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儿童哮喘研究所及医院的流行性急性感染性非细菌性肠胃炎

Epidemic acute infectious nonbacterial gastroenteritis at the Children's Asthma Research Institute and Hospital.

作者信息

Judson F N, Molk L

出版信息

Am J Epidemiol. 1975 Sep;102(3):251-6. doi: 10.1093/oxfordjournals.aje.a112154.

Abstract

During the period from September 8 to October 2, 1970, 44 of the 120 children and 78 of 141 adults questioned at the Children's Asthma Research Institute and Hospital experienced gastroenteritis characterized by nausea, vomiting, and fever and/or chills. Diarrhea was rare in children (4.5%) and common in adults (74%). The median duration of illness for children, 18 hours, was significantly shorter than the 48 hours for adults. All viral and bacterial cultures of 30 stool specimens were negative for viruses and bacterial pathogens. A retrospective survey of 28 ill employees revealed a secondary attach rate of 46% of 76 family contacts. A bacteria-free filtrate prepared from stool swab specimens of 2 ill adults by a team at the National Institute of Allergy and Infectious Diseases was administered orally to 3 adult volunteers. One of the 3 vomited and had 4 watery diarrheal stools on the third post-inoculation day. Diarrheal stool filtrates from this person were then given orally to 8 others; 1 became ill. Although the epidemiologic features point to the respiratory route of infection, the probably successful serial transmission of disease via bacteria-free stool filtrates through 2 generations of volunteers also suggests that the "Denver agent" is a virus-sized particle that replicates in the gastrointestinal tract.

摘要

1970年9月8日至10月2日期间,在儿童哮喘研究所及医院接受询问的120名儿童中有44名,141名成人中有78名出现了以恶心、呕吐、发热和/或寒战为特征的肠胃炎。腹泻在儿童中少见(4.5%),在成人中常见(74%)。儿童疾病的中位持续时间为18小时,明显短于成人的48小时。对30份粪便标本进行的所有病毒和细菌培养,结果显示病毒和细菌病原体均为阴性。对28名患病员工进行的回顾性调查显示,76名家庭接触者的二代感染率为46%。国立过敏和传染病研究所的一个团队从2名患病成人的粪便拭子标本中制备了一种无细菌滤液,并口服给3名成年志愿者。3名志愿者中有1人在接种后第三天出现呕吐和4次水样腹泻。然后将此人腹泻粪便的滤液口服给另外8人;其中1人患病。尽管流行病学特征表明感染途径为呼吸道,但通过无细菌粪便滤液在两代志愿者之间可能成功地进行了疾病的连续传播,这也表明“丹佛病原体”是一种在胃肠道中复制的病毒大小的颗粒。

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