ABSTRACT
Although cattle are a reservoir for influenza D virus (IDV), little is known about human exposure to IDV. We assessed IDV exposure and associated health effects among United States dairy workers, a population at heightened risk of cattle zoonoses. In prospective, cross-shift sampling of 31 workers employed at five large-herd dairy operations in two states, we found evidence of IDV in the nasal washes of 67% of participants at least once during the 5-day study period. IDV exposure was not associated with respiratory symptoms in these workers. These findings suggest that IDV is present in dairy cattle environments and can result in worker exposure.
Subject(s)
Cattle Diseases , Orthomyxoviridae Infections , Thogotovirus , Animals , Humans , Cattle , United States/epidemiology , Orthomyxoviridae Infections/epidemiology , Orthomyxoviridae Infections/veterinary , Prospective Studies , Cattle Diseases/epidemiology , ZoonosesABSTRACT
BACKGROUND: Emergency department evaluation of young febrile children often includes a white blood cell count. Although a high white blood cell count is associated with an increased likelihood of infection, the clinical significance of extreme leukocytosis (EL), defined as a white blood cell count of > or = 25,000/mm, has not been well-studied. OBJECTIVE: To determine diagnoses associated with EL in febrile children evaluated in a pediatric emergency department and to compare rates of serious bacterial infection in those with EL and in those with more modest leukocytosis (LK) (15,000-24,999/mm). METHODS: A retrospective case-control study of children 2-24 months of age was performed. Those with EL were frequency age- and gender-matched to controls with LK. RESULTS: Sixty-nine patients with EL and 94 patients with LK were included. The mean age was 9.9 months, and 91 (56%) patients were male. The diagnoses were similar between the 2 groups, with otitis media, viral syndrome and pneumonia being the most common. The rates of proven serious bacterial infection were similar between EL (25%; 95% confidence interval, 15-36%) and LK (17%; 95% confidence interval, 10-26%) patients. Using different white blood cell cutoff points did not distinguish between patients with and without serious bacterial infection. CONCLUSION: Young febrile children whose emergency department evaluation revealed EL had diagnoses and rates of serious bacterial infection similar to those of children with LK.
Subject(s)
Bacterial Infections/complications , Bacterial Infections/diagnosis , Fever/etiology , Leukocytosis/etiology , Bacterial Infections/epidemiology , Bacterial Infections/microbiology , Case-Control Studies , Child, Preschool , Female , Fever/microbiology , Humans , Infant , Leukocyte Count , Male , Retrospective StudiesABSTRACT
A 10 month-old infant was given a Lychee Mini Fruity Gel (AP Frozen Foods Ltd, Thailand) by his mother while shopping in a supermarket. The child was sucking on the gel when he began to choke and have difficulty breathing. Emergency medical services were called, and paramedics found the child to be in respiratory arrest with a palpable pulse of 40 beats/min. They transported him to the pediatric emergency department, performing bag-valve-mask ventilation with a manual resuscitator. The child was intubated and taken to the operating room for bronchoscopy and then the pediatric intensive care unit for critical care. The initial report was that he choked on gelatin. However, he was found to have aspirated a large hard gel found in the lychee-flavored candy that totally obstructed his airway. This is the third case of aspiration of a gel candy we have seen in 5 years. Parents should be warned not to give these candies to children younger than 5 years.
Subject(s)
Airway Obstruction/etiology , Candy/adverse effects , Foreign Bodies/complications , Child, Preschool , Fatal Outcome , Female , Heart Arrest/etiology , Humans , Infant , MaleSubject(s)
Child Health Services/organization & administration , Adolescent , Child , Child, Preschool , HumansSubject(s)
Cough/etiology , Fever/etiology , Rib Fractures/diagnostic imaging , Diagnosis, Differential , Diagnostic Errors , Humans , Infant , Male , RadiographyABSTRACT
OBJECTIVES: To examine the prevalence of seat belt use among school-aged children in low-income Hispanic communities. METHODS: We conducted unobtrusive observations of school-aged children (aged 5 to 12 years) traveling to and from nine elementary schools in two communities. We documented vehicle type, and belted status and seating position of children, driver, and other passengers. Results are presented as percentages with 95% confidence intervals (CIs). RESULTS: We observed 3651 children, of which restraint use could be determined for 2741. Overall, 29% of children were using seat belts. By seating location, 58% were in the front seat with 40% belted, and 42% were in the back seat with 14% belted. Children were most likely to be restrained when traveling in the front seat (40.0%, CI=37.6-42.5); traveling with a belted driver (42.4%, CI=40.0-44.8); or traveling without additional passengers (40.3%, CI=37.0-43.7) CONCLUSIONS: Seat belt use among children from this study population was below the national average and was alarmingly low among children in the back seat. While traveling, being belted in the back seat provides the most protection in a collision. Prevention efforts need to be based on an understanding of the barriers to restraint use for children traveling in the back seat.
