Unexplained Critical Illnesses and Deaths of Possible Infectious Etiology, 2003

Surveillance for unexplained critical illnesses and deaths of possible infectious etiology in Minnesota began in September 1995. Any case of unexplained critical illness or death that appears to have a possible infectious cause should be reported, regardless of the patient’s age or underlying medical conditions. A subset of reported cases (i.e., persons 6 months to 49 years of age with no serious underlying medical conditions who died of apparent non-nosocomial infectious processes) are eligible for testing performed at CDC as part a special project. For cases who are not eligible for enrollment in the CDC project, some testing may be available at CDC and MDH, at the physician’s request.

Thirty-eight cases were investigated by MDH in 2003, compared to 40 cases in 2002. The cause(s) of illness subsequently were determined for eight cases. Among the remaining 30 cases, nine case-patients presented with respiratory symptoms; seven presented with shock/sepsis; four each presented with neurologic symptoms and hepatic disease; and two each presented with cardiac symptoms, sudden unexpected death, and gastrointestinal (GI) symptoms. case patients with respiratory symptoms ranged from 22 to 75 years of age; those with sepsis were 1 to 72 years of age; those with hepatitic disease were 5 to 55 years of age; the neurologic case-patients were 2 to 53 years of age; the cardiac case-patients were 17 and 29 years of age; the sudden unexpected deaths occurred in a 1- year-old and a 45-year-old; and the case-patients with GI symptoms were one and 11 years of age. Eight patients with respiratory symptoms, five patients with sepsis, and three each with neurologic and hepatic symptoms died as did both patients with GI symptoms and one with a cardiac syndrome. Seven respiratory case patients; 3 each of the neurologic case-patients and shock/sepsis case patients; two each of the GI, hepatic, and cardiac case-patients; and one case-patient with sudden unexpected death resided in the Twin Cities metropolitan area. The remaining case-patients resided in Greater Minnesota, except for two hepatic cases, one respiratory, and one sepsis case-patient who were out-of-state residents hospitalized in Minnesota.

Three respiratory cases; two each of the neurologic, GI, and hepatic cases; and one sepsis case were eligible for inclusion in the CDC project. Specimens have been obtained for testing at MDH or CDC for all cases, except for one hepatic case. Preliminary tests have not revealed an etiology for any of these cases.

• For up to date information see>> Unexplained Deaths and Critical Illnesses
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2003