- MILWAUKEE -- A virus recently
discovered in Japan is suspected in two "crib deaths" in Wisconsin,
raising new questions about how many of these mysterious tragedies might
be caused by germs.
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- The cases mark the first time the virus has been identified
in the United States. Whether it killed the babies is not clear, but both
were sick before they died and had signs of disease in their lungs.
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- Sudden infant death syndrome ó also called "crib
death" for the devastating way it is usually discovered ó is
a catch-all term for unexplained deaths in children less than a year old.
About 2,200 occur each year in the United States, mostly involving babies
between 2 and 4 months old.
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- Brain or breathing abnormalities, genetic mutations and
birth defects are possible causes. The risk rises if babies live with smokers,
are put to sleep on their stomachs, or are bundled in too many clothes
or covers.
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- Infections also have long been implicated. However, many
SIDS victims are not tested for viruses that might be the culprit.
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- The Wisconsin cases should prompt research into whether
SIDS is often caused by the newly discovered type of virus, said Dr. Mark
Pallansch, who identified it at the federal Centers for Disease Control
and Prevention after a Milwaukee virologist detected it.
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- "That is the question to be asked," he said.
"At this stage we just have very little information about the involvement
of these viruses in human disease."
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- Separately, a study in Thursday's New England Journal
of Medicine suggests that a protein long linked to stillbirths and some
birth defects may play a role in SIDS. Researchers from England and Scotland
found that pregnant women who had high amounts of it in their blood were
nearly three times more likely to have a baby die of SIDS than were women
with lower amounts.
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- In recent years, pilot projects in several states have
found a surprising number of infections in SIDS victims. It has also long
been known that many victims have high amounts of immune system cells and
substances, indicating they were fighting germs. SIDS is also more common
in winter, when viruses thrive indoors.
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- Germs that cause mild illness in adults can be fatal
to infants. Sometimes they kill indirectly, by magnifying other dangers,
said Dr. Marian Willinger, who oversees SIDS research for the National
Institute of Child Health and Human Development. If parents pile blankets
on a sick child, it becomes harder for the baby to breathe and regulate
its body temperature, she said.
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- Officials are trying to figure how the newly recognized
virus, human parechovirus-3, or HPEV-3, fits in. Japanese scientists reported
its discovery earlier this year after studying a 1-year-old girl who developed
a high fever, diarrhea and temporary paralysis in 1999.
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- The virus' origin is a mystery. How the Wisconsin babies
got it is another.
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- The first was a 4-week-old Appleton girl who died last
September, after she and her family had colds. Her mother is a travel agent,
but she worked from home in the two previous months and had no face-to-face
contact with clients who went to Asia.
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- The second case occurred two weeks later, 30 miles away,
in a 4-month-old Fond du Lac girl who also had cold symptoms. Her father
had recently been to China and Australia, but her family had no known contact
with the other victim's family.
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- "Other than the virus itself, we do not have a linkage,"
said Wisconsin's state epidemiologist, Dr. Jeffrey Davis.
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- The virus was detected in Wisconsin through a study that
Milwaukee County Medical Examiner Dr. Jeffrey Jentzen launched in 1987
with Gerald Sedmak, the Milwaukee Health Department virologist who discovered
the new germ in the two dead babies.
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- So far, they have found viruses in a third of the 1,200
cases studied, though most are not believed to have caused death. Still,
that is a surprisingly high rate, said Dr. Kurt Nolte, who started a similar
project in New Mexico.
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- "All of these viruses are potentially fatal. That's
why people protect their newborns when they bring them home. You don't
pass your brand-new baby around to 45 people," Nolte said.
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- In a Chicago study in the 1990s, Dr. Fern Hauck, a University
of Virginia SIDS researcher, found infections in 10 percent of SIDS victims.
She is now helping the CDC revise forms for reporting sudden and unexpected
infant deaths.
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- "The goal is to really have everyone in the country
who deals with infant deaths to extensively review everything in the background
to make sure no stone is left unturned to find the diagnosis," Hauck
said.
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- Davis agreed: "Not everything reported as SIDS is
SIDS. Every one of these situations deserves an answer as to why it occurred."
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- SIDS deaths declined 50 percent after the federal government's
Back to Sleep campaign in 1994, which urged parents to put babies to sleep
on their backs.
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- SIDS is more common in babies of parents who are young
or uneducated, and among blacks and American Indians.
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