Summary
Five hundred and eighteen children under the age of five years admitted to hospital with a diagnosis of gastroenteritis over a twelve-month period were studied prospectively. Rotaviruses were demonstrated by stool electron microscopy (EM) in 132 of these cases (25·4 per cent), but in none of io8 age- and sex-matched controls. Non-specific cases, where no potentially pathogenic organism could be demonstrated in stools submitted for EM, viral and bacterial culture accounted for 46 per cent of cases. If EM of the stools had not been performed the proportion of non-specific cases would have risen to 85 per cent, thus demonstrating the importance of this technique in diagnosis.
Rotaviruses were most commonly found in winter and between the ages of six and eighteen months. A history of contact with an adult with diarrheoa, vomiting occuring before diarrhoea, accompanying upper respiratory tract infection (URTI), otitis media and pyrexia and the need for administration of intravenous fluids were all significantly more prominent features of the rotavirus than the non-specific cases of gastroenteritis, and are suggested as pointers to such a diagnosis. Pneumonia is described in three patients as an accompanying illness with rotavirus gastroenteritis.
Footnotes
Presented in part at the spring meeting of the British Society for the Study of Infection, Scottish branch, June 1979.
References
- 1.Bishop RF, Davidson GP, Holmes IH, Ruck BJ. Virus particles in epithelial cells of duodenal mucosa from children with acute non-bacterial gastroenteritis. Lancet. 1973;2:1281–1283. doi: 10.1016/s0140-6736(73)92867-5. [DOI] [PubMed] [Google Scholar]
- 2.Lewis H. Rotavirus gastroenteritis. At British Paediatric Association meetings; York; May 1978. (In press) [Google Scholar]
- 3.Madeley CR, Cosgrove BP, Bell EJ, Fallon RJ. Stool viruses in babies in Glasgow. J Hyg. 1977;78:261–273. doi: 10.1017/s0022172400056151. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Rotaviruses of man and animals. Lancet. 1975;1:257–258. Anonymous. [PubMed] [Google Scholar]
- 5.Davidson GP, Bishop RF, Townley RRW, Holmes IH, Ruck BJ. Importance of a new virus in acute sporadic enteritis in children. Lancet. 1975;1:242–246. doi: 10.1016/s0140-6736(75)91140-x. [DOI] [PubMed] [Google Scholar]
- 6.Walker-Smith J. Rotavirus gastroenteritis. Arch Dis Child. 1978;53:355–362. doi: 10.1136/adc.53.5.355. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Chrystie IL, Totterdell BM, Banatvala JE. Asymptomatic endemic rotavirus infection in the newborn. Lancet. 1978;1:1176–1178. doi: 10.1016/S0140-6736(78)90967-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.von Bonsdorff CH, Hovi T, Makela P, Mortinen A. Rotavirus infections in adults in association with acute gastroenteritis. J Med Virol. 1978;2:21–28. doi: 10.1002/jmv.1890020105. [DOI] [PubMed] [Google Scholar]
- 9.Schreiber DS, Trier JS, Blacklow NR. Recent advances in viral gastroenteritis. Gastroenterology. 1977;73:174–183. doi: 10.1016/S0016-5085(19)32293-0. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Yolken RH, Wyatt RG, Kim HW, Kapikian AZ, Chanock RM. Immunological response to human reovirus-like agent: measurement of anti-human reovirus-like agent IgG and IgM levels by the method of enzyme-linked immunosorbent assay. Infect Immun. 1978;19:540–546. doi: 10.1128/iai.19.2.540-546.1978. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Yolken RH, Wyatt RG, Barbour BA, Kim HW, Kapikian AZ, Channock RM. Measurement of rotavirus antibody by an enzyme-linked immunosorbent assay-blocking assay. J Clin Microbiol. 1978;8:283–287. doi: 10.1128/jcm.8.3.283-287.1978. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.Steinhoff MC. Viruses and diarrhoea — a review. Am J Dis Child. 1978;132:302–307. [PubMed] [Google Scholar]
- 13.Chanock RM, Wyatt RG, Kapikian AZ. Immunization of infants and young children against rotaviral gastroenteritis — prospects and problems. J Am Vet Med Assoc. 1978;173:570–572. [PubMed] [Google Scholar]
- 14.Carr ME, McKendrick GDW, Spyridakis T. The clinical features of infantile gastroenteritis due to rotaviruses. Scand J Infect Dis. 1976;8:241–243. doi: 10.3109/inf.1976.8.issue-4.04. [DOI] [PubMed] [Google Scholar]
- 15.Schnage RD, Holmes IH, Mackey-Scollay EM. A survey of rotaviruses associated with gastroenteritis in aboriginal children in Western Australia. Med J Aust. 1978;1:304–307. doi: 10.5694/j.1326-5377.1978.tb107863.x. [DOI] [PubMed] [Google Scholar]
- 16.Hieber PJ, Shelton S, Nelson JD, Leon J, Molas E. Comparison of human rotavirus disease in tropical and temperate settings. Am J Dis Child. 1978;132:853–858. doi: 10.1001/archpedi.1978.02120340029004. [DOI] [PubMed] [Google Scholar]
- 17.Vierra de Torres B, Muzzali de Ilja R, Esparza J. Epidemiological aspects of rotavirus infection in hospitalized Venezuelan children with gastroenteritis. Am J Trop Med Hyg. 1978;27:567–572. doi: 10.4269/ajtmh.1978.27.567. [DOI] [PubMed] [Google Scholar]
- 18.Rodriquez WJ, Kim HW, Arrobio JO. Clinical features of acute gastroenteritis associated with human reovirus-like agent in infants and young children. J Pediatr. 1977;91:188–193. doi: 10.1016/S0022-3476(77)80810-X. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 19.Birch CJ, Lewis FA, Kenneth MC, Homola M, Pritchard H, Gust ID. A study of the prevalence of rotavirus infection in children with gastroenteritis admitted to an infectious diseases hospital. J. Med Virol. 1977;1:69–77. doi: 10.1002/jmv.1890010109. [DOI] [PubMed] [Google Scholar]
- 20.Delage G, McLaughlin B, Berthianne C. A clinical study of rotavirus gastroenteritis. J Pediatr. 1978;93:455–457. doi: 10.1016/s0022-3476(78)81159-7. [DOI] [PubMed] [Google Scholar]
- 21.Wyn-Jones AP, Lillington AW, Alzacha A. An investigation into the possible role of the family unit in the transmission of rotavirus infections of children. Public Health. 1978;92:291–293. doi: 10.1016/S0033-3506(78)80082-1. [DOI] [PMC free article] [PubMed] [Google Scholar]