Children with influenza A infection: treatment with rimantadine

Treatment with rimantadine of influenza in children and the potential development of resistance in clinical isolates associated with therapy have not been previously studied. We compared rimantadine to acetaminophen therapy in a controlled, double-blind study of 91 children with influenza-like illness. Of 69 children with proven influenza A/H3N2 infection, 37 received rimantadine and 32 received acetaminophen for five days. Children receiving rimantadine showed significantly greater reduction in fever and improvement in daily scores for symptoms and severity of illness during the first three days. Viral shedding also diminished significantly during the first two days but subsequently increased such that by days 6 and 7 the proportion of children shedding virus, as well as the quantity of virus shed, was significantly greater in the rimantadine group. During the seven-day study, of the 22 children in the rimantadine group with serial isolates tested, ten (45.5%) had resistant isolates compared with two (12.5%) of those with serial isolates in the acetaminophen group (P less than .03). Thus, of the total 37 children in the rimantadine group, 27% were found to have resistant isolated compared with 6% in the total group receiving acetaminophen (P less than .04). Furthermore, the mean inhibitory concentration of rimantadine increased with time in the rimantadine group (r = .4, P = .002) but not in the acetaminophen group. Rimantadine therapy, thus, appears to be significantly more effective than acetaminophen in ameliorating the clinical signs and symptoms of influenza in children. Treatment with rimantadine was also associated with increased viral shedding after the medication was discontinued and with the development of resistance in the clinical isolates, the significance of which is unknown.

Characteristics of Crimean-Congo hemorrhagic fever virus (Xinjiang strain) in China

Virus strains isolated from blood of patients during a hemorrhagic fever outbreak in 1968 in southern Xinjiang, China, from Hyalomma asiaticum and from sheep, were found to be identical or closely related to Crimean-Congo hemorrhagic fever (C-CHF) virus by complement fixation and indirect immunofluorescence tests with convalescent sera of patients and with C-CHF reference antibody. The virus was inactivated by ether and acid. Viral synthesis was not suppressed by 5-iododeoxyuridine suggesting an RNA-containing genome. The buoyant density in sucrose was 1.16-1.18 g/cm3. The particle weight was estimated at 3.26 +/- 0.46 X 10(8). The diameter of the virus particles was 85-105 nm.

Mortality of Chinese in New South Wales, 1969-1978

A high proportion of adult Chinese living in New South Wales were born elsewhere, most commonly in China. Mortality among these males from 1969-78 was due mainly to ischaemic heart disease (IHD) cancer and cerbrovascular disease. Females showed a similar general pattern. Chinese males had double the risk of dying from cerebrovascular death, but death rates from IHD were similar to those of the Australian population, although the risk of IHD was significantly lower in Chinese females. Male Chinese had significantly higher rates for cancers of the nasopharynx, lung, intestines and rectum, and stomach and liver, whereas females had a significantly higher risk for cancers of the lung and stomach. Mortality patterns were similar to those for United States Chinese. Apart from cancer, relatively little is known about the causes of death in China. Crude death rates only are available for very broad categories of causes of death. Most of our information on Chinese general mortality comes from studies of migrants, or their descendants overseas, mainly in South-East Asia and the USA. In the latter more detailed studies have been made of cancer mortality and cancer incidence than of other causes. The purpose of our study was to describe mortality in Chinese, born in China, and dying in the state of New South Wales from 1969-78.