Rotavirus diarrhoea in Thai infants and children.

ABSTRACT

PIP: During July 6-August 2, 1990, at the outpatient clinic at Children's Hospital in Bangkok, Thailand, pediatricians recruited the first 5-7 children aged less than 5 with acute diarrhea to a study to determine the incidence, clinical presentation, and severity of human rotavirus (HRV) diarrhea during the monsoon season. The study also aimed to examine the reliability of the detection methods for HRV and the different HRV electropherotypes. 103 cases of gastroenteritis were compared with 44 controls. 17% of cases had a household diarrheal contact. 18% of cases excreted HRV, while none of the controls did. 69% of HRV cases were infants. Vomiting and moderate dehydration occurred significantly more often in HRV cases than non-HRV cases (84% vs. 57% and 47% vs. 12%, respectively; p 0.05). HRV cases were more likely to receive intravenous fluids than non-HRV cases (47% vs. 19%; p 0.01). The researchers used IDEIATM ELISA as the standard for comparison with other screening methods since it is highly reliable. Electron microscopy (EM) and polyacrylamide gel electrophoresis (PAGE) had the highest sensitivity and specificity levels (84 and 90 vs. 80 for latex particle agglutination [LPA] and 100 vs. 81 for LPA, respectively). PAGE found 94.7% of HRV positive samples were of subgroup II and 5.3% of subgroup I. Nine different HRV electropherotypes were identified. EM identified adenovirus in 11 cases. These findings suggest that IDEIATM ELISA and PAGE can be both diagnostically and epidemiologically useful for HRV infection in areas with limited access to expensive equipment.