Week 28 – Question of the Week: Which of these may be deadly?
Week 28: 2012-01-26 (non-consecutive weeks)
Diphtheria. Whooping cough.
Mumps. Rubella. Hepatitis B.
Chicken pox. Haemophilus influenza B. Polio.
I ask, which of these may be deadly, but the answer is, all of them can be.
My real question is this: Which of these have you actually seen cause fatal disease? Do you see a pattern?
Before I offer my own opinion, I invite you to offer feedback. I am particularly interested in input from those of you who have spent time in other parts of the world.
– Doc Cindy
About Cynthia J. Koelker, MD
CYNTHIA J KOELKER , MD is a board-certified family physician with over twenty years of clinical experience. A member of American Mensa, Dr. Koelker holds degrees in biology, humanities, medicine, and music from M.I.T., Case Western Reserve University School of Medicine, and the University of Akron. She served in the National Health Service Corps to finance her medical education.
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I did personally see a fatal case of varicella in the early 80’s while working in the ICU. a young boy about 8-10 years old was admitted with varicella encephalitis. Notably he was recovering from a head injury post auto/ped accident as well
I’ve recently been told about an employee of the company by which I’m employed somehow developing an “internal” form of chickenpox from which he nearly died. Can you address this at some point?
[Although rare, deaths to occur, primarily from pneumonia or central nervous system complications. I’ve heard of but never seen a fatal case of chicken pox. The following paragraph is taken from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5604a1.htm
“During 1970–1994, the average annual number of deaths for which varicella was recorded as the underlying cause was 105; the overall average annual varicella mortality rate was 0.4 deaths per 1 million population. The age distribution of varicella deaths has shifted during this period. During 1970–1974, persons aged <20 years accounted for 80% of varicella deaths, compared with 46% during 1990–1994. During 1970–1994, the average case-fatality rate (CFR) for varicella for all ages combined ranged from 2.0 to 3.6 per 100,000 cases, with higher rates among infants and adults aged >20 years (27). Although CFRs declined substantially during this period, the risk for varicella-related death during 1990–1994 was still 25 times higher for adults than for children aged 12 months–4 years (CFR: 21.3 and 0.8 per 100,000 cases, respectively). During the same period, 89% of varicella deaths among children and 75% of varicella deaths among adults occurred in persons without severe underlying immunocompromising medical conditions. The most common complications among persons who died of varicella were pneumonia, central nervous system complications (including encephalitis), secondary infection, and hemorrhagic conditions. A recent reanalysis of varicella deaths also considered varicella when listed as a contributing cause of death in addition to the underlying cause studied in the previous report (28). During 1990–1994, a varicella diagnosis was listed on an average of 145 death certificates per year (105 as an underlying cause and 40 as a contributing cause), with an overall annual varicella mortality rate of 0.6 deaths per 1 million population.” – Doc Cindy]