Biomedical subjects

Li-Min Huang

Publications and source records attributed to Li-Min Huang.

At least 37 records · Page 2Linked to original sources

PubMed2005

Invasive fungal infection in children with persistent febrile neutropenia.

BACKGROUND AND PURPOSE: Children with persistent febrile neutropenia (fever > 96 hours) refractory to antibacterial therapy carry a high risk of invasive fungal infection (IFI). However, epidemiologic data in such patient populations is lacking in Taiwan. METHODS: A retrospective study was conducted to identify risk factors and outcome of IFI in children with persistent febrile neutropenia (> 96 hours) hospitalized at National Taiwan University Hospital from January 1, 1999 through December 31, 1999. They were categorized into proven, probable, possible, or no IFI according to host, microbiologic and clinical criteria. RESULTS: A total of 29 episodes (35.4%) of IFI occurred in 82 episodes of persistent febrile neutropenia and included 1 proven, 12 probable and 16 possible cases. Pneumonia was most common (69.0%), followed by disseminated infection (17.2%), paranasal sinusitis (6.9%), and hepatosplenic abscess (6.9%). Multivariate analysis revealed 4 risk factors independently associated with IFI: prolonged neutropenia (> 30 days; odds ratio [OR], 10.4; 95% confidence interval [CI], 1.8-60.5), prolonged steroid therapy (OR 2.0, 95% CI 1.0-10.8), allogeneic bone marrow transplantation (OR 5.3, 95% CI 1.0-28.0), and relapsed malignancy (OR 3.5, 95% CI 1.1-11.1). Patients with IFI carried higher in-hospital mortality than those without (51.7% vs 3.8%, p < 0.001). Among those with IFI, delayed antifungal therapy (persistent fever > 7 days) was associated with higher mortality rate than earlier treatment (73.3% vs 28.6%, p = 0.024) and was an independent adverse prognostic factor. CONCLUSION: IFI was common in patients with persistent febrile neutropenia and delayed antifungal therapy was an independent adverse prognostic factor.

Adolescent↗

PubMed2005

Clinical management and outcome of childhood lung abscess: a 16-year experience.

In order to evaluate the clinical manifestations, management and outcome of childhood lung abscess, a retrospective chart review of 27 pediatric patients with International Classification of Diseases, Ninth Revision-Clinical Modification (ICD-9 CM) code of 503.1 (lung abscess) from August 1987 to August 2003 was conducted. Among the 27 patients (14 males and 13 females), 30% (8/27) were primary lung abscess and 70% (19/27) had underlying chronic diseases (secondary lung abscess). The predisposing factors of the primary group (n = 8) included 6 cases of respiratory tract infection, 1 with choking during swimming, and 1 with laceration wound. The underlying diseases in the secondary group (n = 19) included 10 cases of hematologic disorder (52%), 3 of congenital heart disease, 2 of central nervous system anomalies, and 1 each of hyperimmunoglobulin E syndrome, chronic lung disease, liver cirrhosis with fistula formation, and Swyer-James syndrome. Eleven patients (41%) underwent diagnostic tapping, including echo-guided aspiration (10 cases) and computed tomography-guided percutaneous needle aspiration (1 case). Positive yield rate from aspiration of lung abscess was 63.6% (7/11). Surgical intervention was performed in 8 (42%) of the secondary group and in 1 patient from the primary group. The pathogens were identified in 11 patients (41%): 5 with oral flora, 2 with Staphylococcus aureus plus other pathogens, 1 with S. aureus alone, 1 with Pseudomonas aeruginosa plus Proteus mirabilis, 1 with P. aeruginosa alone, and 1 with Aspergillus. The average duration of parenteral antibiotic use was 40 days. Five cases (18.5%) died due to poor control of the underlying diseases, and 4 of the patients (15%) had sequelae (2 with bronchiectasis and 2 with lung fibrosis). Seventy percent of lung abscess occurred in children with underlying medical conditions. Early percutaneous aspiration has an important role in identification of pathogens. Oral anaerobes and S. aureus are the core pathogens in primary lung abscess and gram-negative pathogens should also be considered in secondary lung abscess.

Adolescent↗

PubMed2005

Intussusception in Taiwanese children: analysis of incidence, length of hospitalization and hospital costs in different age groups.

BACKGROUND AND PURPOSE: This study investigated the characteristics of intussusception in Taiwanese children of different age groups, including the incidence, length of hospitalization and hospital costs. METHODS: Children with a diagnosis of intussusception who were hospitalized from 1999 through 2001 were identified from a nationwide health insurance claims database. The incidence of intussusception was calculated by age, gender, and season. Length of hospitalization and hospital costs were also analyzed. RESULTS: A total of 6988 cases of intussusception were identified in Taiwan from 1999 to 2001. Among them, 4859 cases occurred in children below 15 years of age. The average incidence among children below age 15 years was 34.5 per 100,000, with a peak incidence of 118.8 per 100,000 observed among children younger than 24 months old. The highest incidence of intussusception in Taiwanese children occurred between 12 and 24 months of age. According to the data for patients below 15 years of age hospitalized for intussusception in year 2000, males were more likely to be affected than females (61.3% vs 38.7%). Intussusception-related hospitalizations were rare in infants in the first few months of life, increased in those 6 to 12 months old, and peaked among children 1 to 3 years old. Among the 952 patients with intussusception admitted to hospitals in 2000, 297 (31.2%) received surgery, incurring higher median medical costs (New Taiwan Dollars [NT dollars] 42,265 or US dollars 1234) and longer median hospital stay (6.2 days) than the 655 patients who did not require surgery (NT dollars 6290 or US dollars 185 for hospitalization of 2.4 days). CONCLUSIONS: The study found that the incidence of intussusception peaked in the second year of life in Taiwanese children. There was also a male predominance and lack of seasonal variation in incidence.

Adolescent↗

PubMed2005

Clinical manifestations and outcomes of constrictive pericarditis in children.

BACKGROUND AND PURPOSE: Constrictive pericarditis (CP) is rare in children. The purpose of this study was to define the clinical manifestations and outcomes of this disease. METHODS: From January 1985 through December 2003, 8 patients with surgically confirmed CP were enrolled. Data on clinical characteristics, disease manifestations, treatment, and outcomes were collected and analyzed. RESULTS: One patient had l-transposition of the great arteries (l-TGA); the other 7 patients had no underlying cardiovascular diseases. None of the patients had direct evidence of tuberculous infection. Age at disease onset ranged from 8 months to 13 years (median, 10 years), and the interval between symptom onset and correct diagnosis ranged from 2 to 31 months (median, 12 months). Major symptoms and signs included abdominal distension, hepatomegaly, neck vein engorgement and ascites. Evidence of calcification on chest roentgenogram was found in 1 patient (12.5%). Computed tomography or magnetic resonance image studies showed pericardial thickening in 6 patients (75%). Seven patients underwent cardiac catheterization, and all hemodynamic data met the diagnostic criteria for CP. All patients with structurally normal hearts survived during a median follow-up of 31 months after pericardiectomy (range, 5 to 103 months). The patient with l-TGA died of pneumonia 1 year after pericardiectomy. CONCLUSIONS: Symptoms and signs of right heart failure were common in children with CP. The etiology of CP remains largely unknown. Patients with structurally normal hearts have good outcomes after pericardiectomy.

Adolescent↗

PubMed2005

Influenza in Taiwan: seasonality and vaccine strain match.

This article explores seasonality, epidemiology and dominant epidemic strains of influenza in Taiwan. Surveillance in Taiwan demonstrates that influenza is a disease which occurs throughout the year but has peak activity in winter. Due to the high mutability of influenza virus, effective vaccination is the best strategy for protection. Although the World Health Organization-recommended vaccine compositions usually matched with around 77% of circulating strains worldwide, the rate of matching in Taiwan has been markedly lower than this. Between 1997 and 2004 in Taiwan, the match rates were 82% for H1N1, 53% for H3N2, and 47% for influenza B virus. Furthermore, some world epidemic strains appeared earlier in Taiwan than in other countries. In view of Taiwan's proximity to southern China, which is thought to be the epicenter of influenza epidemics, vigilant surveillance and the development of regional strategies for the selection and manufacture of vaccine strains to improve influenza prevention are urgent requirements.

Humans↗

PubMed2005

Viral infections and prolonged fever after liver transplantation in young children with inborn errors of metabolism.

BACKGROUND AND PURPOSE: Liver transplantation could be a useful treatment for selected inborn errors of metabolism. This study evaluated the outcome and viral infections after liver transplantation in young children and infants with these diseases. METHODS: The outcome of liver transplantation and clinical characteristics of the following 4 patients were assessed: 1 infant with ornithine transcarbamylase deficiency (OTCD) who received liver transplant aged 3 years and 4 months; 1 infant with carbamyl phosphate synthetase I deficiency (CPSID) who received liver transplant at 14 months of age; and 2 infants with methylmalonic acidemia (MMA) who received liver transplant at 8 months and 11 months of age, respectively. All donors, except the 8-month-old infant with MMA, showed serologic evidence of previous cytomegalovirus (CMV) infection before transplantation. All 4 of these donors showed serologic evidence of previous infection of Epstein-Barr virus (EBV). None of the recipients had previous CMV infection. Both the infant with OTCD and the 8-month-old infant with MMA had previous EBV infection, while the other 2 patients did not. Preoperative hemodialysis was performed in both infants with MMA. Postoperative follow-up included metabolic stability, disability degree, and viral infections. RESULTS: None of the patients developed severe metabolic decompensation after transplantation and all increased protein intake postoperatively. Symptomatic viral infections, however, were present in all patients postoperatively, including CMV infection in the infant with OTCD and the 11-month-old infant with MMA, reactivation of EBV infection in the infant with OTCD and the 8-month-old infant with MMA, and primary EBV infection in the infant with CPSID. CONCLUSIONS: Liver transplantation was an effective treatment for all 4 of these patients with inborn errors of metabolism. The risk of symptomatic viral infections for these patients was high. This was likely associated with conditions including immunosuppression, young age, endemic nature of CMV and EBV infections, and lack of CMV prophylaxis.

Carbamoyl-Phosphate Synthase I Deficiency Disease↗

PubMed2005

Clinical features and factors of unfavorable outcomes for non-polio enterovirus infection of the central nervous system in northern Taiwan, 1994-2003.

This study investigated the clinical manifestations and outcomes of central nervous system (CNS) infection by enteroviruses. Cases with CNS involvement among all enterovirus-culture-positive cases from January 1995 to June 2003 were retrospectively reviewed. Among 1028 enterovirus-culture-positive cases, there were 333 cases involving the CNS. Of these, the ratio of male to female subjects was 1.78, and the mean (+/- standard deviation) age was 6.83 +/- 5.9 years; 21 were premature neonates, and 10 failed to thrive. Disease entities included 282 cases of aseptic meningitis (84.7%), 44 cases of encephalitis (13.2%), and 7 cases of encephalomyelitis/polio-like syndrome (2.1%). Of these cases, 97.9% (326/333) had fever with peak body temperature at 38.9 degrees C, 85% had headache and vomiting, 70% had meningeal signs, 64% had neck stiffness, 16.6% (55/333) had change of consciousness, 5.4% (18/333) had seizures and 5.2% (17/333) had myoclonic jerks. Mannitol was administered in 77.2% of patients (257/333), along with intravenous immunoglobulin in 6.6% (22/333). Twelve cases received ventilator support. One patient died of hand-foot-and-mouth disease, encephalitis plus cardiopulmonary failure, and 2 premature neonates died of hepatic failure, disseminated intravascular coagulation, sepsis-like syndrome and myocarditis. Eighteen had neurologic sequelae, including 7 with limb weakness, 5 with epilepsy, 2 with sixth cranial nerve palsy, 3 with cerebral palsy, 4 with psychomotor retardation, 2 with spasticity, and 1 with hearing loss. Factors associated with unfavorable outcomes (death or sequelae) included younger age (p=0.0003), higher peak white blood cell count (WBC) [p=0.0009] and skin rash (p=0.005). Younger age and higher peak WBC were poor prognostic factors of severe enterovirus CNS infection. Death was related to neonatal enterovirus infection and enterovirus 71 infection in young children.

Adolescent↗

PubMed2005

Avian influenza.

Influenza is an old disease but remains vital nowadays. Three types of influenza viruses, namely A, B, C, have been identified; among them influenza A virus has pandemic potential. The first outbreak of human illness due to avian influenza virus (H5N1) occurred in 1997 in Hong Kong with a mortality of 30%. The most recent outbreak of the avian influenza epidemic has been going on in Asian countries since 2003. As of March 2005, 44 incidental human infections and 32 deaths have been documented. Human influenza viruses differ with other avian influenza viruses on the choice of cellular receptors. Avian influenza viruses bind to cell-surface glycoproteins or glycolipids containing terminal sialyl-galactosyl residues linked by 2-3-linkage [Neu5Ac(alpha2-3)Gal], whereas human viruses, including the earliest available isolates from the 1957 and 1968 pandemics, bind to receptors that contain terminal 2-6-linked sialyl-galactosyl moieties [Neu5Ac(alpha2-6)Gal]. Recent evidence suggests that human bronchial ciliated epithelial cells contain Neu5Ac(alpha2-3)Gal and can be infected with avian influenza viruses. Nevertheless, avian influenza viruses can not infect non-ciliated bronchial epithelial cells. Hence, adaptation of the avian influenza virus to nonciliated cells is a prerequisite for a pandemic virus to emerge. Biological behaviors of influenza viruses indicate that once a pandemic virus emerges, isolation is not likely to contain this epidemic. A specific vaccine against the pandemic strain will not be available until 6 to 12 months after the inception of the pandemic. Judicious use of antiviral agents and stringent disease control measures are imperative to decrease the impact of a future pandemic.

Animals↗

PubMed2005

Lymphadenitis caused by non-tuberculous mycobacteria in a university hospital in Taiwan: predominance of rapidly growing mycobacteria and high recurrence rate.

BACKGROUND AND PURPOSE: Lymphadenitis is the most common manifestation of infection due to non-tuberculous mycobacteria (NTM) in otherwise healthy children. This disease is rare in adults and its geographic variations in etiology and clinical manifestations remain unclear. The aim of this study was to describe the etiology, clinical presentation, treatment, and outcome of NTM lymphadenitis. METHODS: Medical records of patients with culture-proven NTM lymphadenitis treated at a university hospital in Taiwan from January 1997 through December 2004 were retrospectively reviewed. RESULTS: In total, 12 patients with NTM lymphadenitis were identified, including 6 males and 7 adults (> or = 16 years). The majority (83%) of patients presented with an enlarged palpable mass and 9 (75%) had preceding constitutional symptoms. The most common site of lymphadenitis was the cervical area (83%) and 8 patients (75%) had multiple lymph node involvement. Rapidly growing mycobacteria (RGM) accounted for 75% of the etiology of NTM lymphadenitis, followed by Mycobacterium avium complex (MAC) [2 patients]. A high recurrence rate (42%) after primary treatment was noted among those patients who received clarithromycin-containing regimens for a median of 6 months. CONCLUSIONS: This study found that both previously healthy children and adults were susceptible to NTM lymphadenitis. RGM was the most common etiology rather than MAC among NTM species causing lymphadenitis. Inadequate surgical excision of the diseased lymph nodes and insufficient coverage of antimycobacterial therapy both contributed to the high recurrence rate.

Adolescent↗

PubMed2004

Identification of a novel protein 3a from severe acute respiratory syndrome coronavirus.

The open reading frame 3 of the severe acute respiratory syndrome coronavirus (SARS-CoV) genome encodes a predicted protein 3a, consisting of 274 amino acids, that lacks any significant similarities to any known protein. We generated specific antibodies against SARS protein 3a by using a synthetic peptide (P2) corresponding to amino acids 261-274 of the putative protein. Anti-P2 antibodies and the sera from SARS patients could specifically detect the recombinant SARS protein 3a expressed in Escherichia coli and in Vero E6 cells. Expression of SARS protein 3a was detected at 8-12 h after infection and reached a higher level after approximately 24 h in SARS-CoV-infected Vero E6 cells. Protein 3a was also detected in the alveolar lining pneumocytes and some intra-alveolar cells of a SARS-CoV-infected patient's lung specimen. Recombinant protein 3a expressed in Vero E6 cells and protein 3a in the SARS-CoV-infected cells was distributed over the cytoplasm in a fine punctate pattern with partly concentrated staining in the Golgi apparatus. Our study demonstrates that SARS-CoV indeed expresses a novel protein 3a, which is present only in SARS-CoV and not in other known CoVs.

Animals↗

PubMed2004

Clinical manifestations and molecular epidemiology of necrotizing pneumonia and empyema caused by Streptococcus pneumoniae in children in Taiwan.

Recently, there have been increasing numbers of pneumococcal pneumonia cases, with their associated complications. We conducted a retrospective review to increase the understanding of childhood pneumococcal pneumonia. Seventy-one patients with pneumococcal pneumonia were identified. Forty (56.3%) of them developed complicated pneumonia. Multivariate analysis showed that presence of immature polymorphonuclear leukocytes in peripheral blood (odds ratio [OR], 3.67; 95% confidence interval [CI], 1.08-12.63), high C-reactive protein levels (>12 mg/dL) (OR, 5.24; 95% CI, 1.10-24.93), and no underlying disease at presentation (OR, 5.48; 95% CI, 1.06-28.25) were independent predictors of the occurrence of necrosis or/and abscess. Fourteen isolates (35%), which were genotypically identical and had the same pulsed-field gel electrophoresis pattern (serogroup 14, with MICs of penicillin of 0.1-0.5 mu g/mL), were significantly associated with complicated pneumonia (P=.047). Whether the virulence of antibiotic-resistant pneumococci is evolving deserves further investigation.

Anti-Bacterial Agents↗

PubMed2004

Nutritionally variant streptococcal infections at a University Hospital in Taiwan: disease emergence and high prevalence of beta-lactam and macrolide resistance.

From January 1993 to December 2002, 28 patients with nutritionally variant streptococci (NVS) infections were treated at a university hospital in Taiwan. Twelve (43%) of these patients had various underlying malignancies, and 7 (25%) had underlying valvular heart diseases. Nine patients (32%) had infective endocarditis, and 9 (32%) had primary bacteremia. The deaths of 7 patients (25%) were directly related to NVS infection. Among the 28 isolates recovered from these patients, 50% were not susceptible to penicillin, 33% were not susceptible to cefotaxime, and 93% were not susceptible to azithromycin.

Adolescent↗

PubMed2004

Childhood severe acute respiratory syndrome in Taiwan and how to differentiate it from childhood influenza infection.

OBJECTIVE: To investigate clinical features and outcomes of children in Taiwan with laboratory-confirmed severe acute respiratory syndrome (SARS) vs those of children with influenza to differentiate the 2 diseases. DESIGN, SETTING, AND PARTICIPANTS: Patients 20 years or younger with clinical, epidemiological, and laboratory evidence of SARS from March to July 2003 vs children with virus culture-confirmed influenza in a 1:1 age- and sex-matched control group. MAIN OUTCOME MEASURES: Rates of symptoms, abnormal laboratory data, and outcomes of recovery, sequelae, or death. RESULTS: The 15 SARS patients (9 girls and 6 boys) had a median age of 17 years (age range, 4-20 years). Nine patients (60%) were infected through household contact, 4 (27%) nosocomially, 1 (7%) through contact with a neighbor, and 1 (7%) after returning from Hong Kong. All 15 patients had fever, 3 (20%) had chills, and 11 (73%) had cough. Only 1 patient (7%) had sputum production; 1 (7%) had rhinorrhea. At presentation, 5 patients (33%) had leukopenia, 6 (40%) had lymphopenia, and 5 (33%) had monocytopenia. All children recovered without sequelae. Children with SARS had significantly lower incidences of rhinorrhea (odds ratio [OR], 0.01; 95% confidence interval [CI], 0.00-0.09), sputum production (OR, 0.10; 95% CI, 0.02-0.63), and sore throat (OR, 0.17; 95% CI, 0.03-0.85) than children with influenza. Both groups had similar incidences of leukopenia or lymphopenia, but SARS patients had a significantly higher incidence of monocytopenia (33% vs 0%, P = .04). CONCLUSIONS: Childhood SARS is usually not fatal. The absence of rhinorrhea and presence of monocytopenia in SARS may distinguish it from influenza.

Adolescent↗

PubMed2004

Waning immunity to plasma-derived hepatitis B vaccine and the need for boosters 15 years after neonatal vaccination.

Neonatal immunization with hepatitis B (HB) vaccine is highly effective; however, more needs to be learned about the duration of protection and indications for boosters. We measured antibody to HB core antigen (anti-HBc), HB surface antigen (HBsAg), and pre- and postbooster titers of HBsAg antibody (anti-HBs) 15 years after primary neonatal immunization with plasma-derived HB vaccines in 2 cohorts of 15-year-old children. Group A consisted of 78 children who were born to HB e antigen-positive HBsAg carrier mothers and had developed protective levels of anti-HBs antibodies (> or =10 mIU/mL) following HB immunization. Group B consisted of 113 apparently healthy children whose anti-HBs titers after vaccination were unknown. Anti-HBs was undetectable (antibody titer <10 mIU/mL) in 29.9% in group A and 62.4% in group B (P < .001). Anti-HBc was detected in 33.3 % in group A and 4.4 % in group B (P < .001). After a single booster dose of HB vaccine, 2.7% in group A and 3.3% in group B remained anti-HBs-negative. A blunted serological response was noted in approximately 20% in both groups. One HBsAg carrier was detected in group A (1.3%) and 4 in group B (3.5%). Fifteen years after neonatal immunization with plasma-derived HB vaccine, a large proportion of children exhibited waning immunity. This poses the risk of breakthrough infection. A single booster augmented the serological response to the vaccine in most but not all subjects. In conclusion, our findings suggest that one or more booster immunizations are needed in seronegative subjects by at least 15 years following neonatal immunization with plasma-derived HB vaccine.

Adolescent↗

PubMed2004

Fatal coxsackievirus A16 infection.

A 15-month-old boy presenting with hand, foot and mouth disease died of myocarditis and intractable shock caused by coxsackievirus A16 infection. It is apparent that coxsackievirus A16 infection is not always a benign infection.

Fatal Outcome↗

PubMed2004

Reduction of acute respiratory illness (ARI) due to a voluntary workplace influenza vaccination program: who are more likely to get the benefit?

The study investigated the overall effectiveness and its determinants of an influenza vaccination in the reduction of acute respiratory illness (ARI) clinic visits and sickness absence for a working population. We collected and compared the data of clinic visits and hours of sick leave among vaccinated and non-vaccinated workers during January and April in 1998 and 1999. A multiple regression analysis was conducted to explore possible determinants. The incidence rate of ARI clinic visits dropped 37.9% in 1999, with 57.3% reduction in vaccinated and 14.1% in un-vaccinated workers. Multiple regression analysis showed that the reduction was significantly associated with vaccination status, a history of diabetes, and occurrence of ARI clinic visits in 1998. Influenza vaccination is effective in reducing ARI clinic visits and sickness absence. Workers with a previous history of ARI, diabetes, and possibly young workers living with children were more likely to get the benefit. The identification of potential susceptible subpopulations can also minimize confusion on company policy for isolation during an epidemic of new infectious disease with flu-like symptoms.

Acute Disease↗

PubMed2004

Epidemiologic features of Kawasaki disease in Taiwan, 1996-2002.

OBJECTIVE: Kawasaki disease (KD) is the most common acquired heart disease in children worldwide. The incidence of KD varies among different countries, with Asian countries supposedly having higher incidences than Western countries. However, the incidence of KD in Taiwan has not been well investigated. METHODS: Since the implementation of Taiwan's National Health Insurance (NHI) in 1995, NHI has covered health care for >96% its population. Using the NHI database from 1996 to 2002, we investigated epidemiologic features of KD (International Classification of Diseases, Ninth Revision, code 446.1), the rate of coronary artery aneurysm formation (International Classification of Diseases, Ninth Revision, code 414.11), and the change in incidence during the recent 7 years. We also compared the annual incidences in Taiwan with those reported by other countries. RESULTS: During the 7-year study period, KD occurred most frequently in the summer and least frequently in winter. It is interesting that the highest peak occurred in the summer of 1998 at the same time that Taiwan's enterovirus 71 epidemic was occurring. Ninety-one percent of KD cases occurred in children who were <5 years old, and the male-to-female ratio was 1.70:1. Recurrence of KD was found in 1.3% (94 of 7305) of these children, and coronary artery aneurysm was found in 7.3% (536 of 7305). The annual incidence per 100,000 children was 146 in children <1 year old, 98 in 1-year-old children, 51 in 2-year-old children, 28 in 3-year-old children, 19 in 4-year-old children, and 5.3 in 5- to 9-year-old children; the incidence of KD decreased with increased age. The overall incidence was 66 cases per 100,000 children <5 years old from 1996 to 2002 with the annual incidence not differing significantly during the 7-year study period. CONCLUSIONS: KD in Taiwan occurs more frequently in boys and in the summer months. During the 7-year study period, the annual KD incidence in Taiwan of 66/100000 in children <5 years old was the second highest in the world after Japan.

Adolescent↗

PubMed2004

SARS in hospital emergency room.

Thirty-one cases of severe acute respiratory syndrome (SARS) occurred after exposure in the emergency room at the National Taiwan University Hospital. The index patient was linked to an outbreak at a nearby municipal hospital. Three clusters were identified over a 3-week period. The first cluster (5 patients) and the second cluster (14 patients) occurred among patients, family members, and nursing aids. The third cluster (12 patients) occurred exclusively among healthcare workers. Six healthcare workers had close contact with SARS patients. Six others, with different working patterns, indicated that they did not have contact with a SARS patient. Environmental surveys found 9 of 119 samples of inanimate objects to be positive for SARS coronavirus RNA. These observations indicate that although transmission by direct contact with known SARS patients was responsible for most cases, environmental contamination with the SARS coronavirus may have lead to infection among healthcare workers without documented contact with known hospitalized SARS patients.

Adult↗