Dataset Information

Surveillance for unexplained deaths and critical illnesses due to possibly infectious causes, United States, 1995-1998.

ABSTRACT: Population-based surveillance for unexplained death and critical illness possibly due to infectious causes (UNEX) was conducted in four U.S. Emerging Infections Program sites (population 7.7 million) from May 1, 1995, to December 31, 1998, to define the incidence, epidemiologic features, and etiology of this syndrome. A case was defined as death or critical illness in a hospitalized, previously healthy person, 1 to 49 years of age, with infection hallmarks but no cause identified after routine testing. A total of 137 cases were identified (incidence rate 0.5 per 100,000 per year). Patients' median age was 20 years, 72 (53%) were female, 112 (82%) were white, and 41 (30%) died. The most common clinical presentations were neurologic (29%), respiratory (27%), and cardiac (21%). Infectious causes were identified for 34 cases (28% of the 122 cases with clinical specimens); 23 (68%) were diagnosed by reference serologic tests, and 11 (32%) by polymerase chain reaction-based methods. The UNEX network model would improve U.S. diagnostic capacities and preparedness for emerging infections.

SUBMITTER: Hajjeh RA

PROVIDER: S-EPMC2732455 | biostudies-literature | 2002 Feb

REPOSITORIES: biostudies-literature

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Surveillance for unexplained deaths and critical illnesses due to possibly infectious causes, United States, 1995-1998.

Hajjeh Rana A RA Relman David D Cieslak Paul R PR Sofair Andre N AN Passaro Douglas D Flood Jennifer J Johnson James J Hacker Jill K JK Shieh Wun-Ju WJ Hendry R Michael RM Nikkari Simo S Ladd-Wilson Stephen S Hadler James J Rainbow Jean J Tappero Jordan W JW Woods Christopher W CW Conn Laura L Reagan Sarah S Zaki Sherif S Perkins Bradley A BA

Emerging infectious diseases 20020201 2

Population-based surveillance for unexplained death and critical illness possibly due to infectious causes (UNEX) was conducted in four U.S. Emerging Infections Program sites (population 7.7 million) from May 1, 1995, to December 31, 1998, to define the incidence, epidemiologic features, and etiology of this syndrome. A case was defined as death or critical illness in a hospitalized, previously healthy person, 1 to 49 years of age, with infection hallmarks but no cause identified after routine t ...[more]

PMID: 11897065

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Project description:BackgroundChronic fatigue syndrome (CFS) has no diagnostic clinical signs or biomarkers, so diagnosis requires ruling out conditions with similar signs and symptoms. We conducted a pilot registry of unexplained fatiguing illnesses and CFS to determine the feasibility of establishing and operating a registry and implementing an education outreach initiative. The pilot registry was conducted in Bibb County, Georgia. Patient referrals were obtained from healthcare providers who were identified by using various education outreach initiatives. These referrals were later supplemented with self-referrals by members of a local CFS support group. All patients meeting referral criteria were invited to participate in a screening interview to determine eligibility. If patients met registry criteria, they were invited to a one-day clinic for physical and laboratory evaluations. We classified patients based on the 1994 case definition.ResultsWe registered 827 healthcare providers. Forty-two providers referred 88 patients, and 58 patients (66%) completed clinical evaluation. Of the 188 CFS support group members, 53 were self-referred and 46 (87%) completed the clinical evaluation. Of the 104 participants completing evaluation, 36% (n?=?37) met the criteria for CFS, 17% (n?=?18) had insufficient fatigue or symptoms (ISF), and 47% (n?=?49) were found to have exclusionary medical or psychiatric illnesses. Classification varied significantly by type of referral but not by previous history of CFS diagnosis. Healthcare providers referred more patients who were classified as CFS as compared to support group referrals in which more exclusionary conditions were identified. Family practice and internal medicine specialties made the most referrals and had the highest number of CFS cases. We conducted three CME events, held three "Meet and Greet" sessions, visited four large clinical health practices and health departments, mailed five registry newsletters, and conducted in-person office visits as part of education outreach, which contributed to patient referrals.ConclusionsReferrals from healthcare providers and self-referrals from the patient support group were important to registry enrollment. The number of potentially treatable conditions that were identified highlights the need for continued medical management in this population, as well as the limitations of registries formed without clinical examination. Education initiatives were successful in part because of partnerships with local organizations.

Dataset Information

Surveillance for unexplained deaths and critical illnesses due to possibly infectious causes, United States, 1995-1998.

Publications

Surveillance for unexplained deaths and critical illnesses due to possibly infectious causes, United States, 1995-1998.

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