Acute epiglottitis in children and adults in Sweden 1981-3

Article Abstract:

Meningitis and epiglottitis are the most common invasive infections caused by the bacteria Hemophilus influenzae type B. Both conditions are quite serious. In meningitis, the protective meninges (lining) around the brain and spinal cord are inflamed, and in epiglottitis, inflammation of the epiglottis (which covers the windpipe when swallowing) may prevent the intake of air. Very few data are available on the incidence of epiglottitis in children. A review of admission records of Swedish hospitals was conducted to establish the relationship of epiglottitis to meningitis, which is generally regarded as more common. In contrast to other parts of the world, epiglottitis is a more common manifestation of Hemophilus infection among Swedish children. The contrast is most striking when these results are compared with the incidence of the two diseases among North American Indians and Eskimos, among whom H. influenzae meningitis is common and epiglottitis is very rare. The difference may be attributable to the manner of raising children at home in Sweden, which tends to protect them from most potentially infectious contacts for the first few years of life. Although H. influenzae type B infections have been considered childhood infections, it is clear that infections among adults are not uncommon. The present study found an incidence of H. influenzae epiglottitis of 1.8 cases per 100,000 population per year, indicating that the organism is the most common cause of epiglottitis in adults. The adult rate of meningitis due to H. influenzae infection was over ten times less, at 0.15 per 100,000 per year. Although serious, H. influenzae epiglottitis in adults is generally not as dramatic in presentation as it is in children, and adult cases of epiglottitis require intubation significantly less often. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Meningitis, Hemophilus infections, Hemophilus influenzae, Haemophilus influenzae, Epiglottiditis, Epiglottitis

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Respiratory sequelae and lung function after whooping cough in infancy

Article Abstract:

Whooping cough, an infectious disease of childhood, is caused by the bacteria Bordetella pertussis, and results in spasms of coughing which end in a whooping sound. Whooping cough is most severe in infancy when the airway is most sensitive to damage. Very young children are often vaccinated against this disease, but pertussis vaccination was stopped in Sweden in 1979. Controversy exists as to whether whooping cough can lead to abnormal lung function years after the initial infection. A recent study of 31 children, aged 6 to 13 years, who had whooping cough as infants explored whether whooping cough was a predisposing factor to developing lung problems later in childhood. These patients were compared to 32 children who had no history of whooping cough. Family backgrounds were similar in both groups. No detectable differences were observed between the two groups of children regarding lung function, chest X-ray findings, and the distribution of immunoglobulins (body proteins which help fight infection). In addition, no impairment of the small airways of the lung was detected in the children who had whooping cough during infancy. These results suggest that whooping cough by itself does not lead to subsequent impairment of lung function. Longer follow-up studies may reveal some lung impairment later in life, but this question awaits further study. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Infection, Complications and side effects, Pediatric diseases, Respiratory tract diseases, Whooping-cough, Whooping cough, Infection in children, Pertussis vaccines

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Increasing incidence of coeliac disease in Sweden

Article Abstract:

Celiac disease is an intestinal disorder characterized by diarrhea, malnutrition, poor weight gain, tendency to bleed, and abnormally low calcium levels in the blood. Studies show that the incidence (number of new cases) of celiac disease is decreasing in England, Scotland, and Ireland, but it is unchanged in Italy and Finland. Changes in the incidence of celiac disease among children were assessed in Goteborg, Sweden between 1970 and 1988. Of 188 cases of celiac disease in children, 83 percent developed in patients less than two years of age. The diagnosis was made after biopsy of the duodenum (the first part of the small intestine). It was confirmed after certain diagnostic criteria, established by the European Society for Gastroenterology and Nutrition, were fulfilled. Between 1970 and 1988, the incidence of celiac disease among Swedish two-year-old children increased from 0.31 cases per 1,000 children to 2.93 cases per 1,000 children. The increased incidence was attributed to improved methods of detecting this disorder. These findings suggest that celiac disease is one of the most common chronic diseases among Swedish children. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Celiac disease, Gastrointestinal diseases

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