A year's experience of the rotavirus syndrome and its association with respiratory illness.

Abstract

SUMMARY In a hospital study rotavirus was identified in 51 % of 152 children with diarrhoea. These patients showed a clinical pattern that was distinct from patients in whom the diarrhoea was associated with bacteria, other viruses, or no pathogens. A respiratory illness was described in 66 % of rotavirus patients and usually preceded the gastrointestinal symptoms. Vomiting lasted between one and 3 days and was curtailed by substituting the normal diet with clear fluids. Watery diarrhoea continued for 4 or 5 days, even when rehydration was by the intravenous rather than the oral route. Prolonged diarrhoea was rare. Most children infected with rotavirus were under 2 years of age, but dehydration was most severe in infants aged between 12 and 18 months. A clinician can thus recognise the rotavirus syndrome and expect spontaneous recovery if adequate rehydration is maintained for a critical few days.

Rotavirus Viremia and Extraintestinal Viral Infection in the Neonatal Rat Model

“…One consequence is the possibility that rotavirus can be released into respiratory secretions. Rotavirus has been detected in respiratory secretions from 30 to 60% of children with rotavirus-positive stool or diarrhea (18,20,28,56) and in 100% of nasal swabs from rotavirus-infected pigs (1), suggesting that the rotavirus detected in respiratory secretions could be due to rotavirus infection of epithelial cells in the upper and/or lower respiratory tract. Our data support rotavirus replication in the lower respiratory tract and, coupled with the strong correlation of antigen levels in the lungs and stomach, suggest that rotavirus is released into respiratory secretions and swallowed, thus providing the potential for intestinal reinfection and prolonging the rotavirus infection.…”

“…However, a wide spectrum of clinical manifestations have been associated with rotavirus infection in children, including neurological complications, such as benign to severe convulsions, encephalitis, meningitis, and cerebellitis (23,31,40,42,49,(51)(52)(53); hemophagocytic lymphohistiocytosis (49); and various upper and lower respiratory tract infections, including otitis media, laryngitis, pharyngitis, and pneumonia (28,34,39,41,48). Other reports have cited Kawasaki syndrome (33), sudden infant death syndrome (54), a hepatic abscess (21), pancreatitis (38), and diabetes (22) in association with rotavirus infection.…”

Role of viruses in febrile convulsions.

“…For viral cultures each prepared specimen was inoculated on to human embryonic lung fibroblasts (MRC5), Ohio HeLa cells, and secondary monkey kidney cells (Lewis et al, 1979). CSF and heparinised blood were immediately inoculated into the tissue cultures and incubated in the treatment room where lumbar puncture and venepuncture were performed.…”

Admission to hospital with gastroenteritis.

“…Patients and methods A one year prospective study, July 1986 to June 1987, included all admissions under 16 (ii) Stool frequency and consistency The mean frequency of stools/day before admission was 5-9. Relatively more children with diarrhoea subsequently shown to be of bacterial, protozoal, or mixed pathogen aetiology (53, 36%) had a frequency of stool >7/day, compared with those with rotaviral infection (89, 26%), and those from whom no pathogen was isolated (124, 20%), p<0-001.…”