Twenty year study of the occurrence of reovirus infection in hospitalized children with acute gastroenteritis in Argentina.

We studied the occurrence of reovirus infection in children hospitalized with acute gastroenteritis in Argentina during a 20-year interval (1981 through 2001). Three of 2854 (0.10%) stools were positive for reovirus but negative for adenovirus, astrovirus and rotavirus. Children infected with reovirus were <1 year old; one had meningoencephalitis in addition to gastroenteritis. This study indicates that reovirus is an uncommon cause of childhood gastroenteritis requires medical assistance.

Lack of correlation between infection with reovirus 3 and extrahepatic biliary atresia or neonatal hepatitis.

Infection with reovirus 3 (Reo-3) has been suggested as the cause of extrahepatic biliary atresia and idiopathic neonatal hepatitis, but confirmation has been lacking. Therefore we have searched for a specific anti-Reo-3 antibody response in the sera of patients with biliary atresia or neonatal hepatitis and for Reo-3 antigens in their hepatobiliary tissues. Sera from 23 infants with extrahepatic biliary atresia, 12 with neonatal hepatitis, 30 age-matched control patients with other liver diseases, and 55 control patients without liver disease were tested by an enzyme-linked immunosorbent assay for total (IgA, IgG, and IgM) anti-Reo-3 antibodies; sera of infants younger than 6 months of age were tested also for IgM anti-Reo-3 antibodies alone. There was no difference between either total or IgM anti-Reo-3 antibody levels in infants with extrahepatic biliary atresia or neonatal hepatitis and levels in control infants. Reo-3 antigens were not detected in the hepatobiliary tissues of 19 infants (18 with biliary atresia, one with neonatal hepatitis) by an immunoperoxidase method that readily demonstrated Reo-3 in control infected HEp-G2 cells. Our data do not support a relationship between neonatal liver diseases and infection with Reo-3.

Diarrhea caused by Shigella, rotavirus, and Giardia in day-care centers: prospective study.

We conducted a 19-month prospective study of children attending 20-day-care centers to determine the occurrence, causes, and transmission of gastroenteritis among children, staff, and family members. Nine centers had 15 outbreaks of diarrhea involving 195 patients. An enteropathogen was identified in all outbreaks. Shigella was detected in five outbreaks, rotavirus in two, giardia in one, and in the remaining seven multiple enteropathogens were identified. Rotavirus and Giardia occurred only in children less than 3 years of age; shigellosis occurred at all ages. In six DCC 68 single cases of diarrhea were not associated with an outbreak; an enteropathogen was identified in only three (4%) persons. Thirty-four family members (11%) developed diarrhea associated with the occurrence of gastroenteritis in children in six DCC evaluated for this problem. Secondary attack rates of diarrhea in families according to organisms identified in the DCC outbreaks were: Shigella 26%, rotavirus 15%, and G. lamblia 17%. DCC may play an important role in the epidemiology and transmission of gastroenteritis in the United States.

Stool electrolyte content and purging rates in diarrhea caused by rotavirus, enterotoxigenic E. coli, and V. cholerae in children.

One hundred twenty children below 5 years of age with diarrhea caused by Vibrio cholerae, enterotoxigenic Escherichia coli, or rotavirus were studied for stool electrolyte composition and purging rates. The mean purging rate in cholera was 60.1 ml, in ETEC 39.2 ml, and in rotavirus infection 31.4 ml/kg/8 hour. The mean stool sodium concentration in cholera was 88.9 mMol/L, in ETEC 53.7 mMol/L, and in rotavirus infection 37.2 mMol/L. Stool potassium concentration did not show much variation, Mean CO2 concentration in rotavirus infection was 6 mMol/L, significantly lower than in cholera and in ETEC diarrhea. In cholera, stool sodium concentration increased significantly with increase in purging rates; the same was not true in rotavirus and ETEC diarrhea. These differences are considered important factors in formulating replacement therapy in diarrhea.

Traveler's diarrhea associated with rotavirus infection: analysis of virus-specific immunoglobulin classes.

An enzyme-linked immunosorbent assay for the detection of rotavirus-specific immunoglobulin G (IgG), IgM, and IgA antibodies was used in a serological study of Traveler's diarrhea. The antigenically related simian rotavirus (SA-11) was used as antigen in this study. Serum was obtained from two groups of volunteers before travel (pre-travel) and at various times after arrival at their destination (post-travel). One group consisted of 47 American Peace Corps volunteers who traveled to Honduras, and the second group consisted of 66 Panamanian travelers who visited Mexico. An association between rotavirus and Traveler's diarrhea was found in each group with 36% of American Peace Corps volunteers and 30% of Panamanians with diarrhea demonstrating a greater than or equal to 4-fold increase in rotavirus antibody titers in the post- as compared to the pre-travel specimens. While no rotavirus-specific IgM antibody was detected in any serum tested, increases in specific antibody were found in both the IgG and IgA immunoglobulin classes.

[New concepts on the etiopathogenesis of diarrhea]. / Nuevos conocimientos en relación con la etiopatogenia de las diarreas

The author discusses new knowledge concerning E. coli enterotoxins and Duovirus in the production of diarrheal disease.