American Pediatric Society Presidential Address

Hodes, Horace L.

doi:10.1203/00006450-197603000-00012

Cited by 9 publications

(1 citation statement)

References 8 publications

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“…The initial stool sample contained only one to two HRVs per grid square, but a subse¬ quent diarrheal stool sample con¬ tained large numbers of HRVs Mean total duration of illness, days (range) 6.8 (2-10) 9.0 (3-16) 5 throughout the year and, even in the dry season from December through March, the relative humidity averages 75% to 80% (Fig 4). In Dallas, the mean monthly relative humidity fluctuates between 25% and 60%, roughly in rela¬ tion to the number of days of rain and the mean daily temperatures average greater than 27°C in midsummer and drops to 10°C or lower in the midwinter months (Fig 5).…”

Section: Resultsmentioning

confidence: 99%

Comparison of Human Rotavirus Disease in Tropical and Temperate Settings

Hieber¹

1978

Arch Pediatr Adolesc Med

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\s=b\Human rotaviruses (HRV) are a common cause of acute nonbacterial gastroenteritis in pediatric patients. A prospective study of HRV disease in a temperate (Dallas) and a tropical (San Jose, Costa Rica) setting demonstrated differences in seasonal distribution. In both locales, HRV accounted for 50% to 60% of acute nonbacterial gastroenteritis episodes from December through February; this period corresponded to the cooler months of winter in Dallas and to the dry season in San Jose. During the rest of the observation year, the virus was not recovered from any Dallas patients, but was found in 30% to 40% of Costa Rican patients in every month but May. Signs, symptoms, and laboratory values suggest the small bowel as the major site of pathophysiology; mucosal disruption may occur in some cases.(Am J Dis Child 132: [853][854][855][856][857][858] 1978) The recent application of electron microscopic techniques to the study of fecal viruses' has resulted in the recognition of a close association between the excretion of human rotaviruses (HRV) and the acute nonbacterial gastroenteritis of infan¬ cy commonly known as "winter vomit¬ ing disease."2 ' Rotaviruses are char¬ acterized by a double-stranded RNA core surrounded by a distinctive double-layered capsid with an outside diameter of 70 nm. These agents were formerly considered as solely veteri¬ nary and plant pathogens/7 They have now been confirmed as impor¬ tant causes of winter season epidem¬ ics of acute nonbacterial gastroenteri¬ tis from many areas of the world.812With the exception of the recent Reprint requests to 5323 Harry Hines Blvd, Dallas, TX 75235 (Dr Hieber). seasonal distribution of HRV excre¬ tion has not been prospectively stud¬ ied in a tropical setting that has no winter season, but only rainy and dry seasons. In the latter study of 50 patients during a one-year period, HRV was recovered from 13 patients (26%) during the cooler months of July through December. No patients could be studied from January through March and no HRV was recovered from April through May. None of the 30 control patients were found to be excreting HRVs.We have compared the seasonal distribution of HRV disease in a temperate (Dallas) and tropical area (San Jose, Costa Rica). METHODSA number of infants and children young¬ er than 8 years of age who were seen in the outpatient department or were hospital¬ ized for nonspecific acute gastroenteritis were selected for study. Patients with clin¬ ical features suggestive of a bacterial pathogen, such as high fever or bloody stools, were excluded. Informed, written parental consent was obtained. Acute serum and stool specimens were obtained from patients and, whenever possible, convalescent specimens were obtained sev¬ en to 14 days later. Similar samples were collected from an age-matched control subject in many instances; these patients and their families had not had acute gastroenteritis in the previous week and were being treated for ailments unrelated to the gastrointestinal (GI) tract (frac¬ tures, respiratory and urinar...

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Section: Resultsmentioning

confidence: 99%