Summary
The use of negative contrast electronmicroscopy of stool suspension in the investigation of the aetiology of childhood gastroenteritis has led to the recognition of a number of candidate viral agents. There is convincing evidence that rotavirus is the single most important cause of community acquired gastroenteritis, and is responsible for some nosocomial outbreaks. The epidemiology of rotavirus acquisition, differential clinical susceptibilities of young and older infants, pathogenesis of disease, mechanisms of immunity and breast milk protection, and the role of different viral serotypes are aspects as yet poorly understood; and attempts to propagate human rotavirus in tissue culture have met with only limited success. Moreover, the aetiologically unaccountable one third of cases of infantile diarrhoea, and the association of enteritis with up to six other virus-like particles add to the complexity of the problem. This review considers the available data from human and animal studies, and based on the experience of ourselves and others comments on the present state of knowledge and trends in continuing research.
Keywords: Gastroenteritis, Negative Contrast, Viral Agent, Viral Gastroenteritis, Viral Serotypes
Zusammenfassung
Die Untersuchung von Stuhl-Aufschwemmungen mit Negativ-Kontrast-Elektronenmikroskopie zur Erforschung der Ätiologie der Gastroenteritis im Kindesalter hat zur Entdeckung einer Reihe von in Frage kommenden viralen Erregern geführt. Es bestehen überzeugende Hinweise dafür, daß das Rotavirus die allerwichtigste Ursache für die nicht im Krankenhaus erworbene Gastroenteritis ist und daß es für einige Ausbrüche von nosokomialen Erkrankungen verantwortlich ist. Die Epidemiologie der Rotavirus-Infektion, die unterschiedliche klinische Empfänglichkeit von jungen und älteren Säuglingen, die Pathogenese der Erkrankung, Mechanismen der Immunität und Schutz durch Muttermilch sowie die Rolle verschiedener viraler Serotypen sind Aspekte, von denen wir bisher noch wenig wissen. Versuche, menschliches Rotavirus in Gewebekultur zu züchten, waren bisher nur von begrenztem Erfolg. Darüber hinaus wird die Komplexität des Problems durch das ätiologisch nicht zuordenbare Drittel von Fällen kindlicher Diarrhoe und die Assoziation der Enteritis mit bis zu sechs weiteren virusähnlichen Partikeln noch vermehrt. Die vorliegende Übersicht befaßt sich mit derzeit verfügbaren Fakten von Untersuchungen bei Menschen und Tieren und diskutiert auf der Basis eigener Erhahrung und derjenigen anderer Untersucher den gegenwärtigen Wissensstand und den Trend weiterer Untersuchungen.
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