Haffejee I E, Moosa A
Department of Paediatrics and Child Health, Faculty of Medicine, University of Natal, South Africa.
Ann Trop Paediatr. 1990;10(2):165-72. doi: 10.1080/02724936.1990.11747425.
This study, which is the first one documenting rotavirus (RV) diarrhoea in Asian infants in South Africa, describes the virological and epidemiological aspects of this disease in this population. Fifty-five per cent of 1142 hospitalized cases investigated over a 31-month period showed a positive stool ELISA for RV. Most of these children stopped shedding RV by days 4-6 of hospital admission, though prolonged excretion was recorded in some acute cases for up to 13 days. Mixed RV-bacterial infections occurred in 7% of the total gastro-enteritis (GE) patients, while 8.6% had pure bacterial gastro-enteritis. Sixteen per cent of 188 GE patients had serum anti-RV complement-fixing (CF) antibodies on admission. Rotavirus diarrhoea occurred in half of the seropositive infants. Seroconversion occurred in only two-thirds of the initially seronegative children who had RV diarrhoea. In 5.6% of the RV diarrhoea patients the infection was acquired nosocomially whilst in the hospital for other illnesses. The age-groups mainly affected were between 3 and 14 months, with a peak at 9-11 months; 3% of the RVGE patients were neonates. Both the RVGE and the total GE admissions showed well-marked winter peaks, with an inverse relationship between RV prevalence and both temperature and humidity. It is concluded that RV is the most important cause of infantile GE in this population, whereas pure bacterial infections play a relatively minor role. Circulating anti-RV antibodies do not necessarily afford protection against RV diarrhoea, probably owing to serotypic differences.
本研究是首篇记录南非亚洲婴儿轮状病毒（RV）腹泻情况的研究，描述了该人群中这种疾病的病毒学和流行病学特征。在31个月期间调查的1142例住院病例中，55%的粪便ELISA检测显示RV呈阳性。这些儿童中的大多数在入院第4至6天停止排出RV，不过在一些急性病例中，RV排泄延长记录至13天。混合性RV-细菌感染发生在7%的胃肠炎（GE）患者中，而8.6%的患者患有单纯细菌性胃肠炎。188例GE患者中有16%在入院时血清抗RV补体结合（CF）抗体呈阳性。轮状病毒腹泻发生在一半的血清阳性婴儿中。血清转化仅发生在三分之二最初血清阴性但患RV腹泻的儿童中。在5.6%的RV腹泻患者中，感染是在住院治疗其他疾病期间医院内获得的。主要受影响的年龄组在3至14个月之间，9至11个月达到高峰；3%的RVGE患者为新生儿。RVGE和总的GE入院病例均呈现明显的冬季高峰，RV流行率与温度和湿度均呈负相关。得出的结论是，RV是该人群中婴儿GE的最重要病因，而单纯细菌感染起的作用相对较小。循环抗RV抗体不一定能提供针对RV腹泻的保护，可能是由于血清型差异。
