There are children with AIDS in Chicago. So far, however, there are not very many, nor is their number increasing very fast. Since records were first kept in 1981, the Chicago Department of Health has received reports of 104 infants and children under 13 whose symptoms match the clinical definition for pediatric AIDS.
Compared with other big cities, Chicago is far from the top of the list, and the number of new cases now being reported here appears to be declining. During 1992 Cook County Hospital, which operates one of the city's four pediatric AIDS clinics, received an average of one new patient each week. Last year only 40 new children were enrolled; the clinic's current caseload of 155 patients includes some from as far as Zion and Kankakee.
Because Illinois is one of two states requiring that school principals be notified whenever a child is found to be infected with HIV, there have been suspicions that pediatric AIDS in Chicago is seriously under-reported. The assumption has been that reluctant pediatricians are protecting the privacy of their patients by failing to file official reports. But a recent study by the Chicago Department of Health found no evidence that children with AIDS were being reported less fully here than in states where such laws do not exist.
Although official case reports are the best indicator of the prevalence of AIDS, children who have the disease do not represent the total burden on the health-care system. At Children's Memorial Medical Center, for example, 63 of the 152 children enrolled in the pediatric AIDS program are merely being watched until it is determined whether they are infected with HIV. The program also includes 57 other children whose HIV infections have been confirmed but who have not yet developed any of the symptoms necessary for a clinical diagnosis of AIDS. Only 32 currently are in that group.
Even so, the number of children currently enrolled is fewer than a year ago, and it has not increased since last July.
The pediatric AIDS clinic is also among the hospital's smallest. During 1992 Children's Memorial treated nearly 1,500 children with cancer and more than 800 with spina bifida. If the burden imposed on the health-care system by children with AIDS is manageable, it is because pediatric AIDS patients are rarely hospitalized for extended periods. HIV-infected newborns routinely are sent home, then examined as outpatients on approximately the same schedule as well children.
In most pediatric AIDS clinics children infected with HIV who have not developed symptoms are seen once every three months. Children with symptoms visit the clinic more often, from once every few weeks to once a week. Although most children born to HIV-positive mothers prove to be uninfected and eventually become eligible for release to well-child clinics, many remain in the AIDS clinic programs anyway because other clinics are full.