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A case of myocarditis was defined as 1) a person with myocarditis diagnosed by electrocardiogram, echocardiogram, or cardiac catheterization, which indicates the presence of unexplained arrhythmia or decreased ejection fraction without apparent cause or 2) myocardial inflammatory infiltrates on tissue pathologic examination by using the Dallas criteria (9) or 3) viral isolation or nucleic acid identification in myocardial tissue specimens in persons living in northern Illinois from October 1, 2002, through May 30, 2003.

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