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After a peak of 555 cases in children reported in 1980, there have been no more than 36 cases per year since 1987. Antecedent illnesses were reported in 93 percent of the children, and detectable blood salicylate levels in 82 percent. The overall case fatality rate was 31 percent. The case fatality rate was highest in children under five years of age (relative risk, 1.8; 95 percent confidence interval, 1.5 to 2.1) and in those with a serum ammonia level above 45 micrograms per deciliter ( 26 micromol per liter) (relative risk, 3.4; 95 percent confidence interval, 1.9 to 6.2). Since 1980, when the association between Reye's syndrome and the use of aspirin during varicella or influenza-like illness was the first reported, there has been a s harp decline in the number of infants and children reported to have Reye's syndrome. Because Reye's syndrome is now very rare, any infant or child suspected of having this disorder should undergo extensive investigation to rule out the treatable inborn m etabolic disorders that can mimic Reye's syndrome. |
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