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UNDIAGNOSED INFANT DEATHS - ISRAEL: REQUEST FOR INFORMATION
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A ProMED-mail post
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International Society for Infectious Diseases
<http://www.isid.org>
Date: Tue 16 Dec 2008
Source: Haaretz.com [edited]
<http://www.haaretz.com/hasen/spages/1046900.html>
Spate of mysterious infant deaths prompts health ministry investigation
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The Health Ministry has launched an investigation into the sudden
deaths in the past month of 4 babies and the severe illness of 2
others. The cases, some of which were reported to the ministry in
recent weeks by hospitals, including Schneider Children's Medical
Center and the Sourasky Medical Center in Tel Aviv, involved serious
neurological and cardiac damage to the babies, but in most of the
cases, no reason has been determined as yet for the illnesses or the
deaths. The initial ministry probe has turned up no connection among
all 6 cases, although the ministry is still seeking one.
The Health Ministry released a statement to the press Monday [15 Dec
2008] that Schneider Children's had reported 3 recent cases of
unusual illness among young children in the past 3 weeks. Of these, a
14-month-old girl of Even Yehuda died of unknown causes. The child
arrived at the hospital with extreme brain damage that led to her
death. Her parents donated her organs.
Doctors believe the girl had contracted the common intestinal virus
coxsackie B virus, which doctors say can cause severe damage in rare
cases. However, physicians at Schneider are not sure [this or a]
virus was the cause of the child's death.
Two other children are currently hospitalized at Schneider: an
18-month old girl from Ramat Gan and a boy from Bnei Brak 2 years and
9 months old. Both are suffering from various neurological
conditions, and one suffered cardiac arrest.
The hospital said there had been another case of a 14-month-old boy
who died suddenly, but in an autopsy he was found to have been
suffering from an infection of the heart muscle, said Dr Tommy
Scheinfeld, head of intensive care at Schneider, who explained that
this is "not common, but known cause of death in babies."
According to the Health Ministry statement, following the report from
Schneider, it began an investigation in all of its districts, and
turned up 2 more suspicious cases, one of a 15-month-old girl with an
infectious disease who had died in the Dana Children's Hospital at
Tel Aviv's Sourasky Medical Center, and an 18-month-old girl from the
community of Rekhasim in the north, who died suddenly at home. No
other similar cases have been located in any other hospital in the country.
According to ministry statistics, approximately 170 children die each
year in Israel from illness or accidents. Of these cases, 10 children
between ages 1 and 4 die of infectious diseases.
Dr Itamar Grotto, national director of public health in the Health
Ministry, told Haaretz Monday [15 Dec 2008] that the epidemiological
probe had been looking into possible causes for the 6 cases, such as
the presence of the babies in the same places, possible proximity to
animals, or even trips abroad to the same destinations. No such
connections, however, had come up. "We are now focusing on lab tests
of body fluids, and on autopsy. One of the main possibilities under
investigation is the presence of the common intestinal virus
coxsackie B virus."
Scheinfeld said coxsackie B virus [of which there are 6 distinct
types) causes diarrhea and rash, but in rare cases might also lead to
infection of the pericardium or meningitis. He said viruses in this
group [that is enteroviruses in general] are common and in 98 percent
of cases cause only slight illness among the thousands of babies that
contract it. Schneider Children's Medical Center said it currently
has 2 other babies hospitalized with severe convulsions, in whose
spinal fluid coxsackie B virus has been clearly identified, but that
they had recovered. The hospital said the virus is commonly found in
kindergartens and day-care centers.
Scheinfeld told Haaretz Monday [15 Dec 2008] that, "it is very
possible that this is a coincidental accumulation of cases that
usually extend over a whole year, and that this time occurred over a
3-week period. Sometimes there are cases of death and illness among
babies caused by unknown reasons, but that does not mean there is an
epidemic or that the cases are connected. It is highly likely that
there is no common source for the illness among the children, such as
the food they ate, although this must be investigated by the Health Ministry."
Scheinfeld added, however, that, "it is possible that the reasons
will never be known, even after the investigation has been carried
out. No special steps should be taken other than the usual steps.
[Byline: Ran Reznick]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[It has not been established that these sporadic deaths are more than
coincidental. However the isolation of a coxsackie B virus from the
spinal fluid of 2 babies suggests a viral etiology in these 2 cases
at least. The coxsackie B viruses, although rarely responsible for
disease, have been associated more than other enteroviruses with
aseptic meningitis, fatal neonatal disease, pleurodynia, and myo- or
pericarditis.
Further information concerning the results of the investigations is
awaited. - Mod.CP
The HealthMap/ProMED-mail interactive map of Israel is available at
<http://healthmap.org/promed/en?v=31.9,34.9,7>. - CopyEd.MJ]
[see also:
Onychomadesis, coxsackievirus - USA: (MI), RFI 20080729.2317
Onychomadesis - Spain: (Valencia), coxsackievirus (02) 20080711.2120
Onychomadesis - Spain: (Valencia), coxsackievirus 20080709.2099
Coxsackievirus B1, neonatal disease, 2007 - USA: (AK, CA, IL) 20080522.1691
2007
----1
Conjunctivitis, coxsackievirus A24 - Taiwan (02) 20071025.3470
Conjunctivitis, coxsackievirus A24 - Taiwan 20071017.3393
2005
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Encephalitis, coxsackievirus - India (UP) (02) 20051127.3434
Encephalitis, coxsackievirus - India (Uttar Pradesh) 20051025.3115
Undiagnosed disease, fatal - Greece: coxsackievirus susp. 20050521.1403
2003
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Coxsackievirus & heart disease 20000331.0482]
...................................cp/mj/dk
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