Data from 1271 patients with perennial rhinitis has been assessed. This condition predominantly affects children and young adults; 31-5% stated that symptoms first appeared before the age of 10 years, less than 10% were aged 50 years or more suggesting that the disease process may well disappear in later life.The total sample size was equally divided between the sexes and the mean age for the sexes was similar. In terms of age distribution a sex difference was found in that the peak incidence for males occurred in the age group 10-19 years whereas for females it was in the third decade (P<0 001).The duration of the disease was, in most cases, between 2 and 9 years but it can extend to over 15 years and thus become subacute or chronic. The major symptom is blocking which could be due to either bistological changes in the mucosa or immunological reactions.Skin tests showed that 64% had a positive reaction to common allergens; however, nasal challenge tests were of little value in determining whether a patient could be classified as allergic. Eosinophils were noted in 66%. The value of skin tests and nasal smears is discussed.
An outbreak of acute nonbacterial gastroenteritis occurred among residents and staff in a nursing home in Baltimore, Maryland, in December 1980. A total of 101 residents and 69 staff members were surveyed by questionnaire. The attack rate (defined as acute onset of vomiting or two or more loose stools per 24 hours) was 46% in each group. Illness was brief and mild; no patients were hospitalized, and there were no deaths. Person-to-person transmission was documented by temporal clustering of cases (the demonstration of higher rate of illness among residents exposed to an ill roommate one or two days earlier than among those not similarly exposed; relative risk = 3.74), by a higher rate of illness among employees having daily contact with residents than among those without such contact (57% vs. 17%, p less than 0.01), and by secondary transmission to household contacts of ill employees (secondary attack rate = 33%). Three of 11 serum pairs from patients demonstrated a fourfold increase in antibody titer to the Norwalk virus between acute- and convalescent-phase specimens. The analysis of temporal clustering of cases was particularly useful in documenting person-to-person transmission in this outbreak and might be used for this purpose in other outbreaks caused by Norwalk or Norwalk-like viruses, as well as in outbreaks associated with other infectious organisms.
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