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      Hemolytic Uremic Syndrome Incidence in New York1

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          Abstract

          A comparison of New York’s traditional communicable disease surveillance system for diarrhea-associated hemolytic uremic syndrome with hospital discharge data showed a sensitivity of 65%. Escherichia coli O157:H7 was found in 63% of samples cultured from hemolytic uremic syndrome patients, and samples were more likely to be positive when collected early in illness.

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          Most cited references 18

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          Food-related illness and death in the United States.

          To better quantify the impact of foodborne diseases on health in the United States, we compiled and analyzed information from multiple surveillance systems and other sources. We estimate that foodborne diseases cause approximately 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths in the United States each year. Known pathogens account for an estimated 14 million illnesses, 60, 000 hospitalizations, and 1,800 deaths. Three pathogens, Salmonella, Listeria, and Toxoplasma, are responsible for 1,500 deaths each year, more than 75% of those caused by known pathogens, while unknown agents account for the remaining 62 million illnesses, 265,000 hospitalizations, and 3,200 deaths. Overall, foodborne diseases appear to cause more illnesses but fewer deaths than previously estimated.
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            The risk of the hemolytic-uremic syndrome after antibiotic treatment of Escherichia coli O157:H7 infections.

            Children with gastrointestinal infections caused by Escherichia coli O157:H7 are at risk for the hemolytic-uremic syndrome. Whether antibiotics alter this risk is unknown. We conducted a prospective cohort study of 71 children younger than 10 years of age who had diarrhea caused by E. coli O157:H7 to assess whether antibiotic treatment in these children affects the risk of the hemolytic-uremic syndrome and to assess the influence of confounding factors on this outcome. Estimates of relative risks were adjusted for possible confounding effects with the use of logistic-regression analysis. Among the 71 children, 9 (13 percent) received antibiotics and the hemolytic-uremic syndrome developed in 10 (14 percent). Five of these 10 children had received antibiotics. Factors significantly associated with the hemolytic-uremic syndrome were a higher initial white-cell count (relative risk, 1.3; 95 percent confidence interval, 1.1 to 1.5), evaluation with stool culture soon after the onset of illness (relative risk, 0.3; 95 percent confidence interval, 0.2 to 0.8), and treatment with antibiotics (relative risk, 14.3; 95 percent confidence interval, 2.9 to 70.7). The clinical and laboratory characteristics of the 9 children who received antibiotics and the 62 who did not receive antibiotics were similar. In a multivariate analysis that was adjusted for the initial white-cell count and the day of illness on which stool was obtained for culture, antibiotic administration remained a risk factor for the development of the hemolytic uremic syndrome (relative risk, 17.3; 95 percent confidence interval, 2.2 to 137). Antibiotic treatment of children with E. coli O157:H7 infection increases the risk of the hemolytic-uremic syndrome.
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              Injuries and deaths associated with use of snowmobiles--Maine, 1991-1996.

                (1997)
              During the 1995-96 winter season (i.e., November 1995 through April 1996), both the Maine Department of Inland Fisheries and Wildlife (DIFW) and the Maine Office of the Chief Medical Examiner (OCME) detected an increase in deaths associated with snowmobile use in Maine. From the fall of 1991 through the spring of 1995, three to eight snowmobile-related deaths occurred each winter season (mean: 5.4 per winter season); during the 1995-96 winter season, 12 deaths were recorded--the largest number of snowmobile-related deaths in 25 years. In addition, from 1991 through 1996, the number of registered snowmobiles increased from 61,641 to a record high of 76,477, respectively, and the death rate per registered vehicle in 1996 was higher than in any of the previous 5 years. To assist in the development and evaluation of strategies to prevent injury and death associated with the use of snowmobiles in Maine, the Bureau of Health, Maine Department of Human Services (BOH), collaborated with DIFW and OCME to examine data about fatal and nonfatal injuries associated with use of snowmobiles from 1991 through 1996. This report summarizes the results of this analysis and recommends strategies for preventing such deaths and injuries.
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                Author and article information

                Journal
                Emerg Infect Dis
                Emerging Infect. Dis
                EID
                Emerging Infectious Diseases
                Centers for Disease Control and Prevention
                1080-6040
                1080-6059
                May 2004
                : 10
                : 5
                : 928-931
                Affiliations
                [* ]New York State Department of Health, Albany, New York
                []University at Albany, Albany, New York
                Author notes
                Address for correspondence: Hwa-Gan Chang, New York State Department of Health, Corning Tower Building Room 1143, Empire State Plaza, Albany, New York 12237; fax: 518-402-5012; email: hgc04@ 123456health.state.ny.us
                03-0456
                10.3201/eid1005.030456
                3323227
                15200834
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