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Unexplained immunodeficiency in children. A surveillance report
Insights
Pediatric acquired immune deficiency syndrome (AIDS) cases surged in 1983, with 35 children diagnosed. Many had opportunistic infections, suggesting a new transmission pattern in infants and young children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- The Centers for Disease Control (CDC) identified 35 pediatric acquired immune deficiency syndrome (AIDS) cases between October 1982 and October 1983.
- These children presented with severe opportunistic infections, lacking identifiable underlying conditions predisposing them to illness.
Purpose of the Study:
- To investigate the emergence and characteristics of AIDS in children.
- To determine if opportunistic infections in children without known immunodeficiency represented a new phenomenon.
Main Methods:
- Case surveillance by the CDC for pediatric AIDS.
- Review of pentamidine isethionate requests to the CDC for Pneumocystis carinii pneumonia (PCP) cases in children.
Main Results:
- Pediatric AIDS cases were reported across ten states, with concentrations in major metropolitan areas.
- Risk factors included parental AIDS, blood transfusions from affected individuals, and parental association with high-risk groups.
- A notable increase in pediatric PCP from 1979 to 1983 was observed, suggesting a potential rise in pediatric AIDS cases.
Conclusions:
- Pediatric AIDS emerged as a significant concern, with transmission potentially occurring through perinatal or other routes.
- The rise in PCP cases indicated an increasing incidence of opportunistic infections in immunocompromised children.
- Early diagnosis and intervention are crucial for managing pediatric AIDS and associated infections.
Abstract:
From Oct 1, 1982, to Oct 1, 1983, the Centers for Disease Control (CDC) received reports of 35 children whose illness met the CDC definition of acquired immune deficiency syndrome (AIDS). All of the children had serious opportunistic infections without a known underlying illness to explain susceptibility to the infections. The 35 children were residents of ten different states; cases clustered in five major metropolitan areas. Three of the children had a parent with AIDS, and one child who had been previously reported had received a blood transfusion from a person in whom AIDS later developed. Most of the children had at least one parent in a population group in which adult AIDS cases have occurred. Many of the children had histories of prodromal symptoms, including pneumonitis, lymphadenopathy, hepatomegaly, and oral thrush. The mean age at onset of illness was 5 months, and the mean age at diagnosis was 12 months. To determine whether opportunistic infection in children without underlying immunodeficiency was truly a new phenomenon, a review of requests to the CDC for the drug pentamidine isethionate was undertaken. This revealed an apparent increase from 1979 to 1983 in Pneumocystis carinii pneumonia in children without known underlying immunodeficiency.