Antibodies to seven rotavirus serotypes in cord sera, maternal sera, and colostrum of German women.

Forty percent of colostrum samples from German women showed neutralizing antibody titers of greater than or equal to 50 to rotavirus (RV) serotypes 1, 3, 4, and 6. Antibody to serotypes 2, 8, and 9 was less prevalent. Titers are, however, too low to indicate an important effect of colostrum on the RV vaccine take rate. On the other hand, about 50% of the cord serum samples showed high neutralizing-antibody titers to serotypes 1, 3, and 4, which could interfere with the take rate of RV vaccines based on these serotypes in very young infants.

An outbreak of Acinetobacter calcoaceticus infection in a neonatal care unit.

Between January and December 1988, 383 neonates were admitted to our neonatal intensive care unit. 1,991 swabs and blood cultures were tested bacteriologically. Among them 90 specimens obtained from 41 patients were positive for Acinetobacter calcoaceticus. During this period we discovered and treated three cases with A. calcoaceticus sepsis. Three additional cases had blood cultures positive for this bacterium without demonstrating any clinical signs of infection. There is good evidence that contaminated warm air humidifiers were the source of infection. A review of microbiological data for several months preceding the outbreak showed a definite increase in the presence of A. calcoaceticus. The affected neonates required specific antibiotic therapy and intensive care. All of them survived. Conditions favoring the spread of these generally non-pathogenic bacteria and modes of preventive measures are discussed. The necessity of continuous bacteriological surveillance and careful disinfection of intensive care equipment is emphasized.

Seroconversion patterns to four human rotavirus serotypes in hospitalized infants with acute rotavirus gastroenteritis.

We studied rotavirus-specific antibodies in paired sera from 71 hospitalized infants with acute rotavirus gastroenteritis. Most of the infants were less than six months old. Infants with serological evidence of a secondary rotavirus infection were excluded. With an enzyme-linked immunosorbent assay, 46% of the 71 infants studied showed specific IgM in convalescent sera. Titers of specific IgG and IgA increased in 7% and 2% of the infants, respectively. The presence of specific IgM correlated positively with age and severity of clinical symptoms. With a neutralization test, 59% of the infants showed a seroconversion: 20% to a single serotype (7% to serotype 1, 7% to serotype 3, and 6% to serotype 4), 21% seroconverted to two serotypes (nearly exclusively to serotypes 1 and 3), and 18% seroconverted to three serotypes (exclusively to serotypes 1, 3, and 4). No infant seroconverted to serotype 2 or to the heterologous (bovine) serotype 6.

[Effect of various weather parameters on the incidence of inpatient treated children with stenosing laryngotracheitis (pseudocroup)]. / Einfluss verschiedener Wetterparameter auf die Häufigkeit von stationär behandelten Kindern mit stenosierender Laryngotracheitis (Pseudokrupp).

A total of 1470 hospitalized children with croup in the cities of Bochum and Herne were examined over a period of 19 years, with the aim of checking whether there was any relationship between croup incidence and changes in different weather parameters such as temperature, air pressure, absolute and relative air humidity, and wind speed. The incidence of croup was seasonal, being higher in the months of January, February, and March and from September to December. Statistical evaluation by discriminant analysis, t-test and chi 2-test showed a significant correlation (alpha greater than or equal to 0.95) between croup incidence and individual weather parameters in some months. The results seem to indicate a higher frequency of croup after decreases in temperature and influx of dry air masses (decreases in absolute humidity). In some months an increased incidence of hospitalized children with croup was observed after decreases in air pressure and during weather with extremely high (w greater than 4.5) or low (w less than 1.5) wind speed. In summary, no clear and consistent relationship between incidence of croup and particular weather parameters could be found.

Prevalence of antibodies to rotavirus in different age-groups of infants in Bochum, West Germany.

We studied the prevalence of antibody to rotavirus in 386 serum samples obtained from different age-groups of infants in Bochum, West Germany. Cord sera mirrored the IgG titer and serotype specificity of the corresponding maternal sera. IgG antibody prevalence decreased with age, reached a minimum between four and 12 months, and increased thereafter. IgM antibodies appeared first in the eight- to 12-month age-group, and IgM prevalence remained high thereafter. The serum level of IgA was low in all age-groups. Significant prevalence increases with increasing age were observed for neutralizing antibodies to rotavirus serotypes 1 and 3. Antibodies to serotype 4 had not reached adult level at 2.5 y of age. Prevalence of antibodies to serotype 2 was low in all age-groups. The percentage of monospecific sera neutralizing only one serotype was high in young infants eight to 12 months of age and decreased significantly with increasing age.

[Catamnestic studies of the vaccination status of 7,176 children in Bochum]. / Katamnestische Erhebungen über den Impfstatus von 7176 Kindern in Bochum.

7176 children, who were hospitalized between 1978 and 1983 in the Children's Hospital of the University of Bochum were analysed by the use of case histories and vaccination certificates for their status of vaccination. An age related complete vaccination status was found only in 46.7% for diphtheria, in 55.3% for tetanus and in 48.1% for poliomyelitis. A quarter of all children had not received any vaccinations for diphtheria, tetanus or poliomyelitis. Considerable gaps for at least one of these three vaccinations were found in half of all children. It was striking that especially the booster vaccinations for diphtheria in the sixth and seventh year and for tetanus and poliomyelitis in the tenth or eleventh year were frequently missed. While vaccinations for measles and mumps were increasing in younger children a general decrease for pertussis vaccination was noted. Vaccination quotes and the socio-economic situation of the families were statistically significantly correlated. Highest rats were found in children from university graduates with a decreasing tendency towards a lower socio-economic level. The situation for foreign worker families was significantly worse than for German children. However especially for these children standard vaccinations are very important as visits in there home countries produce a high incidence of exposure to infections. The general aim of the study was to find out those groups where special informations and propagations for vaccination are necessary.

[Recurrent staphylodermas in marked IgE elevation: the hyper-IgE syndrome]. / Rezidivierende Staphylodermien bei ausgeprägter IgE-Erhöhung: Hyper-IgE-Syndrom.

This is a report of a 6-year-old boy with repeated staphylococcus infections especially in the hairy region of the head. Investigating the disease an extremely elevated IgE of 10,000 KU/l was found, specific IgE in RAST only at a low level. The immunologic investigations showed a reduction of the T-suppressor-cells and an increase of IgG levels. Defects of phagocytosis or chemotaxis could not be demonstrated.

[Effect of nitrogen oxides and suspended dust in the air on the incidence of inpatient treatment of children with stenosing laryngotracheitis (pseudocroup). Results of an 8-year epidemiologic retrospective study based on inpatient case figures and area-related data of air measurements in the Bochum city district]. / Untersuchungen zum Einfluss von Stickoxid- und Schwebstaubgehalt der Luft auf die Häufigkeit von stationär behandelten Kindern mit stenosierender Laryngotracheitis (Pseudokrupp). Ergebnisse einer 8jährigen epidemiologischen Retrospektivstudie basierend auf stationären Fallzahlen und ortsbezogenen Luftmessdaten im Stadtgebiet Bochum.

Results of a recently published study over a test period of 18 years showed no relationship between croup incidence of hospitalized children and SO2 levels measured in the city of Bochum. In the following study 642 hospitalized children with stenosing laryngotracheitis were examined for a possible time-dependent relationship between croup incidence and NO2, NO- and dust immission levels measured in the city of Bochum (approx. 1000 000 readings). Evaluation of a 6-year period yielded a decrease of croup patients for the lower NO2 concentration range and a statistical increase of croup cases during days with higher NO2 concentrations. However no cause-effect relationship between both variables can be established because other determinants like infections, temperature, weather change influences, in door pollution etc., could not be excluded. Evaluation of NO levels over 3 years and dust levels over a test period of 1 year showed no statistical relationship with corresponding croup incidence.

Use of bovine milk concentrate containing antibody to rotavirus to treat rotavirus gastroenteritis in infants.

The use of a concentrate containing milk immunoglobulins prepared from rotavirus-hyperimmunized cows (neutralization titer, 1:6,000 for a 10% solution) to treat infants hospitalized for acute rotavirus gastroenteritis resulted in a significant (P = .008) reduction in the duration of excretion of virus. Stool samples from treated infants showed the presence of bovine milk immunoglobulins in 47% of cases and of neutralizing activity in 43% (mean neutralization titer, 1:48); stool samples from control infants showed neutralizing activities in only 3% of cases (neutralization titers, less than 1:20). Immunoelectrophoresis of stool extracts revealed fragment A, a bovine analogue of F(ab')2 or Fab, as the major product of in vitro and in vivo digestion of the immunoglobulins. Cessation of excretion of virus correlated with the appearance of neutralizing activities in 19 of 25 infants. Only concentrate-treated infants with high neutralizing activity in stools showed a statistically significant reduction in duration of excretion of virus; this duration in concentrate-treated infants with low neutralizing activity was comparable with controls.

Bovine milk immunoglobulins for passive immunity to infantile rotavirus gastroenteritis.

Pregnant cows were successfully hyperimmunized with all four human rotavirus serotypes, resulting in a 100-fold increase in neutralizing milk antibody titers over those of controls. Milk antibodies were isolated batchwise from 1,000 kg of pooled milk for the first 10 lactation days, yielding 10 kg of freeze-dried milk immunoglobulin concentrate consisting of 50% bovine milk immunoglobulins. Milk immunoglobulin concentrate showed neutralizing activities against all four human rotavirus serotypes that were 100 times higher than those in pooled human milk samples and 10 times higher than those in a commercial pooled immunoglobulin preparation from pooled human blood serum. In vitro neutralization tests showed that milk immunoglobulin concentrate had powerful antiviral activity, even against very high doses of infectious rotaviruses. Because the technology of the milk immunoglobulin concentrate ensures that it is innocuous and can be used for oral application, it is proposed that milk immunoglobulin concentrate be used to induce passive immunity to infantile rotavirus gastroenteritis.

Development of a monoclonal antibody specific for serotype 3 rotavirus strains.

Monoclonal antibodies were prepared against serotype 3 simian rotavirus SA11. Antigenic analysis of 18 hybridoma cell lines secreting monoclonal antibodies by radioimmunoprecipitation and Western blot revealed that seven monoclonals were directed against the major inner capsid protein VP6, four against VP3, an outer capsid protein with hemagglutinating activity, and one against VP7, the main outer capsid protein of the virus. The specificity of six monoclonals could not be determined. One monoclonal (1P14E2) directed against VP3 showed serotype 3-specific neutralizing activity. This monoclonal, which recognized only serotype 3 viruses in an enzyme-linked immunosorbent assay, could be useful in assays for serotyping rotavirus directly in stool samples.

[Results of virologic studies in 620 children with abacterial meningitis over a 15-year period (1971-1985)]. / Ergebnisse virologischer Untersuchungen bei 620 Kindern mit abakterieller Meningitis in 15 Jahren (1971-1985).

Cases of non-bacterial meningitis being hospitalized at the Children's Hospital of the University of Bochum in the years 1971 to 1985 were analysed retrospectively according to etiological and epidemiological aspects. Altogether 620 non-bacterial cases of meningitis were included in this study. For 378 (60.9%) children the infecting agent could be identified while in 242 cases (39.1%) the etiology remained open. In 237 cases enterovirus had been the causative agent. The average age of the patients was 6.5 years, boys were more frequently involved than girls (65% versus 35%). The majority of enterovirus infections occurred during the summer months July to September whereas (mumps) parotitis infections were equally distributed over the whole year. Yearly increases in certain enterovirus types were correlated to an increase in ECHO 11-infections in 1982, Coxsackie B5-infection in 1983 and 84 and ECHO 7-infection in 1985 based on data from the whole Federal Republic of Germany. However the majority of enterovirus-caused meningitis occurred during local endemics.

[Stenosing laryngotracheitis (pseudocroup) and sulfur dioxide content of the air. Results of an 18-year retrospective long-term study of possible spatial and temporal relations]. / Stenosierende Laryngotracheitis (Pseudokrupp) und Schwefeldioxidgehalt der Luft. Ergebnisse einer 18jährigen retrospektiven Langzeitstudie über mögliche räumliche und zeitliche Zusammenhänge.

Based on the immission levels measured in the city of Bochum (approx. 20,000 readings), 1200 hospitalized children with pseudocroup were examined for a possible relationship between croup incidence and sulphur dioxide levels. Evaluation according to geographic location showed no statistically significant correlation between croup incidence and SO2 levels over a test period of 13 years. Only for 3 of 13 years did Spearman's rank correlation coefficient show a weakly significant positive correlation (P less than 0.05). In one test year, however, there was a statistically significant negative correlation (P less than 0.025). Evaluation of the 16-year study in terms of time-dependent relationships yielded no significant deviation of pseudocroup incidence from the expected mean value for the individual SO2 concentration ranges. Over the period of this study, there was therefore no cause-effect relationship between sulphur dioxide levels and pseudocroup incidence.

Epidemiology of rotavirus gastroenteritis in infants from the area of Bochum as revealed by electrophoresis of genome RNA.

Rotaviruses were detected by enzyme-linked immunosorbent assay (ELISA) in stool samples from 504 infants admitted with gastroenteritis to the children's hospital of the University Bochum in the period from 1979 to 1984. In most infants rotaviruses persisted in the stools for 6-8 days. Rotavirus RNA was extracted from stool samples from 203 infants. By acrylamide gel electrophoresis, bands characteristic of rotavirus double-stranded RNA were detected in 172 (85%) of these 203 samples in which the presence of rotavirus had been demonstrated by ELISA. Of the RNA-positive samples 87% had a "long" RNA pattern. Six different electropherotypes co-circulated and one electropherotype predominated for more than 4 years. In stool samples of one infant 12 genome segments were found, suggesting the possibility of simultaneous infection by more than one electropherotype or the occurrence of modification in the length of RNA segments during infection. In another infant the sequential infection by two different electropherotypes was observed.

[Epidemiology and symptoms of stenosing laryngotracheitis (pseudo-croup) in 1322 inpatients in Bochum in the last 17 years]. / Epidemiologie und Symptomatik der stenosierenden Laryngotracheitis (Pseudocroup) bei 1322 stationären Patienten in Bochum im Verlauf der letzten 17 Jahre.

During the 17 years period from 1967 to 1983 a total number of 1322 children were hospitalized for infectious croup (stenosing laryngotracheitis) at the Children's Hospital in Bochum. The epidemiology of this disease, especially the yearly and seasonal incidence as well as clinical symptoms were analyzed. For this purpose at least 18 data were obtained from each patient and processed by computer using an especially elaborated FORTRAN IV program. The main incidence of infectious croup was in fall and winter, with a peak in September and October. The symptoms began usually at nighttime and boys were affected 2.5 times more frequently than girls. The risk of disease was highest in the second year of life and decreased sharply with the begin of school age. Sixteen per cent of the children had recurrent attacks of stenosing laryngotracheitis. The main therapeutic procedures were listed and discussed. Besides air humidification, sufficient application of liquids and steroids in serious cases, racemic epinephrine given by mask and positive pressure ventilation has been demonstrated to be very effective. While the viral etiology of this disease has been well established possibilities in which way meteorological and environmental factors might contribute to the manifestation of this disease are discussed. This problem can be solved only by prospective investigations. No statistically relevant increase in the number of cases of stenosing laryngotracheitis during recent years can be found in the presented results.

[Quantitative aberrations in serum immunoglobulins in children with acute viral hepatitis]. / Quantitative Abweichungen der Serumimmunglobuline bei Kindern mit akuter Virushepatitis.

Serum levels of IgG, IgA and IgM were determined by LASER nephelometry in 134 patients with acute viral hepatitis. Different types of hepatitis were serologically differentiated by radioimmunoassays. 102 patients had hepatitis A, 27 patients hepatitis B and 5 hepatitis non-A-non-B infections. 30 patients with hepatitis A and 9 with hepatitis B were checked in a follow-up-study. The IgA levels showed the least changes and were found to be within normal range in over 75% in hepatitis types A and B. On the other hand, IgG levels and - to a greater extent - IgM levels were found to be elevated in a great number of these patients. Levels below the 2s-range were found only rarely. Children with hepatitis B had elevated IgG and IgM in 44,4% and 33,3% of the cases. In patients with hepatitis A IgG level elevations (above 2s-range) were found in 44,2% and IgM level elevations in 96, 1% of the cases. No significant differences were found between the age Groups 0-1 year, 1-2, 3-5, 6-8 and 9-15 years of patients with hepatitis A regarding their serum immunoglobulin levels. 14 days after diagnosis a decrease of the elevated IgM was found in patients with hepatitis A parallel to an increase in the IgG values. No significant changes were observed in patients with hepatitis B. The IgA levels remained constant both in patients with hepatitis A and B infections. For hepatitis non-A-non-B a statistical evaluation was not possible due to the small number of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

[C brachydactyly in four generations]. / C-Brachydaktylie in view Generationen.

The article reports on a 18-days old female newborn with a symmetrical C-Brachydactyly with dominant inheritance. This brachydactyly type C also occurred in four further family members in four generations. The variability of symptoms and inheritance are discussed.