To determine whether complicated febrile seizures occur more often in children with a proven viral infection, we performed viral examinations on 144 children with febrile convulsions, of whom 112 had simple and 32 had complicated seizures. A diagnosis of virus infection was verified in 46% of the former patients and 53% of the latter. Three adenoviruses, one parainfluenza virus type 2 and one type 3, one respiratory syncytial virus, one echovirus type 11, one herpes simplex virus type 2, and one influenza B virus were isolated from the cerebrospinal fluid. A simple febrile convulsion occurred in seven children with a positive cerebrospinal fluid viral isolation, and two had a complex febrile seizure. In a follow-up of 2 to 4 years (mean 3.3 years), 21 of the 107 children with simple seizures (19.6%) and 3 of the 32 children with complicated seizures (9.4%) had recurrent febrile seizures. The children with positive evidence for a viral infection, even with a virus isolated from the cerebrospinal fluid, had no more recurrences than those without any proven viral infection. We conclude that children with a proven viral infection have no worse prognosis than those without.

Subjects with allergic IgE-mediated rhinitis had more severe paranasal sinus changes in CT scans than nonallergic subjects during viral colds. These changes indicate impaired sinus functioning and may increase the risk of bacterial sinusitis.

Background. Infections cause significant morbidity in children with acute lymphoblastic leukemia (ALL). The incidence of viral infections commonly occurring in children with ALL receiving chemotherapy was compared with viral infections in control children and the spread of infections in families was traced. Methods. Fifteen families of children with ALL receiving chemotherapy (62 members) and 26 matched control families (106 members) were monitored for a total of 36,197 and 36,583 days, respectively, from November/1987 to December/1989 for the occurrence of infections. Results. The children with ALL had more infections than their control counterparts (P < 0.01) with respiratory infections the most common in both groups. Viral etiology was verified for 47 episodes [5.2/1000 days at risk, 95% confidence interval (CI) 3.9‐7.0] in the children with ALL and 22 (2.4/1000 days at risk, 95% CI 1.5‐3.7) in the control subjects (P < 0.01 for the difference). Parain‐fluenza viruses, enteroviruses, and adenoviruses were the most common agents in both groups. The infections of the other members of the patients' families were similar to those of their controls. The children most commonly fell ill first, and although children with ALL had more infections, they did not appear to spread the infections to their family members. Conclusions. The children with ALL had more infections than their controls, but they managed to recover well from viral infections caused by common respiratory viruses. The children with ALL did not change the spread of infections among family members.

A method of solid-phase enzyme-immunoassay (EIA) with horseradish-peroxidase-conjugated anti-mu-globulin was used to determine IgM antibodies to measles virus in human sera. Antigens prepared from measles-infected and noninfected Vero cells passively adsorbed to polystyrene cuvettes were both important for the tests, because sera from many patients convalescing from viral infections and sera from rheumatoid arthritis patients were able to bind to control antigen. Sera from measles patients, patients with other viral infections, rheumatoid arthritis (RA) patients, and from blood donors were tested in a dilution of 1:200. Almost all of the acute-phase measles sera (37/38) were positive. The first measles-IgM-negative specimen was found 9 weeks after the onset of rash. Seven percent (15/213) of patients with other viral infections gave positive results in these IgM tests. False-positive reactions were also found in 33 of 51 (65%) sera from RA patients. This nonspecific binding could be abolished by absorptions with latex-IgG particles. This treatment did not have any effect on specific IgM. The IgM-EIA test developed for measles virus antibodies, which requires only a single serum specimen, appears to be a useful diagnostic method for routine virus laboratories.

We carried out a prospective case-control study to analyze the etiology of respiratory tract infections among children with and without acute otitis media (AOM). Of the 658 patients admitted to our hospital during the period concerned, 197 (29.9%) had AOM, and for each such child the next patient of the same age was chosen as a control. The total number of virologically positive samples was 99 (50.3%) among the patients with AOM vs. 93 (47.2%) among the controls. The only etiologic agent that was more common in the patients with AOM was respiratory syncytial virus, found in 31 cases vs. 15 controls (relative risk [2.27]; 95% confidence interval, 1.18-4.35; P < .02). Our results confirm earlier observations from uncontrolled studies regarding the fact that respiratory syncytial virus is especially liable to cause AOM. Since respiratory syncytial virus is causing predictable epidemics, this finding could be useful for the timing of efforts to prevent AOM in young infants.