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Secondary Cases (secondary + case)
Selected AbstractsEssential versus reactive thrombocythemia in children: Retrospective analyses of 12 casesPEDIATRIC BLOOD & CANCER, Issue 1 2007Abeer Abd El-Moneim Abstract Background Essential thrombocythemia (ET) rarely occurs in the pediatric population and little is known about the clinical course and the molecular characteristics. Procedure In this retrospective multi-institutional study we examine the clinical, hematological, and molecular features of 12 children aged 5,16 years with thrombocytosis and a suspected diagnosis of ET. Results Median follow-up was 59 months (range 10,72). Seven patients presented with clinical symptoms potentially related to thrombocytosis. The remaining five patients were diagnosed incidentally. Median platelet count at diagnosis was 1,325,×,109/L (range 600,3,050). In 11 out of 12 cases bone marrow morphology was consistent with ET, the remaining patient had chronic idiopathic myelofibrosis. Cytogenetic analyses were normal in all studied cases and only one out of nine analyzed cases harbored a JAKV617F allele. Within 6 months after initial presentation one patient who was initially asymptomatic developed thrombosis and another patient had mild bleeding. Eight patients were treated with acetylsalicylic acid, one patient received hydroxyurea, and two patients received anagrelide. At last follow-up, all patients were alive and none had developed leukemia. Five patients experienced hematological remission. Two children had not received any therapy. During the course of their disease, nine patients developed symptoms possibly attributable to an elevated platelet count. Conclusions In JAK2 mutation negative cases, long-term follow-up is helpful to distinguish between primary and secondary thrombocytosis. Secondary cases are not associated with organomegaly but may present with unspecific symptoms. Indications for treatment in children remain unclear. Pediatr Blood Cancer 2007;49:52,55. © 2006 Wiley-Liss, Inc. [source] Risk of Norovirus Transmission during Air TravelJOURNAL OF TRAVEL MEDICINE, Issue 5 2009Krista Kornylo MPH Background. During October 2006, an outbreak of norovirus gastroenteritis sickened 200 (59%) of the 379 passengers and 26 (18%) of the 144 crew members on a riverboat. In November 2006, CDC was notified that a group of ill passengers had boarded a commercial flight from St Louis, Missouri, to Atlanta, Georgia. A recent study demonstrated probable norovirus transmission from eight symptomatic flight attendants to passengers on board an aircraft during an international flight; however, there are no published reports of transmission of norovirus on flights of short duration. Methods. We investigated the risk of norovirus transmission on a short flight as part of an outbreak response. Using a standardized questionnaire, we conducted interviews of passengers and flight attendants who were on the flight. We collected information on traveler demographics and illness before, during, and after the flight. We also collected information about potential onboard risk factors for norovirus transmission, such as proximity and contact with ill appearing persons during the flight, as well as use of onboard lavatories and hand hygiene. Results. We were able to complete questionnaires for 50 (56%) of the 89 passengers on the flight and 2 (67%) of the 3 flight attendants. Two (5%) of 42 possible secondary cases were identified. These two passengers neither sat in proximity to an index-case passenger during the flight nor reported use of an onboard lavatory. Conclusions. Although onboard transmission cannot be excluded, likelihood of norovirus transmission on a short flight when ill travelers do not have episodes of vomiting or diarrhea appears minimal. [source] Paroxysmal exercise-induced dystonia as a presenting feature of young-onset Parkinson's diseaseMOVEMENT DISORDERS, Issue 12 2003Maria Bozi MD Abstract Paroxysmal exercise-induced dystonia (PED) is a rare, typically idiopathic familial condition, although sporadic and secondary cases have been reported. We present 2 cases where PED was the presenting feature of young-onset idiopathic Parkinson's disease (PD), preceding the onset of parkinsonian symptoms by 1.5 and 5 years, respectively. Initially, the dystonic symptoms occurred after prolonged exercise and were unilateral, affecting the foot in both patients. Over time, symptoms occurred with minimal exercise. We conclude that PED can rarely be the first and only feature of PD. © 2003 Movement Disorder Society [source] Monitoring measles elimination in VictoriaAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2005Niels G. Becker Objectives: To weigh the evidence from outbreak data that Victoria has achieved, and is maintaining, elimination of measles. To identify age groups that measles vaccination has not protected adequately. Methods: Data on observed measles outbreaks in Victoria since the start of 1998 are used to estimate the reproduction number of cases, and the probability that it is maintained below unity, its threshold value for elimination. The relative susceptibility to measles is estimated as a function of age, with confidence intervals. Results: Seventeen measles introductions led to secondary cases, while 22 were single-case introductions. From these, the probability that the reproduction number for cases exceeds unity is estimated to be 0.044, or less, depending on assumptions made. There is no evidence that the reproduction number increased over time. Those aged between 19 and 32 years were most susceptible, followed by those in the first and second year of life. Conclusions: The data provide strong evidence that Victoria has maintained elimination of measles over the period 1998 to mid-2003. There is scope to improve the immunisation coverage. It is not clear how much outbreak intervention is contributing to the success in achieving apparent elimination. Implications: To prevent importations from causing a major epidemic of measles, Victoria must maintain its immunisation coverage and outbreak control at current levels, or better. It is important to monitor the control of measles even when elimination is achieved. [source] Improved infection control in the prevention of variant Creutzfeldt-Jakob disease in Australia: costs and benefitsAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 6 2004Trang Vu Objective: To evaluate the costs and benefits of infection control strategies to prevent the transmission of variant Creutzfeldt-Jakob disease (vCJD) in ophthalmic surgery in Australia. Methods: The reduction in the risk of iatrogenic transmission of vCJD from feasible infection control strategies was calculated using decision analytic models. A static model calculated the direct secondary transmission for surgical eye procedures, and a simple dynamic model estimated the change in the risk of a subsequent sustained epidemic over the longer term. The expected number of vCJD infections, their cost of care and years of life lost and the estimated cost of strategies included the direct costs of infection control measures were calculated taking a health system perspective. Results: The dynamic model (Markov process) predicted that from a hypothetical pool of as many as 100 primary vCJD cases there would be less than five iatrogenic infections in the next 30 years. If there are fewer than five primary cases the model predicted no secondary cases of vCJD. The costs of providing care for a vCJD case is estimated to be about 50,000, subject to considerable uncertainty. The minimum cost for using a partial infection control strategy to prevent an iatrogenic infection is likely to be in the order of several millions of dollars. Conclusions: Substantial public health investment would need to be made in order to reduce a low risk of iatrogenic transmission of vCJD. Given the likely number of cases of iatrogenic infection, and the order of magnitude of the costs of caring for cases of vCJD, it may be difficult to justify the high cost of risk reduction strategies. [source] | ||||||||||