A Study of an Unexplained and Large Increase in Respiratory Deaths in England and Wales: Is the Pattern of Diagnoses Consistent with the Potential Involvement of Cytomegalovirus?
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2014, Vol 4, Issue 33
Abstract
Aims: To determine if the ubiquitous herpes virus, cytomegalovirus (CMV), could be involved in a large and unexplained increase in all-cause mortality in England and Wales in 2012, and more specifically if this involvement was via a respiratory etiology. Study Design: Analysis of respiratory system cause of death in England and Wales and of respiratory system emergency hospital admissions in England. Place and Duration of Study: Cause of death statistics with primary respiratory system involvement in England and Wales in 2011 and 2012. Trends in emergency hospital admissions in England where there is a respiratory system primary diagnosis over the period 2000/01 to 2012/13. Methodology: Respiratory diagnoses which show a statistically significant increase as cause of death in 2012 were identified, as were diagnoses showing a statistically significant increase as the primary cause of an emergency hospital admission in 2012/13. These diagnoses were then compared with medical case studies for hospitalization and death due to CMV. Results: Deaths in England and Wales showed a sudden and unexplained increase in early 2012 which continued for 18 months before abating. The increase was equivalent to a large influenza epidemic, although higher levels attributable to influenza were absent. The increase was age and gender specific, and highest among those with neurodegenerative diseases (+15%); however, due to the way in which the primary cause of death is coded the role of respiratory diseases as the trigger for decease can be obscured. The next highest increase was for respiratory conditions, the most notable for bronchiectasis (+19%), asthma (female +14%), lung diseases due to external agents (+12%), interstitial pulmonary diseases (female +12%), chronic pulmonary disease (+7%) and a range of other conditions with >4% increases. After adjusting for the way in which deaths in the dementia group are coded the increase due to pneumonia rises to +8% for males and +15% for females. For the whole of the respiratory group augmented with the dementia group the increase in deaths was specific to those aged over 65 (average for 65+ of male +8.3%, female + 8.7%) with a peak at 90-94 (male + 15%, female + 17%). A corresponding large increase in respiratory admissions accompanies the increase in deaths. Given that the increase in admissions and deaths moved across England and Wales in a time-based spread, indicative of an infectious agent, with spurts of rapid local spread compatible with respiratory transmission, the increase in respiratory deaths were examined to see if the nature of any putative infectious agent could be discerned. There was a striking match with the known clinical effects of CMV. Conclusion: In an aged population lifelong exposure to the immune erosive effects of CMV presents the potential for the emergence of diseases reliant on immune impairment for their modus operandi. The lung is a primary reservoir for permanent CMV infection in humans and conditions/diagnoses showing a large increase in both death and hospital admissions in 2012 are all potentially CMV-mediated. In view of the very large increase in death for particular respiratory diagnoses further research is urgently required.
Authors and Affiliations
Rodney P. Jones
Keywords
Related Articles
- EP ID EP348732
- DOI 10.9734/BJMMR/2014/11382
- Views 79
- Downloads 0
Reduced Vascular Endothelial Growth Factor A Levels are Correlated with the Incidence of Brain Edema in Acute Ischemic Stroke Patients
Aims: To study the correlation between the vascular endothelial growth factor A/VEGF-A level and the incidence of brain edema in acute ischemic stroke patients. Study Design: A prospective observational analytic case-co...
Role of Sildenafil in Acceleration of Delayed Union Fracture Healing on Sprague-Dawley Rats Model
Introduction: Delayed union with its subsequent morbidity remains a major problem in fracture healing. Angiogenesis plays an important role in fracture healing. Sildenafil has been shown to be a potent stimulator of angi...
Clinical Effects of Mixed Infection of Trypanosomes and Ancylostoma caninum in Dogs and Treatment with Diminazene and Mebendazole (Nigeria)
The socio-economic importance of trypanosomosis and ancylostomosis in both humans and animal necessitated the investigation of the clinical signs of single and conjunct infection of both parasites in dogs. Sixteen dogs g...
Latent Viruses, Microcompetition, Transcription Factor Deficiency and the Cause of Acute Lymphoblastic Leukemia
The cause of B-cell Acute Lymphoblastic Leukemia (B-ALL) is unknown. Some studies suggested that the cause might be a deficiency in certain transcription factors due to a genetic deletion. We would like to propose a diff...
Oral Health Advices and Illustrations Card for Use in Mother-and-Child Health Clinics: Face and Content Validity
Background: The prevalence of Early Childhood Caries (ECC) in Peruvian children is very high especially in sub-urban areas. The dental profession is unable to solve this problem alone. Nurses have close contact with moth...