Fifteen years of child drowning--a 1967-1981 analysis of all fatal cases from the Brisbane Drowning Study and an 11 year study of consecutive near-drowning cases.

A total population study of childhood fresh water drowning accidents (fatalities) for the 15 year period, 1967-1981, is reported. These data are from the ongoing Brisbane Drowning Study which has now also analysed 255 fresh water child immersions (both fatalities and near-fatalities) over the eleven year period, 1978-1981, and as such forms a consecutive unselected series for over one decade. The annual fatality (drowning) rate is 3.53 per 100,000. Details of immersion accidents by site, sex and by outcome (survivors versus fatalities) are presented. An analysis of secular trends revealed that one epidemic peak of child drownings in swimming pools and domestic baths (noted in the mid 1970s in Australia and other countries) is now passed. Evidence is presented to suggest that a vigorous education, and public awareness campaign can reduce the incidence of serious child immersion accidents by one-third. Such a campaign may have influence on all types of childhood household drownings (pools, baths, garden ponds), irrespective of site. Survival rates for unsupervised children who lose consciousness in fresh water are site-dependent, only 21% of such potential victims surviving after losing consciousness in rivers and creeks, compared with the survival rate of 65% for those in potential drowning incidents in their own backyard. Violent death continues to account for more than half of all deaths in childhood up to the age of 14 years [Gratz, 1979; Mayer, Walker and Johnson et al., 1981].(ABSTRACT TRUNCATED AT 250 WORDS)

Sepik granuloma.

An unusual infection occuring in the East Sepik Province of Papua New Guinea is reported. The patients come from villages on the Sepik River or its tributaries. The lesions consist of cutaneous nodules and papillomas which are slowly progressive. An unidentified organism, apparently a gram positive bacillus, is seen in large numbers in the lesions; a natural habitat in soil or water or on vegetation seems likely.

A probable case of Chromobacterium violaceum infection in Australia.

A case of a north-Queensland Aboriginal child, who died of a septicaemic illness probably caused by Chromobacterium violaceum, is reported. This organism is a Gram-negative bacillus found in soil and water. Human and animal infections are very rare, but have been reported from various tropical and subtropical areas of the world. Most of these have been fatal, although survival after recognition, appropriate antibiotic therapy, and surgical intervention has also been reported.

Freshwater drowning and near-drowning accidents involving children: a five-year total population study.

A large total population study of childhood fresh water immersion accidents is reported. The study was undertaken in the City of Brisbane over the five-year period 1971 to 1975 inclusive, and 111 fresh water immersion accidents involving children were studied and analysed. The childhood fresh water immersion accident rate, including drowning and near-drownings, of 10-43 per year per 100,000 at risk (fatality rate of 5-17) is the highest reported. If an unsupervised child gets into difficulties in fresh water and loses consciousness he has a 50% chance of dying. The immersion accident rate has doubled over the last six years. Age-specific immersion accident rates have been calculated, and have revealed that, in the toddler group (12 months to 23 months), the fresh water immersion accident rate is 50-01 per 100,000 (fatality rate of 22-55). Rates for drowning and near-drowning accidents after a fresh water immersion, by site, age and outcome (survival versus fatality), are also presented for the first time. Swimming pools produce 6-20 immersion accidents per year per 100,000 children at risk, and the domestic family bath tub produces 1-78. Possible factors explaining the high incidence are discussed, and comparisons of drowning rates from other centres are made.

Geographical distribution of amyloidosis in Papua New Guinea.

During an 11 year period 73 cases of amyloidosis were diagnosed at Port Moresby General Hospital as a result of histological examination of autopsy or biopsy material. No case of amyloidosis came from either the Highlands or North Coast regions although these two areas together accounted for 16% of the medical admissions at the hospital and made up a similar percentage of Port Moresby's Papua New Guinean population. Within the sub-district in which Port Moresby is situated there was a much higher incidence of amyloidosis in the inland, more sparsely populated, census divisions of the sub-district. Aetiological factors which may be related to the common occurrence of amyloidosis in Papua New Guinea are discussed in light of the observed geographical distribution of cases.

Amyloid fibril protein AA in Papua New Guinean amyloidosis.

In this study of protein composition of amyloid fibrils isolated from eight patients representative of the spectrum of amyloidosis found in Papua New Guinea has been investigated. All fibril preparations, including three from patients with amyloidosis secondary to lepromatous leprosy and one from an unusual juvenile case of primary amyloidosis, contained the non-immunogobulin amyloid protein, protein AA. However, only 44% of thirty-six amyloid patients had detectable levels of the protein AA-related serum component, protein SAA. Alkali-degraded material from each of the fibril preparations failed to react in double immunodiffusion test with antiserum to the amyloid-related light chain VgammaV, but evidence was found for this immunoglobulin light chain-specificity in the serum of one patient.