Sudden and Fulminant Deaths of Healthy Children in Italy During the 2010-11 and 2011-12 Seasons: Results of an Online Study
Identifieur interne : 000675 ( Pmc/Checkpoint ); précédent : 000674; suivant : 000676Sudden and Fulminant Deaths of Healthy Children in Italy During the 2010-11 and 2011-12 Seasons: Results of an Online Study
Auteurs : Stefano PrandoniSource :
- Journal of Public Health Research [ 2279-9028 ] ; 2012.
Abstract
The 2009 pandemic in Italy has been viewed as a false alarm, and it has not been properly understood based on historical precedents and more in-depth studies that have been conducted in other countries. Some of these studies have pointed to a phenomenon of sudden and fulminant death among healthy children, which is not the sole prerogative of pandemic influenza, but was, in 2009, a more frequent occurrence than in previous years. The purpose of this study is to gather such cases occurring during the 2010-11 and 2011-12 seasons. Google Search was used in order to find cases of children and teens with no reported preexisting conditions of relevance and who died suddenly and unexpectedly after exhibiting flu-like symptoms during the two seasons. During the 2010-11 season, 29 deaths were found to meet the above conditions, 18 of which were fulminant and 11 sudden. For the 2011-12 season, there were ten such cases: five fulminant and five sudden. Most of these cases occurred during the period of maximum circulation of the flu virus. Fulminant deaths were three times more frequent during 2010-11 season and involved children of a higher average age than the more recent season. It is not possible to come to any definite conclusions, but there is reason to suspect that the driver of this significant increase may be the A(H1N1)pdm09 virus. Regardless of how reading these results, it is advisable that the surveillance systems be strengthened and more recent study techniques be adopted in order to determine the causes of similar deaths in the future.
Prof. Gaetano Thiene, Department of Medical Diagnostic Sciences and Special Therapies, University of Padua; Prof. Paolo Prandoni, Department of Cardiothoracic and Vascular Sciences, University of Padua; Prof. Pierluigi Lopalco, European Centre for Disease Prevention and Control Stockholm; Sharon Sanders, Editor-in-Chief & President of the International FluTrackers Forum; Giuseppe Michieli, Director of the Italian FluTrackers Forum; Grey A. Drane, Rinaldo Sperotto, my wife and my children.
Url:
DOI: 10.4081/jphr.2012.e29
PubMed: 25170463
PubMed Central: 4140362
Affiliations:
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PMC:4140362Le document en format XML
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<front><div type="abstract" xml:lang="en"><p>The 2009 pandemic in Italy has been viewed as a false alarm, and it has not been properly understood based on historical precedents and more in-depth studies that have been conducted in other countries. Some of these studies have pointed to a phenomenon of sudden and fulminant death among healthy children, which is not the sole prerogative of pandemic influenza, but was, in 2009, a more frequent occurrence than in previous years. The purpose of this study is to gather such cases occurring during the 2010-11 and 2011-12 seasons. Google Search was used in order to find cases of children and teens with no reported preexisting conditions of relevance and who died suddenly and unexpectedly after exhibiting flu-like symptoms during the two seasons. During the 2010-11 season, 29 deaths were found to meet the above conditions, 18 of which were fulminant and 11 sudden. For the 2011-12 season, there were ten such cases: five fulminant and five sudden. Most of these cases occurred during the period of maximum circulation of the flu virus. Fulminant deaths were three times more frequent during 2010-11 season and involved children of a higher average age than the more recent season. It is not possible to come to any definite conclusions, but there is reason to suspect that the driver of this significant increase may be the A(H1N1)pdm09 virus. Regardless of how reading these results, it is advisable that the surveillance systems be strengthened and more recent study techniques be adopted in order to determine the causes of similar deaths in the future.</p>
<sec><title>Acknowledgments</title>
<p>Prof. Gaetano Thiene, Department of Medical Diagnostic Sciences and Special Therapies, University of Padua; Prof. Paolo Prandoni, Department of Cardiothoracic and Vascular Sciences, University of Padua; Prof. Pierluigi Lopalco, European Centre for Disease Prevention and Control Stockholm; Sharon Sanders, Editor-in-Chief & President of the International FluTrackers Forum; Giuseppe Michieli, Director of the Italian FluTrackers Forum; Grey A. Drane, Rinaldo Sperotto, my wife and my children.</p>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Public Health Res</journal-id>
<journal-id journal-id-type="iso-abbrev">J Public Health Res</journal-id>
<journal-id journal-id-type="publisher-id">JPHR</journal-id>
<journal-title-group><journal-title>Journal of Public Health Research</journal-title>
</journal-title-group>
<issn pub-type="ppub">2279-9028</issn>
<issn pub-type="epub">2279-9036</issn>
<publisher><publisher-name>PAGEPress Publications</publisher-name>
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<article-meta><article-id pub-id-type="pmid">25170463</article-id>
<article-id pub-id-type="pmc">4140362</article-id>
<article-id pub-id-type="doi">10.4081/jphr.2012.e29</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Perspective and Debates</subject>
</subj-group>
</article-categories>
<title-group><article-title>Sudden and Fulminant Deaths of Healthy Children in Italy During the 2010-11 and 2011-12 Seasons: Results of an Online Study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Prandoni</surname>
<given-names>Stefano</given-names>
</name>
<xref ref-type="corresp" rid="cor1"></xref>
</contrib>
</contrib-group>
<aff>Family Pediatrician, Member of the International FluTrackers Forum,<addr-line>Valdagno, Italy</addr-line>
</aff>
<author-notes><corresp id="cor1">Correspondence: Stefano Prandoni, via Madonnetta 4/B, 36078 Valdagno, Italy. <phone>+39.0445.402590</phone>
. <email>prandot@libero.it</email>
</corresp>
<p>This work is licensed under a Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0).</p>
<fn fn-type="conflict"><p>Conflicts of interest: the author declares no conflict of interests.</p>
</fn>
</author-notes>
<pub-date pub-type="epub"><day>31</day>
<month>7</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="collection"><day>15</day>
<month>6</month>
<year>2012</year>
</pub-date>
<volume>1</volume>
<issue>2</issue>
<fpage>184</fpage>
<lpage>191</lpage>
<history><date date-type="received"><day>26</day>
<month>4</month>
<year>2012</year>
</date>
<date date-type="accepted"><day>31</day>
<month>7</month>
<year>2012</year>
</date>
</history>
<permissions><copyright-statement>©Copyright S. Prandoni, 2012</copyright-statement>
<copyright-year>2012</copyright-year>
<copyright-holder>Licensee PAGEPress, Italy</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<uri xlink:type="simple" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</uri>
) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p>The 2009 pandemic in Italy has been viewed as a false alarm, and it has not been properly understood based on historical precedents and more in-depth studies that have been conducted in other countries. Some of these studies have pointed to a phenomenon of sudden and fulminant death among healthy children, which is not the sole prerogative of pandemic influenza, but was, in 2009, a more frequent occurrence than in previous years. The purpose of this study is to gather such cases occurring during the 2010-11 and 2011-12 seasons. Google Search was used in order to find cases of children and teens with no reported preexisting conditions of relevance and who died suddenly and unexpectedly after exhibiting flu-like symptoms during the two seasons. During the 2010-11 season, 29 deaths were found to meet the above conditions, 18 of which were fulminant and 11 sudden. For the 2011-12 season, there were ten such cases: five fulminant and five sudden. Most of these cases occurred during the period of maximum circulation of the flu virus. Fulminant deaths were three times more frequent during 2010-11 season and involved children of a higher average age than the more recent season. It is not possible to come to any definite conclusions, but there is reason to suspect that the driver of this significant increase may be the A(H1N1)pdm09 virus. Regardless of how reading these results, it is advisable that the surveillance systems be strengthened and more recent study techniques be adopted in order to determine the causes of similar deaths in the future.</p>
<sec><title>Acknowledgments</title>
<p>Prof. Gaetano Thiene, Department of Medical Diagnostic Sciences and Special Therapies, University of Padua; Prof. Paolo Prandoni, Department of Cardiothoracic and Vascular Sciences, University of Padua; Prof. Pierluigi Lopalco, European Centre for Disease Prevention and Control Stockholm; Sharon Sanders, Editor-in-Chief & President of the International FluTrackers Forum; Giuseppe Michieli, Director of the Italian FluTrackers Forum; Grey A. Drane, Rinaldo Sperotto, my wife and my children.</p>
</sec>
</abstract>
<kwd-group><title>Key words</title>
<kwd>children</kwd>
<kwd>A(H1N1)pdm09 subtype</kwd>
<kwd>influenza</kwd>
<kwd>sudden death</kwd>
<kwd>fulminant death</kwd>
<kwd>myocarditis</kwd>
</kwd-group>
<counts><fig-count count="2"></fig-count>
<table-count count="2"></table-count>
<equation-count count="0"></equation-count>
<ref-count count="45"></ref-count>
<page-count count="8"></page-count>
</counts>
</article-meta>
</front>
<floats-group><fig id="fig001" orientation="portrait" position="float"><label>Figure 1.</label>
<caption><p>Influenza-like illness chart for most recent seasons in Italy. From the Influnet epidemiological report, week 15-2012.</p>
</caption>
<graphic xlink:href="jphr-2012-2-e29-g001"></graphic>
</fig>
<fig id="fig002" orientation="portrait" position="float"><label>Figure 2.</label>
<caption><p>Research algorithm.</p>
</caption>
<graphic xlink:href="jphr-2012-2-e29-g002"></graphic>
</fig>
<table-wrap id="table001" orientation="portrait" position="float"><label>Table 1</label>
<caption><p>Deaths during the 2010-11 season.</p>
</caption>
<table frame="box" rules="all"><thead><tr><th align="left" rowspan="1" colspan="1">Case</th>
<th align="left" rowspan="1" colspan="1">Gender</th>
<th align="left" rowspan="1" colspan="1">Age (years, months)</th>
<th align="left" rowspan="1" colspan="1">Date</th>
<th align="left" rowspan="1" colspan="1">Type of death</th>
<th align="left" rowspan="1" colspan="1">Prior symptoms</th>
<th align="left" rowspan="1" colspan="1">Additional information</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">1</td>
<td align="left" rowspan="1" colspan="1">F</td>
<td align="left" rowspan="1" colspan="1">3 y</td>
<td align="left" rowspan="1" colspan="1">December 13</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Fever convulsions vomiting</td>
<td align="left" rowspan="1" colspan="1">Sepsis of unknown cause</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">2</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">16 y</td>
<td align="left" rowspan="1" colspan="1">December 19</td>
<td align="left" rowspan="1" colspan="1">SD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">3</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">17 y</td>
<td align="left" rowspan="1" colspan="1">December 23</td>
<td align="left" rowspan="1" colspan="1">SD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">4</td>
<td align="left" rowspan="1" colspan="1">F</td>
<td align="left" rowspan="1" colspan="1">2 y</td>
<td align="left" rowspan="1" colspan="1">December 28</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Ill for 2 days</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">5</td>
<td align="left" rowspan="1" colspan="1">F</td>
<td align="left" rowspan="1" colspan="1">9 y</td>
<td align="left" rowspan="1" colspan="1">December 28</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Fever respiratory symptoms for 2 days</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">6</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">11 m</td>
<td align="left" rowspan="1" colspan="1">December 30</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Fever respiratory symptoms for 2 days</td>
<td align="left" rowspan="1" colspan="1">Died in sleep pneumonia</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">7</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">17 y</td>
<td align="left" rowspan="1" colspan="1">December 31</td>
<td align="left" rowspan="1" colspan="1">SD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">8</td>
<td align="left" rowspan="1" colspan="1">F</td>
<td align="left" rowspan="1" colspan="1">8 y</td>
<td align="left" rowspan="1" colspan="1">January 4</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Fever tonsillitis</td>
<td align="left" rowspan="1" colspan="1">Respiratory complications</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">9</td>
<td align="left" rowspan="1" colspan="1">F</td>
<td align="left" rowspan="1" colspan="1">7 y</td>
<td align="left" rowspan="1" colspan="1">January 6</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Fever abdominal pain for 1 day</td>
<td align="left" rowspan="1" colspan="1">Myocarditis</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">10</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">13 y</td>
<td align="left" rowspan="1" colspan="1">January 7</td>
<td align="left" rowspan="1" colspan="1">SD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">11</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">11 y</td>
<td align="left" rowspan="1" colspan="1">January 11</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">High fever</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">12</td>
<td align="left" rowspan="1" colspan="1">F</td>
<td align="left" rowspan="1" colspan="1">11 y</td>
<td align="left" rowspan="1" colspan="1">January 15</td>
<td align="left" rowspan="1" colspan="1">SD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">13</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">8 y</td>
<td align="left" rowspan="1" colspan="1">January 15</td>
<td align="left" rowspan="1" colspan="1">SD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">14</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">3 y</td>
<td align="left" rowspan="1" colspan="1">January 15</td>
<td align="left" rowspan="1" colspan="1">SD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">Indeterminate heart pathology</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">15</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">1 y</td>
<td align="left" rowspan="1" colspan="1">January 16</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">General malaise vomiting</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">16</td>
<td align="left" rowspan="1" colspan="1">F</td>
<td align="left" rowspan="1" colspan="1">3 y</td>
<td align="left" rowspan="1" colspan="1">January 17</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Fever for 2 days</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">17</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">3 y</td>
<td align="left" rowspan="1" colspan="1">January 18</td>
<td align="left" rowspan="1" colspan="1">SD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">18</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">9 y</td>
<td align="left" rowspan="1" colspan="1">January 23</td>
<td align="left" rowspan="1" colspan="1">SD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">19</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">14 y</td>
<td align="left" rowspan="1" colspan="1">January 24</td>
<td align="left" rowspan="1" colspan="1">SD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">Died in sleep</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">20</td>
<td align="left" rowspan="1" colspan="1">F</td>
<td align="left" rowspan="1" colspan="1">7 y</td>
<td align="left" rowspan="1" colspan="1">January 27</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Vomiting abdominal pain</td>
<td align="left" rowspan="1" colspan="1">Pneumonia organ failure</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">21</td>
<td align="left" rowspan="1" colspan="1">F</td>
<td align="left" rowspan="1" colspan="1">10 m</td>
<td align="left" rowspan="1" colspan="1">January 28</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Three episodes of vomiting</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">22</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">7 y</td>
<td align="left" rowspan="1" colspan="1">February 8</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Rhinitis</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">23</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">11 m</td>
<td align="left" rowspan="1" colspan="1">February 11</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Minor intestinal symptoms</td>
<td align="left" rowspan="1" colspan="1">Excess blood salts ?</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">24</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">5 m</td>
<td align="left" rowspan="1" colspan="1">February 12</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Fever for 2 days</td>
<td align="left" rowspan="1" colspan="1">Premature</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">25</td>
<td align="left" rowspan="1" colspan="1">F</td>
<td align="left" rowspan="1" colspan="1">2 y</td>
<td align="left" rowspan="1" colspan="1">February 18</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Fever for 2 days</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">26</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">6 m</td>
<td align="left" rowspan="1" colspan="1">February 20</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">Released from hospital the day before</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">27</td>
<td align="left" rowspan="1" colspan="1">F</td>
<td align="left" rowspan="1" colspan="1">9 y</td>
<td align="left" rowspan="1" colspan="1">February 27</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Fever for a few hours</td>
<td align="left" rowspan="1" colspan="1">Tonsils removed 5 days before</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">28</td>
<td align="left" rowspan="1" colspan="1">F</td>
<td align="left" rowspan="1" colspan="1">18 y</td>
<td align="left" rowspan="1" colspan="1">March 11</td>
<td align="left" rowspan="1" colspan="1">SD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">29</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">13 m</td>
<td align="left" rowspan="1" colspan="1">March 22</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Vomiting abdominal pain for 3 days</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn><p>FD, fulminant death; SD, sudden death.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="table002" orientation="portrait" position="float"><label>Table 2</label>
<caption><p>Deaths during the 2011-12 season.</p>
</caption>
<table frame="box" rules="all"><thead><tr><th align="left" rowspan="1" colspan="1">Case</th>
<th align="left" rowspan="1" colspan="1">Gender</th>
<th align="left" rowspan="1" colspan="1">Age (years, months)</th>
<th align="left" rowspan="1" colspan="1">Date</th>
<th align="left" rowspan="1" colspan="1">Type of death</th>
<th align="left" rowspan="1" colspan="1">Prior symptoms</th>
<th align="left" rowspan="1" colspan="1">Additional information</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">1</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">10 y</td>
<td align="left" rowspan="1" colspan="1">December 5</td>
<td align="left" rowspan="1" colspan="1">SD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">2</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">5 y</td>
<td align="left" rowspan="1" colspan="1">January 15</td>
<td align="left" rowspan="1" colspan="1">SD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">A brother died of congenital cardiopathy</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">3</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">17 y</td>
<td align="left" rowspan="1" colspan="1">January 29</td>
<td align="left" rowspan="1" colspan="1">SD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">4</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">2.5 y</td>
<td align="left" rowspan="1" colspan="1">February 4</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">High fever, gastroenteritis</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">5</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">16 m</td>
<td align="left" rowspan="1" colspan="1">February 5</td>
<td align="left" rowspan="1" colspan="1">SD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">Fulminant pneumonia</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">6</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">10 m</td>
<td align="left" rowspan="1" colspan="1">February 11</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Vomiting for 1 day</td>
<td align="left" rowspan="1" colspan="1">Prior hospital stay for asthma pneumonia</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">7</td>
<td align="left" rowspan="1" colspan="1">F</td>
<td align="left" rowspan="1" colspan="1">10 m</td>
<td align="left" rowspan="1" colspan="1">February 12</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Vomiting diarrhea for 1 day</td>
<td align="left" rowspan="1" colspan="1">Prior hospital stay for influenza</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">8</td>
<td align="left" rowspan="1" colspan="1">F</td>
<td align="left" rowspan="1" colspan="1">7 y</td>
<td align="left" rowspan="1" colspan="1">February 14</td>
<td align="left" rowspan="1" colspan="1">SD</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">9</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">13 m</td>
<td align="left" rowspan="1" colspan="1">February 15</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Fever vomiting for 2 days</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">10</td>
<td align="left" rowspan="1" colspan="1">M</td>
<td align="left" rowspan="1" colspan="1">20 m</td>
<td align="left" rowspan="1" colspan="1">February 16</td>
<td align="left" rowspan="1" colspan="1">FD</td>
<td align="left" rowspan="1" colspan="1">Fever for 1 day</td>
<td align="left" rowspan="1" colspan="1">No</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn><p>FD, fulminant death; SD, sudden death.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
<affiliations><list></list>
<tree><noCountry><name sortKey="Prandoni, Stefano" sort="Prandoni, Stefano" uniqKey="Prandoni S" first="Stefano" last="Prandoni">Stefano Prandoni</name>
</noCountry>
</tree>
</affiliations>
</record>
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