Intended for healthcare professionals

Minerva Minerva


BMJ 1999; 319 doi: (Published 02 October 1999) Cite this as: BMJ 1999;319:930

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Just over a month ago, a captive black bear cub died of rabies in an Iowa zoo, which is unlucky for the bear but unluckier still for the estimated 400 Americans and one Australian who played with it in the weeks leading up to its death (Morbidity and Mortality Weekly Report 1999;48:761). The bear lived in a petting zoo, where it romped with hundreds of visitors and nipped a substantial minority. Anyone exposed to the bear's saliva needs a rabies vaccine and immune globulin, but tracing the zoo's visitors—who don't always sign the visitors book—is proving difficult.

Fever doesn't necessarily accompany bronchiolitis, but when it does it may signal a more severe infection, longer hospital stay, and worse lung disease (Archives of Diseases in Childhood 1999:81:231-4). In a cohort of 90 infants from Kent, only 28 had a fever on admission to hospital. Nearly two thirds of the febrile infants had radiological evidence of collapse or consolidation of the lungs, compared with only 15% of the afebrile infants. Infants with a fever were also more likely to need supplementary oxygen.

Asymptomatic carriers of the gene mutation responsible for hereditary haemachromatosis—between 5% and 10% of northern Europeans—have an increased risk of …

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