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 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.
Hajjeh
Rana A
RA
Division of Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. rfh5@cdc.gov
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
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality*; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011159:Population Surveillance / Q000379:methods*; D014481:United States / Q000453:epidemiology; D014777:Virus Diseases / Q000150:complications* / Q000175:diagnosis / Q000401:mortality*