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

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 etiolog...

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Bibliographic Details
Published in:Emerging infectious diseases 2002-02, Vol.8 (2), p.145-153
Main Authors: Hajjeh, Rana A, Relman, David, Cieslak, Paul R, Sofair, Andre N, Passaro, Douglas, Flood, Jennifer, Johnson, James, Hacker, Jill K, Shieh, Wun-Ju, Hendry, R Michael, Nikkari, Simo, Ladd-Wilson, Stephen, Hadler, James, Rainbow, Jean, Tappero, Jordan W, Woods, Christopher W, Conn, Laura, Reagan, Sarah, Zaki, Sherif, Perkins, Bradley A
Format: Article
Language:English
Subjects:
Adolescent
Adult
Bacterial Infections - complications
Bacterial Infections - diagnosis
Bacterial Infections - epidemiology
Bacterial Infections - mortality
Cause of Death
Child
Child, Preschool
Clinical epidemiology
Communicable diseases
Critical Illness - mortality
Environmentally induced diseases
Evaluation
Female
Humans
Incidence
Infant
Male
Medical Records
Medical screening
Middle Aged
Polymerase Chain Reaction
Population Surveillance - methods
United States - epidemiology
Virus Diseases - complications
Virus Diseases - diagnosis
Virus Diseases - mortality
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Summary: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.
ISSN:1080-6040
DOI:10.3201/eid0802.010165