Studies of bacterial, rotaviral and Cryptosporidium etiology of acute diarrheal diseases in hospitalized children.

657 hospitalized children with acute diarrheal disease were studied for bacterial and rotaviral etiology. Cryptosporidium presence was followed in 123 children. Intestinal pathogens were detected in 195 (29.6%) cases: 132 (20.3%) enterobacteria, 47 (7.1%) rotaviruses, 4 (3.2%) Cryptosporidium sp. and 12 (1.8%) combined infections. Among enterobacteria, E. coli was the most frequent (10% cases) with enteropathogenic (EPEC), enterotoxigenic (ETEC), enterohemorrhagic (EHEC) and enteroinvasive (EIEC) groups. Other isolated pathogens were Salmonella--21 (3.1%), C. jejuni/coli--13 (1.9%), Shigella--3 (0.9%), Y. enterocolitica O3--1 (0.1%). Among opportunistic pathogenic enterobacteria, the following were isolated: Kl. pneumoniae--24 (3.7%), Enterobacter species--4 (0.6%), Providencia alcalifaciens--1 (0.1%). Aeromonas hydrophila was isolated in 1 child. Combined infections were detected in 12 children: 10--enterobacteria + rotaviruses associations and 2--pathogenic enterobacteria associations.

Epidemic outbreak of Coxsackie virus meningitis. Note II. Virological and serological investigations.

Virological and serological investigations of the viral meningitis cases recorded in a county of Romania in the summer of 1975 demonstrated that in a certain zone (A) the prevalent etiological agent was Coxsackie B3 virus. This virus could be isolated from the feces, exudate or cerebrospinal fluid of some diseased children. At the same time, the appearance of neutralizing antibodies to Coxsackie B3 virus or significant titer increases were observed in 20 of the 25 children tested serologically in zone A.

[The presence of enterovirus in species of shellfish and fish]. / Entérovirus présents sur quelques espèces de coquillages et de poissons.

Enteroviruses were isolated from 12% of the digestive tract samples collected from Anodonta cygnea (9.4%) and Dreysena polymorpha (13.2%) shell species and from 8.4% of the branchiae sample from fish species Rutilus rutilus, Perca fluviatilis and Silurus glanis. The isolated belonged to the following antigenic types: ECHO 2 and 7, Coxsackie B 2, 4 and 6, and poliovirus 1 and 2.

Preliminary data on the survival length of enteroviruses in nonalcoholic beverages. Inactivating action of some medicinal herb infusions.

Vaccinal poliovirus type 1, Coxsackie B3 virus and echovirus type 1 survived in mineral water, camomile infusion and coffee for over 20 days. In contrast, Chinese tea, lime and mint infusions had a possibly transient inactivating effect on the same enterovirus strains. There was a direct relationship between the concentration of the infusions and their inactivating action. The vaccinal poliovirus was more sensitive than Coxsackie and echoviruses to the inactivating action of the infusions.

[Risk of transmission of enterovirus from the surface of toilets]. / Investigations concernant les risques de transmission des entérovirus par l'intermédiaire des surfaces des cabinets.

Experimental studies using dyes and microbial agents as indicators showed that a viral contamination of the various surfaces of the water closets is possible through the droplets formed when one flushes the W.C. pan. An investigation conducted in several public water closets allowed to reveal the presence of enteroviruses in 2.8% to 5.8% of the samples collected from various surfaces of the water closets. The results of the investigations showed that the hinged seats were contaminated the most frequently (6.8% of the samples).

[Mixed viral-bacterial infections in infants with gastroenteritis]. / Infections mixtes virobactériennes chez des enfants atteints de gastro-entérite.

Fecal specimens from 84 children with gastroenteritis were submitted to virological and bacteriological analysis. Enteroviruses other than poliovirus were found in 8.3%, rotavirus in 4.8% and enterobacteria in 1.9% of the investigated subjects. Mixed infections were detected in 8.4% of the cases.

Surveillance of enterovirus circulation in children communities.

In three children communities covered by a virological study enteroviruses could be isolated from 19.3% of the stool samples, 52.3% of the sewage samples and 9.7% of the samples taken from different objects and surfaces. The isolates belonged to 14 enterovirus serotypes, Coxsackie viruses being predominant. There was a good concordance between the serotypes of enteroviruses shed in the stools and those isolated from the environment. The high epidemiological potential of enteroviruses calls for a surveillance of their circulation in children communities, preferably by the virological monitoring of sewage.

[Virologic research on the quality of 2 sources of drinking water from zone "I"]. / Investigations virologiques sur la qualité de deux sources d'eau potable de la zone "I".

Enteroviruses were isolated from 4.6% out of the examined tap water samples. No relation could be established between viral pollution and classic quality indexes of water.

[Clinico-epidemiologic and laboratory studies of patients with primary hepatocellular carcinoma]. / Investigatii clinico-epidemiologice si de laborator la bolnavi cu carcinom hepatocellular primar.

The investigations carried out in 92 patients with confirmed diagnosis of primitive hepatocellular carcinoma (HCC) have demonstrated that in almost half of them hepatitis was present in their antecedents, indicating the intervention of hepatitis virus in the etiology of this disease. In this context, the primary prophylaxis of primitive HCC is mainly based on the prophylaxis and control of viral hepatitis. As the interval detection-death was in most cases very short (1-2 month), the secondary prophylaxis consisting in performing more of the investigations recommended for the early diagnosis of primitive HCC is essential.

Enterovirus contamination of swimming pool water; correlation with bacteriological indicators.

The investigation of swimming pool water samples revealed the presence of enteroviruses (in 28.4% of the samples), as well as of coliforms, fecal streptococci, staphylococci and Candida albicans (in proportions ranging from 37.0 to 86.9% of the samples). A direct correlation could be established between the extent of viral and microbial pollution and the length of stagnation of the swimming pool water.

Coxsackie A virus-associated herpetiform angina.

Virological investigations were performed in 25 herpangina cases that occurred in a large urban centre in the summer season of 1982. Twelve Coxsackie A virus strains (10 Coxsackie A5 strains, one Coxsackie A4 and one Coxsackie A6 strain) could be isolated from 9 (36.0%) of the patients.

Enteroviral etiology of some epidemic outbreaks in a zone of Romania.

The authors describe three enterovirus epidemics: an outbreak of Coxsackie B1 epidemic myalgia, one of echovirus 4 meningitis and one of epidemic vomiting and diarrhea caused by Coxsackie A9 virus. Etiological diagnosis was established by virological and serological tests.

Presence of hepatitis B antigen in the saliva of viral hepatitis patients.

The presence of hepatitis B antigen (HBsAg) in the saliva of 14 (43.7%) out of 32 patients with viral hepatitis (VH) and antigenemia was revealed by discontinuous counter-immunoelectrophoresis. HBsAg was found in the saliva of both children and adults, more frequently during the first weeks after the onset of illness. The findings point out the possibility of non-parenteral VH transmission (kissing, sneezing, dishes, toys, etc.).

Epidemic outbreak of Coxsackie virus meningitis. Note I. Clinico-epidemiological features.

An epidemic outbreak of viral meningitis mainly caused by Coxsackie B3 virus is described. Characteristic of the outbreak was the involvment of a large number of infants under 1 year of age (about 1/4 of the total number of cases) and the elevated incidence of encephalitis symptoms, as compared with the meningitis outbreak caused by echovirus 4 in 1973.

[Enzymatic aspects of severely acute diarrheal disease in infants]. / Aspectele enzimatice în boala diareica acuta grava a sugarului.

Acute dehydration of diarrhoea of the breast-fed child is a type of hypovolemic shock which, by its severity and frequency is one of the major emergencies of pediatrics. The liver, as the site of many metabolic processes is mainly affected in the frame of the multiple-tissue involvement which is characteristic for this condition. The authors carried out a study of several enzymes (total LDH and the thermally-labile fraction, gluthamatdehydrogenase, gammaglutamyltranspeptidase, acid and alkaline phosphatase) in 27 breast-fed children. Determination of the enzymes was done on hospitalization, and 10 days later. The study showed that all the enzymes that were evaluated had moderate increases in 40.7-71% of all cases. The increases were significant (p less than 0.001). After 10 days the enzyme titers showed a tendency to become normal again, and slightly higher values were found in only 15-12% of all cases. Minimal hepatopathy can be considered, associated to the clinico-biological evolution of this severe conditions of the breast-fed child pathology.

[Epidemiological investigations among the viral hepatitis contact in a close children collectivity]. / Investigatii epidemiologice printre contactii de hepatita virala dintr-o colectivitate închisa de copii.

The results of the clinico-epidemiological and laboratory (TGP, tymol and HBsAg) investigations carried out in 164 contacts of an icteric case of viral hepatitis from a creche type children collectivity are presented. A wide spread of the infection, expressed by subclinical forms of disease identified on the basis of the alterations of TGP and their dynamics (27.4%) was pointed out. The increased incidence of HBsAg carriers and the correlation with the TGP increased values allowed the conclusion that the infection was caused by the hepatitis virus type B. The epidemiological investigation established that the infection was transmitted by direct contact favoured by children's close physical contact.

Our experience in viral hepatitis (VH) immunoglobulin prophylaxis.

Two experiments on 72 888 children, out of which 36 270 received standard immunoglobulins (IG) and another 36 618 represented the control group, were carried out. IG was administered preventatively, during autumn before the occurrence of the annual peak, and in focus after contact with VH patients. Prophylactic IG administration led to a 4-14 fold decrease in the incidence of icteric VH as compared with controls, and to the disappearance of the peak characteristic of autumn-winter. The efficacy lasted for 5-6 months. The incidence of subclinical VH forms--as evaluated by clinical examinations and SGPT was about 3 times lower in IG pre-exposure recipients. In the group of children where IG was administered only to the contacts in epidemiological foci, the incidence of icteric VH remained as high in the controls and the incidence of subclinical VH forms was twice as high in the controls.

[Presence of the rotavirus antigen in newborn infants at maternity hospitals in Moldavia]. / Présence de l'antigène rotaviral de groupe chez des nouveau-nés des maternités de Moldavie.

Studies conducted on 417 feces samples collected from newborn infants from seven maternity homes revealed the presence of rotavirus in 1.2 to 9.5% of the subjects. The infants get infection during the first 24 to 48 hours of life (1.8%) and the positivity rate reaches a peak the 7th day (9.7%). Enteroviruses were found in 3.4% and enterobacteria in 11.8% of the samples.

[Incidence of HBsAg among different population groups in Moldavia in 1991 compared with 1973]. / Incidence de l'AgHBs dans différents groupes de population de Moldavie en 1991 par rapport à 1973.

AgHBs incidence in various population groups from the Iassy region was relatively high in 1991, ranging from 3.8% in blood donors to 75.0% in patients with severe acute virus hepatitis. As compared to the incidence values recorded in 1973, 18 years ago, in the population of the same territory, some mutations were observed, the most important being the more then threefold reduction of the AgHBs incidence in blood donors. In subjects with liver diseases and in risk groups, the frequency of AgHBs carriers maintains at a high level.