In October 1977 an outbreak of acute infectious diarrhea occurred in an infant home in the city of Sapporo, Japan. Of 34 residents aged two to 20 months, 26 (77%) suffered from diarrhea. In ten of these patients the diarrhea was accompanied by vomiting. Electron microscopic examinations revealed typical calicivirus particles in eight faecal specimens, seven of which were from the group of 26 affected patients (28%) and one of which was from the group of eight infants without symptoms (13%). Immune electron microscopy tests for antibody responses against one of the isolated strains of calicivirus were carried out on 27 paired pre- and post-outbreak sera. Seroconversions were demonstrated in 18 of 19 (95%) affected infants and in six of eight (75%) unaffected infants. One patient with lack of antibody response was the youngest child--two months old. Periodic surveys on enteric viruses circulating in the home revealed that calicivirus was specifically associated with the outbreak of gastroenteritis. These observations provide further evidence for the causative role of calicivirus in acute gastroenteritis in children.
Fecal shedding of virus in relation to the days of illness was studied by electron microscopic examinations of stool specimens collected during two consecutive outbreaks of gastroenteritis associated with calicivirus in an orphanage in the city of Sapporo, Japan. Of 61 stool specimens examined, 29 (48%) were found to contain typical calicivirus particles. Although caliciviruses were found in none of the seven stools obtained by chance before the onset of illness, they were found in 18 (95%) of 19 stool specimens collected within four days after the onset of illness. Seven (50%) of 14 specimens collected during the next five days were virus-positive, and the viruses were rarely detected in the stools collected thereafter. Thus correlation between viral shedding and the days of illness was clearly demonstrated. This finding should provide additional evidence for the etiologic role of calicivirus in acute infantile gastroenteritis.
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