A cCMV screening program should be universal and routine to successfully screen all newborns. Maternal CMV seropositivity varies widely within the Canadian population. In the present pilot study, DBS PCR was not a sensitive screening tool and throat swab was the best screening specimen.

This study evaluated the clinical significance of human astrovirus‐associated gastroenteritis in young children in the community. Placebo‐ (n = 1207) and rhesus rotavirus tetravalent (RRV‐TV) vaccine‐ (n= 1191) recipient children were followed from 2 mo to 2 y of age. Stool specimens from 1528 episodes of acute gastroenteritis (805 in the placebo group and 723 in the RRV‐TV vaccine group) were tested for astrovirus with a sensitive reverse transcription‐polymerase chain reaction (RT‐PCR) assay and positive results were confirmed by Southern hybridization using probes specific for astrovirus serotypes 1 and 2. Astroviruses were detected in 144 (9%) episodes of gastroenteritis; 92% of the findings were serotype 1 and 6% were serotype 2. The astrovirus peak season was in winter. Of the 102 children who had gastroenteritis with astrovirus as the only diarrhoea virus in the stools, 72% had watery diarrhoea, 59% had vomiting, 26% had fever, 5% needed oral rehydration and 3% were hospitalized. Overall, the clinical severity of astrovirus gastroenteritis was much lower than that of rotavirus gastroenteritis. RRV‐TV rotavirus vaccine did not protect against astrovirus gastroenteritis. It is concluded that astroviruses are common causative agents in acute gastroenteritis in young children, but the symptoms of astrovirus gastroenteritis are usually mild and the illness is therefore only of minor clinical significance. □Astrovirus, diarrhoea, gastroenteritis, rotavirus vaccine

To investigate the incorporation of oral rhesus-human reassortant rotavirus tetravalent (RRV-TV) vaccine into a routine immunization programme, RRV-TV or oral placebo was coadministered with a pentavalent diphtheria-tetanus-whole-cell pertussis-Haemophilus influenzae b (Hib)-inactivated polio vaccine and hepatitis B vaccine following a 3-4-5-mo schedule in a double-blind trial involving 249 infants. Seroconversion rates after 3 doses of rotavirus vaccine were 80% for rotavirus immunoglobulin A (IgA) and 93% for RRV neutralizing antibodies. Rotavirus vaccine did not interfere with the immune responses to diphtheria, tetanus, pertussis, Hib, poliovirus 1, 2 and 3, or hepatitis B. Following the first, second and third doses of vaccine, fever >38 degrees C on the day of vaccination was seen in 31%, 24% and 24%, respectively, with no difference between RRV-TV- and placebo-vaccinated children. This fever was presumably due to the whole-cell pertussis vaccine. Those vaccinees who received concomitant RRV-TV vaccine had another peak of fever around d 4 after the first dose, when 25% of them had fever >38 degrees C and 3% >39 degrees C. It is concluded that RRV-TV rotavirus vaccine can be given concurrently with other childhood immunizations following a 3-4-5-mo vaccination schedule. However, febrile reactions to RRV-TV rotavirus vaccine are common when the first dose is given at the age of 3 mo.

Nous avons mis en évidence un cas d'infection aiguë par le virus de l'hépatite A (VHA) liée à l'utilisation du cannabis. Le service de santé publique local a reçu un rapport de cas concernant un homme dans la mi-vingtaine avec un tableau clinique classique d'hépatite-jaunisse, douleurs abdominales, vomissements, sensation de malaise généralisé et urine foncée-de même que des niveaux élevés d'aminotransférase sérique et un résultat positif aux anticorps IgM anti-VHA. Lors de l'interrogation, il n'a signalé aucun contact avec des personnes malades ni aucun voyage à l'extérieur de sa zone métropolitaine. Sa source d'eau exclusive était l'approvisionnement municipal local. Il a déclaré avoir consommé principalement des aliments préemballés à moindre risque provenant de grands magasins de style supermarché et avoir mangé dans plusieurs restaurants locaux. Pendant l'administration du questionnaire, l'enquêteur a déterminé que le patient avait fumé du cannabis. Sur demande, le patient a accepté de fournir un échantillon de cannabis aux fins de tests. Une élution virale de feuilles de cannabis fraîches a été effectuée. Les séquences dérivées de l'échantillon sérique du patient et de l'éluat de feuilles de cannabis étaient identiques, mais ne correspondaient à aucune autre séquence de VHA de sous-génotype 1 d'isolats canadiens dans la base de données du Laboratoire national de microbiologie. Le virus de l'hépatite A peut survivre plus de 60 jours une fois séché, à température ambiante et à une faible humidité; le VHA peut rester infectieux dans l'eau à température ambiante pendant 300 jours. On ne peut pas conclure avec certitude que le cannabis était la source de l'hépatite A. Cependant, étant donné que d'autres sources ont été exclues ou étaient de probabilité moindre, l'association du cannabis avec l'acquisition de sa maladie demeure solide.

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