SUMMARY The pattern of virus isolation and illness was studied in 64 children with acute lymphoblastic leukaemia (ALL) during periods of apparent infection and when the children were well. The virus isolation rate of 2.2 viruses per child a year is similar to that previously found in normal children. In only 32% of children with symptoms were viruses found and 14.5% had viruses isolated when asymptomatic. The children with ALL appear to be more vulnerable to multiple virus infections and to excrete the virus for longer periods. This may be due to failure of production of both local and systemic antibodies. The failure in the past to recognise the true importance of virus infections in ALL may have been due to inadequate diagnostic techniques.Infections are playing an increasingly important role in the death of children with acute lymphoblastic leukaemia (ALL) and viruses are emerging as important pathogens . While it is recognised that varicella zoster and measles may be particularly severe in the immunosuppressed host (Feldman and Cox, 1976), it has been suggested that the common upper respiratory virus infections are neither more frequent nor more severe in children with ALL (Levine et al., 1974). However, there has been little systematic study of virus infections in this disease. In the present investigation viruses were studied in children with ALL, both when an infection was suspected and when the children were well. The results are presented in the light of locally acquired experience of virus infections in normal children. Patients and methods 64 children with ALL, 34 boys and 30 girls, were followed for at least 2 months, some for as long as 33 months. Their ages at diagnosis ranged from 1 1 to 14 years. All were being treated with conventional combination chemotherapy and prophylactic cranial irradiation and most were on a modified ALGB 6801 regimen . During the initial phase of the investigation children were studied only when they were suspected of having an infection. 31 such children were followed for a total of 468 patient months. The remaining 33 children were investigated when they were infected and also routinely at monthly intervals. They were followed for a total of 397 patient months. When an infection was suspected a specimen of nasopharyngeal secretion was investigated by the fluorescent antibody technique (FAT) (Gardner and McQuillin, 1974