The high burden of hospitalizations for primary EBV infection: a 6-year prospective survey in a French hospital.

Primary Epstein-Barr virus infection (PEI) is acquired increasingly later in life in developed countries, involving a growing number of adults. No studies have examined the effect of age on PEI. We conducted a prospective, single-centre, noninterventional survey to assess the clinical and economic effects of PEI care according to age. We included all serology-confirmed cases observed in all departments of a large regional hospital. Clinical and biologic data, therapeutics and costs of care were examined. Over a 6-year period, we included 292 subjects (148 children and 144 adults) with a median age of 15.4 years (range 9 months to 79 years). Adults were hospitalized more often (83% vs. 60%) and for longer periods of time (median 4 days vs. 2 days) than children (p ≤ 0.0001 for both). Two adults required a secondary transfer into the intensive care unit, although no children did. Typically, adults showed higher levels of activated lymphocytes and liver abnormalities. They also required the use of systemic corticosteroids more often (45% vs. 23%, p < 0.0001) and for longer periods of time (median 7 days vs. 3 days, p 0.02) than children. Overall, the costs were significantly higher for adults than for children (median, €1940 vs. €1130, p < 0.0001), mainly because of the frequency and duration of hospitalizations. Age increases the immune response and clinical severity of PEI, resulting in substantial additional costs for the community. Better recognition of the disease in adults could shorten the average length of hospital stay.

The IOMC organisations: a source of chemical safety information.

The Inter-Organisation Programme for the Sound Management of Chemicals (IOMC) was established in 1995 as a mechanism to co-ordinate the efforts of Inter-governmental Organisations in promoting the sound management of chemicals. The seven participating organisations are the United Nations Environment Programme (UNEP), the International Labour Organisation (ILO), the United Nations Food and Agriculture Organisation (FAO), the World Health Organisation (WHO), the United Nations Industrial Development Organisation (UNIDO), the United Nations Institute for Training and Research (UNITAR), and the Organisation of Economic Cooperation and Development (OECD). Members consult on the planning, programming, implementation and monitoring of activities undertaken jointly or individually, and help ensure that programmes are mutually supportive, complementary and avoid duplication of efforts, thus meeting the overall needs of the users more efficiently and effectively. To deal with technical work, the IOMC established smaller thematic groups in the main programme areas of Agenda 21's Chapter 19. One such group promotes information exchange work. Within this IOMC framework, the seven organisations have developed approaches and products to help customers find chemical safety information, as well as improving modalities of access to these data. These mechanisms come in addition to and complement the extensive information products and databases developed and provided by the individual organisations. This article presents an overview of the role of each organisation, an introduction to its electronic information products and tools, and a discussion of the products of this joint effort.