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of 280 normal children in a children's home were hospitalized with influenza, and detailed clinical and laboratory observations were made. The diagnosis was confirmed by isolation of Type B influenza virus or demonstration of a 4-fold hemagglutination-inhibiting antibody rise in 123 children. The majority of the children who were admitted had fever, headache, cough, and no localizing signs. Complications included pneumonia (3 cases), otitis media (4), and sinusitis (3 ). A 4-fold rise in hemagglutination-inhibiting antibody was demonstrated in 60% of the asymptomatic children who were not hospitalized. Influenza virus was recovered from the rectal swabbings of 11 of 96 children, a new observation which indicates that myxoviruses may be present in the feces more frequently than previously recognized. rriHERE ARE FEW CLINICAL DESCRIPin The Children's Home, Inc., Winston-Salem. This report describes the clinical find¬ ings and complications of influenza B infections in these children and methods of specific virologie diagnosis, including isolation of the virus from rec¬ tal swabbings.Description of Study Group There were 280 white children from 5 through 19 years of age living in the home. All were in good health and of normal intelligence and were living in the home for socioeconomic reasons. The 156 boys and 124 girls were assigned to cottages on the basis of age and sex. The younger children attended school at the home, but children in grades 10 through 12 attended a nearby public high school.The home had been under constant observation for infectious diseases for 2 years, with routine viral, bacterial, and sérologie studies. No similar illness was occurring in the city and no hemadsorbing agents had been isolated recently. None of the children had received influenza vaccine.During the outbreak, 182 children reported to the infirmary and were interviewed and examined by one of the authors. All children with an oral temperature of 101°F. (38.3°C.) or higher or with any abnormality on physical examination were ad¬ mitted to the infirmary. Visits were made to some cottages by a physician who referred febrile chil¬ dren to the infirmary for admission. A total of 133 children were admitted. Children were usually dis¬ charged to the cottages after their temperature had been less than 100°F. (37.7°C.) for 24 hours. Viral and bacterial cultures of the throat were obtained at the time of initial physical examination from all 133 children who were admitted to the in¬ firmary. Rectal cultures were obtained from 96 of the children. A specimen of blood was obtained if a recent specimen was not available. A second speci¬ men of blood was obtained 2 to 4 weeks after the onset of the illness. All children who did not report to the infirmary in January were interviewed in the first 2 weeks of February and a specimen of blood was obtained. Pairs of sera were available from 92% of children in the home and for 100% of children who reported to the infirmary. Laboratory MethodsCollection of Specimens.-The throat or rectum was swabbed ...

Middleton, G. K., Jr. (Bowman Gray School of Medicine, Winston-Salem, N.C.), H. G. Cramblett, H. L. Moffet, J. P. Black, and H. Shulenberger . Micro diffusion precipitin tests for enteroviruses and influenza B virus. J. Bacteriol. 87: 1171–1176. 1964.—A simple micro precipitin gel diffusion test has been adapted to the study of viral antigens. As far as is known from a review of recent literature, this is the first use of the ECHO viruses in precipitin tests and the first attempt to demonstrate by the gel diffusion technique precipitins in a patient's serum after natural virus infection rather than artificial immunization. The principal value of this technique in virology is the rapid identification or qualitative analysis of viral antigen preparations by use of pooled or specific hyperimmune sera. Virus concentrations of 10 7 tcid 50 per 0.1 ml are required for reliable results, but only 0.015 ml of serum is necessary for each test. Virus-serum precipitin reactions were type-specific except for reciprocal precipitation of ECHO 1 and ECHO 8 by their hyperimmune sera. No viral antigens have been found common to two or more virus types among those tested. Precipitins for viral antigens occur frequently in serum of patients after a viral infection and are readily detected by micro precipitin gel diffusion tests. However, this precipitin test remains at present a tool for virus and antigen identification and offers an approach for research appraisal of host response to infections.

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