LOBALLY, CERVICAL CANCER IS the second most common cause of cancer morbidity and mortality in women. 1 Human papillomavirus (HPV) infection has been identified as a necessary cause for the development of cervical cancer, with HPV genotypes 16 and 18 accounting for approximately 70% of cervical cancer cases. Prevention of cervical cancer using either the bivalent (HPV-16 and HPV-18) or quadrivalent (HPV-6, HPV-11, HPV-16, and HPV-18) vaccine is the goal of immu-Author Affiliations are listed at the end of this article.
On the basis of epidemiological data demonstrating that the majority of cases of pharyngitis, necrotizing fasciitis, and other invasive streptococcal infections are caused by a limited number of serotypes, this 26-valent vaccine could have significant impact on the overall burden of streptococcal disease.
Specific host/environmental factors can be used to identify which 33-35GA infants are at greatest risk of hospitalization for RSV infection and likely to benefit from palivizumab prophylaxis.
The number of deaths attributable to influenza is believed to be considerably higher than the number certified by vital statistics registration as due to influenza. Weekly mortality data for Canada from the 1989/1990 to the 1998/1999 influenza seasons were analysed by cause of death, age group, and place of death to estimate the impact of influenza on mortality. A Poisson regression model was found to accurately predict all-cause, as well as cause-specific mortality, as a function of influenza-certified deaths, after controlling for seasonality, and trend. Influenza-attributable deaths were calculated as predicted less baseline-predicted deaths. In summary, throughout the 1990s there were on average just under 4000 deaths attributable to influenza annually (for an influenza-attributable mortality rate of 13/100,000 persons), varying from no detectable excess mortality for the 1990/1991 influenza season, to 6000-8000 influenza-attributable deaths for the more severe influenza seasons of 1997/1998 and 1998/1999. On average, 8% (95% CI 7-10) of influenza-attributable deaths were certified as influenza, although this percentage varied from 4% to 12% from year to year. Only 15% of the influenza-attributable deaths were certified as pneumonia, and for all respiratory causes, 40%. Deaths were distributed over most causes. The weekly pattern of influenza-certified deaths was a good predictor of excess all-cause mortality.
Influenza is a significant cause of morbidity leading to hospitalization in Canadian children, particularly for those under 2 years of age. RSV, PIV and other respiratory viruses were found to be major causes of respiratory illness leading to hospital care, surpassing influenza.
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