In Japan, the leading cause of death for children over 1 year old is injury, and for children aged 0-14, drowning is the second leading cause of death. The purpose of the present study was to describe the epidemiological factors of drownings and near-drownings among Japanese children and to ascertain whether there are characteristic patterns for different age groups.Epidemiologic data was obtained by questionnaire. A total of 604 cases of submersion injuries were reported from 49 hospitals located in 22 Japanese prefectures. In the present paper, victims of drowning (n = 134) and near-drowning with permanent severe brain damage ( n = 5 I) and those of near-drowning with intact survival or mild impairment (n = 4 19) were investigated. Preschool-aged children, especially toddlers, are at the greatest risk of drowning and near-drowning, and for children over 2 years of age, boys have three times greater risk than girls. The bathtub is the most common place of submersion injuries in Japan, especially for children under 4 years of age. The important risk factors for the victims who died or were severely impaired were associated with duration of submersion and necessity of emergency cardiopulmonary resuscitation on arrival at hospital. Abstract Key wordsbathtub drownings, childhood drownings and near-drownings, childhood injury.In Japan, the mortality rate for children is decreasing every year due to recent advances in medical technology and improvement in sanitation. According to the Ministry of Health and Welfare statistical year book (1990), the overall death rate per 100 000 children is 44.8 for those aged 1-4; 18.7 for those aged 5-9; and 14.7 for the 10-14 year age group. The death rate from injuries was 13.7 for children aged 1-4; 7.1 for those aged 5-9; and 3.8 for those aged 10-14.' In Japan, injuries cause approximately 32.2% of all deaths of children aged 1-4; 43.7% for ages 5-9, and 30.5% for ages IO-14.Accidents are the leading cause of deaths in children and there are nearly 2000 victims yearly. Next to motor vehicle trauma, drowning is the most prevalent type of injury causing death in children aged 0-14. It is the most common cause for children aged 0-4.The purpose of the present study was to investigate the epidemiological factors, such as age, sex, season, site of submersion and outcome of drowning and near-drowning in childhood, and to formulate preventive strategies for Correspondence: Ryuzo Mizuta MD, Department of Pediatrics, Kyoto Second Red Cross Hospital, 355-5 Haruobicho Kamigyoku, Kyoto 602, Japan. IS Frisby ML, Hill H. A community's response to childhood drownings. Crit. Care Nurs. Clin. North Am. 1991; 3 373-9. 16 Leach SC. Continuing care for the near-drowning child, Crit. Cure Nurs. C h North Am. I 99 I ; 3: 30% 1 7. I7 Rivara FP. Traumatic deaths of children in the United States: Currently available prevention strategies. Pediclrrics 1985; 75: 18 Pearn JH, Wong RYK, Brown J el al. Drowning and neardrowning involving children: A fiveyear total population study from the city and county of ...
We describe a fatal case of adenovirus pneumonia accompanied by encephalitis in a neonate who showed lethargy on the 6th day and died on the 12th day. Adenoviral particles as well as viral intranuclear inclusions were noted in pulmonary alveolar epithelium cells. Neuropathological examination revealed diffuse oedema, perivascular cuffing and gliosis in the white matter. Adenovirus type 11 was isolated from lung, hilar lymph node, and brain tissue. This is the first instance of adenovirus isolation from brain tissue in a newborn infant. The virological and neuropathological findings suggest the invasion of neural tissue by adenovirus and substantiate the significance of neurological symptoms observed in neonatal adenovirus infection.
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