Health and Safety - Hiv/aids

Acquired Immune Deficiency Syndrome (AIDS) was identified as a new disease in 1981, and, according to the CDC, an estimated 886,575 cases had been diagnosed in the United States through 2002. AIDS is caused by the human immunodeficiency virus (HIV), which weakens the victim's immune system, making it vulnerable to other

TABLE 5.4

Infant mortality rates for the 10 leading causes of infant death, by race and Hispanic origin, 2002
Rank1	Non-Hispanic white	Number	Rate per 100,000 live births
— Category not applicable.
1Rank based on number of deaths.
2Race and Hispanic origin are reported separately on both the birth and death certificate. Data for persons of Hispanic origin are included in the data for each race group, according to the decedent's reported race.
SOURCE: Adapted from "Table 8. Infant Deaths and Infant Mortality Rates for the 10 Leading Causes of Infant Death, by Race and Hispanic Origin: United States, Preliminary 2002," in "Deaths: Preliminary Data for 2002," National Vital Statistics Report, vol. 52, no. 13, February 11, 2004, http://www.cdc.gov/nchs/data/nvsr/nvsr52/nvsr52_13.pdf (accessed September 16, 2004)
—	All causes	13,542	587.9
1	Congenital malformations, deformations and chromosomal abnormalities	3,110	135.0
2	Disorders related to short gestation and low birth weight, not elsewhere classified	1,811	8.6
3	Sudden infant death syndrome	1,112	48.3
4	Newborn affected by maternal complications of pregnancy	821	35.6
5	Newborn affected by complications of placenta, cord and membranes	493	21.4
6	Respiratory distress of newborn	446	19.4
7	Accidents (unintentional injuries)	437	19.0
8	Bacterial sepsis of newborn	361	15.7
9	Diseases of the circulatory system	320	13.9
10	Intrauterinehypoxia and birth asphyxia	311	13.5
—	All other causes	4,321	187.6
Total black2
—	All causes	8,380	1,419.0
1	Disorders related to short gestation and low birth weight, not elsewhere classified	1,836	310.9
2	Congenital malformations, deformations and chromosomal abnormalities	1,023	173.2
3	Sudden infant death syndrome	603	102.1
4	Newborn affected by maternal complications of pregnancy	575	97.3
5	Respiratory distress of newborn	336	57.0
6	Newborn affected by complications of placenta, cord and membranes	315	53.3
7	Accidents (unintentional injuries)	303	51.4
8	Bacterial sepsis of newborn	231	39.1
9	Diseases of the circulatory system	189	32.1
10	Intrauterinehypoxia and birth asphyxia	147	24.8
—	All other causes	2,822	477.8

opportunistic infections. Young children with AIDS usually have the virus transmitted to them either by an infected parent or through contaminated transfusions of blood or blood products. Adolescents who are exploring their sexuality or experimenting with drugs are also vulnerable to HIV infection, which can be spread through sexual inter-course without the use of a condom or through shared hypodermic needles.

In adults the most common opportunistic infections of AIDS are Kaposi's sarcoma—a rare skin cancer—and pneumocystis carinii pneumonia. In infants and children a failure to thrive and unusually severe bacterial infections characterize the disease. With the exception of pneumocystis carinii pneumonia, children with symptomatic HIV infection seldom develop opportunistic infections as adults do. More often they are plagued by recurrent bacterial infections, persistent oral thrush (a common fungal infection of the mouth or throat), and chronic and recurrent diarrhea. They may also suffer from enlarged lymph nodes, chronic pneumonia, developmental delays, and neurological abnormalities.

HOW MANY ARE INFECTED? As of December 2002 the CDC reported a cumulative total of 9,300 AIDS cases in children under the age of thirteen since record-keeping began in 1981. (See Table 5.7.) African-American children made up the overwhelming majority with 5,476 cases, followed by Hispanic children (2,111 cases), non-Hispanic white children (1,606 cases), Asian/Pacific Islanders (59 cases), and Native American/Alaska Natives (31 cases). By the end of 2002, 5,315 children ages fourteen and under had died from the disease.

MEANS OF TRANSMITTAL. Most babies of HIV-infected mothers do not develop HIV. HIV-positive mothers can reduce the risk of transmission by taking antiretroviral drugs during the last two trimesters of pregnancy and during labor; giving birth by caesarean section; giving the infant a short course of antiretroviral drugs after birth; and not breast feeding. With these interventions, the transmission rate can be reduced to as low as 2%.

The overwhelming majority of children with AIDS, however, contracted it from mothers either infected with HIV or at risk for AIDS (93%). (See Table 5.7.) Other means of transmission were a blood transfusion contaminated with the virus and regular receipt of blood products because of a hemophilia/coagulation disorder.

ADOLESCENTS WITH AIDS. The number of AIDS cases among adolescents is comparatively low. The CDC reported that, as of December 31, 2002, 5,108 adolescents ages

TABLE 5.5

Leading causes of death and numbers of deaths, by age, 1980 and 2001
(Data are based on death certificates)
Age and rank order	1980		2001*
	Cause of death	Deaths	Cause of death	Deaths
— Category not applicable.
*Figures for homicide and suicide include September 11, 2001 related deaths for which death certificates were filed as of October 24, 2002.
SOURCE: Adapted from "Table 32. Leading Causes of Death and Numbers of Deaths, according to Age: United States, 1980 and 2001," in Health: United States, 2003, Centers for Disease Control and Prevention, National Center for Health Statistics, 2003, http://www.cdc.gov/nchs/data/hus/tables/2003/03hus032.pdf (accessed September 16, 2004)
1–4 years
—	All causes	8,187	All causes	5,107
1	Unintentional injuries	3,313	Unintentional injuries	1,714
2	Congenital anomalies	1026	Congenital malformations, deformations and chromosomal abnormalaties	557
3	Malignant neoplasms	573	Malignant neoplasms	420
4	Diseases of heart	338	Homicide	415
5	Homicide	319	Diseases of heart	225
6	Pneumonia and influenza	267	Influenza and pneumonia	112
7	Meningitis	223	Septicemia	108
8	Meningococcal infection	110	Certain conditions originating in the perinatal period	72
9	Certain conditions originating in the perinatal period	84	In situ neoplasms, benign neoplasms and neoplasms of unknown behavior	58
10	Septicemia	71	Cerebrovascular diseases	54
5–14 years
—	All causes	10,689	All causes	7,095
1	Unintentional injuries	5,224	Unintentional injuries	2,836
2	Malignant neoplasms	1,497	Malignant neoplasms	1,008
3	Congenital anomalies	561	Congenital malformations, deformations and chromosomal abnormalities	376
4	Homicide	415	Homicide	326
5	Diseases of heart	330	Suicide	279
6	Pneumonia and influenza	194	Diseases of heart	272
7	Suicide	142	In situ neoplasms, benign neoplasms and neoplasms of uncertain or unknown behavior	105
8	Benign neoplasms	104	Chronic lower respiratory diseases	104
9	Cerebrovascular diseases	95	Influenza and pneumonia	92
10	Chronic obstructive pulmonary diseases	85	Cerebrovascular diseases	80
15–24 years
—	All causes	49,027	All causes	32,252
1	Unintentional injuries	26,206	Unintentional injuries	14,411
2	Homicide	6,537	Homicide	5,297
3	Suicide	5,239	Suicide	3,971
4	Malignant neoplasms	2,683	Malignant neoplasms	1,704
5	Diseases of heart	1,223	Diseases of heart	999
6	Congenital anomalies	600	Congenital malformations, deformations and chromosal abnormalites	505
7	Cerebrovas cular diseases	418	Human immunodeficiency virus (HIV) disease	225
8	Pneumonia and influenza	348	Cerebrovascular diseases	196
9	Chronic obstructive pulmonary diseases	141	Influenza and pneumonia	181
10	Anemias	133	Chronic lower respiratory diseases	171

thirteen to nineteen had been diagnosed with AIDS since the beginning of the epidemic in the early 1980s. But because of the lengthy incubation period between the time of infection and the onset of symptoms, it is highly probable that many people who develop AIDS in their early twenties became infected with HIV in their teenage years.