Information de reference pour ce titreAccession Number: | 00000433-200406000-00005.
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Author: | Li, Melissa K. MD; Beck, Melinda A. PhD; Shi, Qing MS; Harruff, Richard C. MD, PhD
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Institution: | From the University of Florida, Gainesville, Florida (M.K.L.); Departments of Pediatrics and Nutrition, University of North Carolina, Chapel Hill, North Carolina (M.A.B., Q.S.); and King County Medical Examiner's Office, Seattle, Washington (R.C.H.).
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Title: | |
Source: | American Journal of Forensic Medicine & Pathology. 25(2):117-124, June 2004.
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Abstract: | We present a group of 18 illegal immigrant stowaways who arrived in a shipboard cargo container suffering from gastroenteritis, dehydration, and malnutrition and showing evidence of viral myocarditis in 3 of 4 fatalities. Our investigation included an evaluation of the 2-week ocean voyage, analysis of medical records and laboratory results of the survivors, autopsies on the decedents, and viral studies on their heart tissue. Of 3 stowaways who died shipboard, 2 showed lymphocytic myocarditis and 1 could not be evaluated histologically due to decomposition. A fourth stowaway died 4 months after arrival with dilated cardiomyopathy and lymphocytic myocarditis. Reverse-transcriptase polymerase chain reaction and nucleotide sequencing of viral isolates from the decedents' heart tissues demonstrated Coxsackie virus B3 genome. We believe that these cases represent an outbreak of viral myocarditis, exacerbated by acute dehydration and malnutrition, due to confinement within the shipping container. Our evidence indicates that close confinement promoted the spread of the virus, and nutritional deprivation increased the stowaways' vulnerability. Furthermore, our observations support the conclusion, based on experimental studies, that nutritionally induced oxidative stress increased the virulence of the etiologic viral agent. In summary, these cases represent a potential infectious disease hazard of illegal immigration.
(C) 2004 Lippincott Williams & Wilkins, Inc.
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Author Keywords: | viral myocarditis; emerging infectious disease surveillance; cardiomyopathy; illegal immigration; malnutrition; dehydration; death investigation.
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Language: | English.
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Document Type: | Original Article.
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Journal Subset: | Clinical Medicine.
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ISSN: | 0195-7910
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NLM Journal Code: | 3hc, 8108948
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