoning caudal block, which gave better analgesia.
https://rapm.bmj.com/content/early/2026/09/11/rapm-2026-108027
Cross-cutting
10. Dominican Republic, epidemiological week 38: pertussis (8 cases versus 1) and leptospirosis nearly doubled
[Epidemiological alert] [Dominican Republic]
According to the Ministry of Public Health bulletin for week 38, as reported in the press on October 9 and 10, pertussis stands at 8 confirmed cases in 2026 versus 1 in the same period of 2025 (the Infobae report expresses this as a 680% increase in incidence). Leptospirosis totals 279 confirmed cases versus 142, and 20 deaths versus 13, with no new confirmed cases in week 38; weeks 35 to 38 had 4 confirmed cases, versus 21 in the same weeks of 2025.
Why it matters: for pertussis the absolute numbers are small and the percentage is more striking than the data, although under-reporting is likely. It supports insisting on vaccination in pregnancy and on completing infant schedules. The press reports give no pediatric breakdown for leptospirosis.
11. South Korea: the regulator does not track shortages of pediatric medicines separately
[Publication — parliamentary audit] [South Korea]
At the National Assembly audit of the Ministry of Food and Drug Safety (October 13), Rep. Heo Jong-sik reported that of 1,513 supply-interruption reports between 2021 and June 2026, none involved children's antipyretic syrups (the 3 antipyretic reports were for adult tablets), despite shortages of those syrups; the rule requires reporting only when an active ingredient has 2 or fewer products, or 3 or fewer manufacturers or importers. Cases cited: three disruptions of Erwinaze (pediatric leukemia) in 2022, 2023, and 2025; suspension of injectable phenobarbital in 2023 as unprofitable; and suspension of theophylline dry syrup, reported in October 2024 and still under review at the end of June 2026.
Why it matters: this is health policy, not clinical data, and it comes from a legislator's office; but the problem (unprofitable pediatric formulations disappearing with nobody measuring it) is the same in the Caribbean.
https://www.newspim.com/news/view/20261013000393
Upcoming meetings and dates
- ObesityWeek 2026: November 14 to 17, Washington, DC; Novo Nordisk has announced that detailed results of STEP Young (semaglutide in children aged 6 to under 12 with obesity) will be presented there.
- FDA: target action date for roflumilast cream 0.05% in infants from 3 months, February 23, 2027 (beyond the next 6 weeks; noted for reference).
Ready-to-paste LinkedIn post
Monthly pediatrics bulletin — October 13, 2026 11 verified items, centered on the week of October 7–13: NEJM, Pediatrics (AAP), Regional Anesthesia & Pain Medicine, PAHO, and conference abstracts. Three worth your time: • Measles in the Americas: 55,792 confirmed cases and 77 deaths in 17 countries and territories through October 3, a 4.8-fold increase over the same period of 2025. PAHO rates the risk "very high"; regional first-dose coverage was 88% in 2025. • PrEggNut (NEJM, 2,137 pregnant women): higher egg and peanut intake in pregnancy and lactation did not reduce allergy at 1 year (7.8% vs 8.4%; RR 0.93). Allergy was half as common as planned for, so a moderate benefit is not excluded. • Hepatitis B birth dose: the University of Southern Denmark approved the trial that would withhold the birth dose from half of 14,000 newborns in Guinea-Bissau. This is a decision about a design, not a result, and government authorization is pending. Full bulletin, with a critical reading of each study and links to sources: https://boletinesmedicos.com/en/pediatrics/2026-10-13.html #Pediatrics #Neonatology #ChildHealth #Measles #Vaccines
Ready-to-paste X (Twitter) post
Pediatrics, Oct 7–13: measles in the Americas at 55,792 cases and 77 deaths; PAHO rates risk "very high". PrEggNut (NEJM): more egg and peanut in pregnancy did not prevent allergy at 1 year (7.8% vs 8.4%). https://boletinesmedicos.com/en/pediatrics/2026-10-13.html
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