Intensive exposure as a risk factor for severe polio: A study of multiple family cases
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Intensive exposure as a risk factor for severe polio : A study of multiple family cases. / Nielsen, N. M.; Aaby, P.; Wohlfahrt, J.; Pedersen, J. B.; Melbye, M.; Mølbak, K.
I: Scandinavian Journal of Infectious Diseases, Bind 33, Nr. 4, 2001, s. 301-305.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Intensive exposure as a risk factor for severe polio
T2 - A study of multiple family cases
AU - Nielsen, N. M.
AU - Aaby, P.
AU - Wohlfahrt, J.
AU - Pedersen, J. B.
AU - Melbye, M.
AU - Mølbak, K.
PY - 2001
Y1 - 2001
N2 - To examine the importance of intensity of exposure for the outcome of the poliomyelitis infection 429 polio cases were identified belonging to families with 2, 3 or 4 polio cases, all hospitalized in Copenhagen from 1919 to 1953. Furthermore, 87 pairs of polio cases living on the same stairway, but not in the same household, were identified. Severity among multiple cases in families analysed according to time of appearance showed a U-shaped curve. Initial cases had a higher risk of developing paralysis [relative risk (RR) = 1.5, 95% confidence interval (CI) 1.2-1.9] and of dying (RR = 2.5, 95% CI 0.9-6.9). Decreased severity was observed among subsequent cases appearing within 11 d after the initial case (RR = 1.0); however, severity increased again, with higher mortality for cases likely to have been infected by the initial case (cases appearing more than 11 d later) (RR = 5.7, 95% CI 1.8-17.8). The pattern described among multiple family cases was not found among cases from the same stairway. Since family cases appearing within 11 d were probably infected simultaneously, a short incubation period is associated with severe disease and a prolonged incubation period with milder infections. Furthermore, intensive exposure from being infected in the household increased severity. These observations therefore suggest that intensity of exposure and dose of infection are important factors in the severity of poliomyelitis.
AB - To examine the importance of intensity of exposure for the outcome of the poliomyelitis infection 429 polio cases were identified belonging to families with 2, 3 or 4 polio cases, all hospitalized in Copenhagen from 1919 to 1953. Furthermore, 87 pairs of polio cases living on the same stairway, but not in the same household, were identified. Severity among multiple cases in families analysed according to time of appearance showed a U-shaped curve. Initial cases had a higher risk of developing paralysis [relative risk (RR) = 1.5, 95% confidence interval (CI) 1.2-1.9] and of dying (RR = 2.5, 95% CI 0.9-6.9). Decreased severity was observed among subsequent cases appearing within 11 d after the initial case (RR = 1.0); however, severity increased again, with higher mortality for cases likely to have been infected by the initial case (cases appearing more than 11 d later) (RR = 5.7, 95% CI 1.8-17.8). The pattern described among multiple family cases was not found among cases from the same stairway. Since family cases appearing within 11 d were probably infected simultaneously, a short incubation period is associated with severe disease and a prolonged incubation period with milder infections. Furthermore, intensive exposure from being infected in the household increased severity. These observations therefore suggest that intensity of exposure and dose of infection are important factors in the severity of poliomyelitis.
UR - http://www.scopus.com/inward/record.url?scp=0035055375&partnerID=8YFLogxK
U2 - 10.1080/003655401300077360
DO - 10.1080/003655401300077360
M3 - Journal article
C2 - 11347591
AN - SCOPUS:0035055375
VL - 33
SP - 301
EP - 305
JO - Scandinavian Journal of Infectious Diseases, Supplement
JF - Scandinavian Journal of Infectious Diseases, Supplement
SN - 0300-8878
IS - 4
ER -
ID: 259463636