RESUMEN
This report describes the results of additional analyses of the trial carried out with the rhesus rotavirus-based quadrivalent vaccine in Venezuela. In the present study, we re-examined the data from this previous rotavirus vaccine trial to assess the statistical interaction between vaccine efficacy and (i) the duration of efficacy into the second year of life, (ii) socioeconomic conditions, and (iii) rotavirus seasonality. We found that among Venezuelan children, the rotavirus vaccine confers protection against severe diarrhea during the first 2 years of life independently of socioeconomic conditions and seasonality.
Asunto(s)
Infecciones por Rotavirus/epidemiología , Infecciones por Rotavirus/prevención & control , Rotavirus/inmunología , Vacunas Virales/farmacología , Factores de Edad , Animales , Diarrea/epidemiología , Diarrea/prevención & control , Método Doble Ciego , Femenino , Humanos , Lactante , Macaca mulatta , Masculino , Estaciones del Año , Factores Socioeconómicos , Venezuela/epidemiologíaRESUMEN
BACKGROUND: Rotaviruses are the principal known etiologic agents of severe diarrhea among infants and young children worldwide. Although a rhesus rotavirus-based quadrivalent vaccine is highly effective in preventing severe diarrhea in developed countries, in developing countries its efficacy has been less impressive. We thus conducted a catchment study in Venezuela to assess the efficacy of the vaccine against dehydrating diarrhea. METHODS: In this randomized, double-blind, placebo-controlled trial, 2207 infants received three oral doses of the quadrivalent rotavirus vaccine (4x10(5) plaque-forming units per dose) or placebo at about two, three, and four months of age. During approximately 19 to 20 months of passive surveillance, episodes of gastroenteritis were evaluated at the hospital. RESULTS: The vaccine was safe, although 15 percent of the vaccinated infants had febrile episodes (rectal temperature, > or =38.1 degrees C) during the six days after the first dose, as compared with 7 percent of the controls (P<0.001). However, the vaccine gave 88 percent protection against severe diarrhea caused by rotavirus and 75 percent protection against dehydration, and produced a 70 percent reduction in hospital admissions. Overall, the efficacy of the vaccine against a first episode of rotavirus diarrhea was 48 percent. Horizontal transmission of vaccine virus was demonstrated in 15 percent of the vaccine recipients and 13 percent of the placebo recipients with rotavirus-positive diarrhea. CONCLUSIONS: In this study in a developing country, the quadrivalent rhesus rotavirus-based vaccine induced a high level of protection against severe diarrheal illness caused by rotavirus.
Asunto(s)
Diarrea Infantil/prevención & control , Infecciones por Rotavirus/prevención & control , Vacunas contra Rotavirus , Vacunas Virales , Anticuerpos Antivirales/sangre , Deshidratación/etiología , Deshidratación/prevención & control , Países en Desarrollo , Diarrea Infantil/complicaciones , Diarrea Infantil/virología , Transmisión de Enfermedad Infecciosa , Método Doble Ciego , Femenino , Hospitalización , Humanos , Lactante , Masculino , Rotavirus/clasificación , Rotavirus/inmunología , Infecciones por Rotavirus/complicaciones , Infecciones por Rotavirus/transmisión , Venezuela , Vacunas Virales/efectos adversos , Vacunas Virales/inmunologíaRESUMEN
In a four cell trial, a single 10(4) plaque-forming unit dose of rhesus rotavirus (RRV) vaccine (serotype G3), a human rotavirus-rhesus rotavirus reassortant vaccine with serotype G1 specificity, a similar vaccine with serotype G2 specificity, or a placebo was administered with buffer orally at 2 months of age to 800 Peruvian infants. Only the RRV vaccine was associated with a febrile response (< 38 degrees C) that occurred in 9% of the infants on day 4 after vaccination. Diarrhea or other side-effects were not associated with administration of vaccine. Vaccine strains were shed by only 12-18% of the infants as determined by examination of a single stool specimen obtained on days 4 or 5 after vaccination. Fifty per cent of vaccines developed an IgA ELISA seroresponse; however, a serotype-specific seroresponse by plaque reduction neutralization was demonstrated in < 20% of the participants against each of the three candidate vaccine strains. Vaccine efficacy was evaluated by twice-weekly home surveillance for diarrheal diseases during 24 months post-immunization. Rotavirus diarrheal episodes were identified by ELISA. Only the RRV vaccine had a significant protective efficacy (29%, p = 0.03, chi-square test) against rotavirus diarrhea. Analysis of vaccine efficacy against rotavirus episodes of any severity in which no other enteropathogen was isolated showed a trend towards higher vaccine efficacy. In addition, a similar trend was observed in rotavirus-only episodes in which there was some degree of dehydration or when health services were utilized. Serotype G1 or G2 rotavirus strains were most prevalent during surveillance. Neither serotype G1 or serotype G2 vaccines were protective against serotype 1 or 2 rotavirus diarrhea, respectively. The serotype G2 vaccine was 84% protective against serotype 1 and 2 dehydrating rotavirus diarrhea in the small numbers of individuals evaluated. We conclude that one dose of 10(4) p.f.u. of the RRV, serotype G1, or serotype G2 rotavirus vaccine failed to induce either an adequate serotype-specific seroresponse or serotype-specific protection in children immunized at 2 months of age. Only the RRV vaccine induced a low level of protection against rotavirus diarrhea mainly of serotype G1 specificity. Future studies need to explore whether higher vaccine dose and/or more than one dose would increase the immunogenicity and efficacy of the rotavirus vaccine, especially in developing countries with a high level of baseline rotavirus antibodies.
Asunto(s)
Diarrea Infantil/prevención & control , Infecciones por Rotavirus/prevención & control , Vacunas contra Rotavirus , Rotavirus , Vacunas Virales/administración & dosificación , Método Doble Ciego , Humanos , Lactante , PerúRESUMEN
The efficacy of a rhesus rotavirus vaccine (MMU 18006, serotype 3) against infantile diarrhea was evaluated by active home surveillance of a group of 320 children 1-10 months of age in Caracas, Venezuela. During a 1 year period following oral administration of vaccine or placebo under a double-masked code, over 600 diarrheal episodes were detected. Etiologic studies revealed that heat-stable toxin (ST) producing enterotoxigenic E. coli (ETEC) was the most common diarrheal agent detected (34%) followed by enteropathogenic E. coli (EPEC, 10.9%), heat-labile toxin (LT) producing ETEC (7.6%), rotavirus (6.9%), Cryptosporidium (4.8%) and Campylobacter (1.3%). ST-producing ETEC were also recovered from over 20% of control stool specimens obtained during diarrhea-free periods, whereas EPEC, rotavirus, Cryptosporidium, and Campylobacter were rarely detected in such control specimens. Rotavirus was responsible for about one-half of the more severe cases of diarrhea. Twenty-two of 151 infants who received placebo (14.6%) and eight of 151 receiving a 10(4) PFU dose of vaccine (5.3%) had rotavirus diarrhea during the follow-up period for an efficacy level of 64% against any rotavirus diarrhea. However, vaccine efficacy reached 90% against the more severe cases of rotavirus diarrhea and was noticeably high in the 1-4 month age group. Serotypic analysis of the rotaviruses detected suggests that the resistance induced by the vaccine was type specific since significant protection was only evident against serotype 3 rotaviruses. A 10(3) PFU dose tested initially in 18 children did not appear to protect against rotavirus diarrhea.
Asunto(s)
Diarrea Infantil/prevención & control , Vacunas contra Rotavirus , Rotavirus/inmunología , Vacunación , Vacunas Atenuadas , Vacunas Virales/administración & dosificación , Pruebas de Fijación del Complemento , Diarrea Infantil/microbiología , Diarrea Infantil/parasitología , Método Doble Ciego , Evaluación de Medicamentos , Ensayo de Inmunoadsorción Enzimática , Escherichia coli/aislamiento & purificación , Heces/microbiología , Humanos , Lactante , Recién Nacido , Pruebas de Neutralización , Estudios Prospectivos , Distribución Aleatoria , Rotavirus/aislamiento & purificación , Venezuela , Vacunas Virales/efectos adversosRESUMEN
Phase I studies of an oral quadrivalent rotavirus vaccine were conducted in 130 Venezuelan infants 10 to 20 weeks of age. The vaccine consists of a mixture of equal amounts of rhesus rotavirus (RRV) vaccine (serotype 3 [VP7]) and each of three human rotavirus-RRV reassortant strains: D x RRV (serotype 1 [VP7]), DS1 x RRV (serotype 2 [VP7]), and ST3 x RRV (serotype 4 [VP7]). Three different doses of the quadrivalent vaccine (0.25 x 10(4), 0.5 x 10(4), and 10(4) PFU of each component) were evaluated sequentially for safety and antigenicity in placebo-controlled, double-blind trials. Starting the day after vaccination, the infants were monitored by daily home visits for 7 days. Only minor reactions were observed during this period; these were limited to mild transient febrile episodes which began day 2 or 3 after vaccination and lasted 1 to 2 days in 15 to 30% of the infants. Serological studies demonstrated that 68 to 96% of the infants developed a rotavirus serum immunoglobulin A response following vaccination. However, when tested by plaque reduction neutralization assay against individual human rotavirus serotype 1, 2, 3, or 4, the response rates ranged from 4 to 23% with the low dose, 21 to 33% with the medium dose, and 32 to 58% with the high dose. Most (73 to 79%) infants developed neutralizing antibodies to RRV following administration of each dose schedule. Vaccine virus shedding was analyzed by utilizing tissue culture isolation of virus from stool. All of the infants who received the lower of medium dose and 89% of those fed the high dose shed one or more components of the vaccine. Analyses of rotavirus serotypes isolated from the stool of infants who received the 0.25 x 10(4) -PFU dose revealed that DS1 x RRV was the most commonly shed vaccine component, followed by RRV, D x RRV, and ST3 x RRV in that order.
Asunto(s)
Anticuerpos Antivirales/biosíntesis , Rotavirus/inmunología , Vacunas Virales/inmunología , Administración Oral , Método Doble Ciego , Evaluación de Medicamentos , Ensayo de Inmunoadsorción Enzimática , Heces/microbiología , Estudios de Seguimiento , Humanos , Inmunoglobulina A/biosíntesis , Lactante , Pruebas de Neutralización , Ensayos Clínicos Controlados Aleatorios como Asunto , Rotavirus/aislamiento & purificación , Vacunas Virales/administración & dosificación , Vacunas Virales/efectos adversosRESUMEN
A randomized placebo-controlled double-blind field trial of RIT 4237 attenuated rotavirus vaccine in Lima, Peru, evaluated the protection against diarrheal illness by one, two, or three doses of vaccine. There were 391 children, 2-18 months old, studied for the occurrence of diarrhea during the 18 months after vaccination. Three doses of the vaccine provided 40% protection against any diarrheal illness associated with rotavirus alone but 58%-75%; protection against the more severe rotaviral illnesses. The vaccine appeared to be more efficacious when it was administered to children in the first year of life. Three doses provided up to 89% efficacy against more severe diseases due to serotype 1 rotavirus, and one dose also afforded significant protection. The protection was lower, even with three doses, against serotype 2 rotavirus. This vaccine trial has provided important insights on how such trials should be conducted and on the serotype-specificity of protection from rotavirus infection. Future vaccines should be able to protect against severe disease caused by all rotavirus serotypes and must work in developing countries where rotavirus is the most important cause of diarrheal mortality.
Asunto(s)
Diarrea/prevención & control , Infecciones por Rotavirus/prevención & control , Rotavirus/inmunología , Vacunas Atenuadas/administración & dosificación , Vacunas Virales/administración & dosificación , Anticuerpos Antivirales/biosíntesis , Preescolar , Relación Dosis-Respuesta Inmunológica , Humanos , Lactante , Perú , Rotavirus/clasificación , SerotipificaciónRESUMEN
The reactions to and antigenicity of two human-rhesus rotavirus (RRV) reassortants (human rotavirus strain D x RRV and human rotavirus strain DS1 x RRV) with the VP7 neutralization specificity of a serotype 1 or serotype 2 rotavirus were evaluated in a placebo-controlled double-blind trial in 116 1- to 5-month-old infants in Caracas, Venezuela. The children were randomly divided into five groups to receive orally the following inocula: (i) 10(4) PFU of D x RRV reassortant; (ii) 10(4) PFU of DS1 x RRV reassortant; (iii) 10(4) PFU of RRV; (iv) 5 x 10(3) PFU of D x RRV and 5 x 10(3) PFU of RRV; and (v) placebo. The children were examined daily for 7 days following vaccine administration; 8 to 26% of the vaccinated infants developed a mild febrile reaction which in most cases lasted only 1 day. Seroresponses to rotavirus were observed in 39 to 65% of the vaccinees by plaque neutralization assay and in 57 to 88% by an immunoglobulin A enzyme-linked immunosorbent assay. Vaccine shedding was detected in 53 to 86% of the vaccinees. Analysis of neutralization antibody responses indicates that the VP4 protein represents an important component of the response induced by the vaccines.
Asunto(s)
Anticuerpos Antivirales/biosíntesis , Rotavirus/inmunología , Vacunas Virales/inmunología , Factores de Edad , Ensayo de Inmunoadsorción Enzimática , Estudios de Seguimiento , Humanos , Inmunoglobulina A/biosíntesis , Lactante , Pruebas de Neutralización , Distribución Aleatoria , Vacunas Sintéticas/efectos adversos , Vacunas Sintéticas/inmunología , Venezuela , Vacunas Virales/efectos adversosRESUMEN
The reactogenicity and antigenicity of the rhesus rotavirus vaccine, strain MMU18006, developed at the Laboratory of Infectious Diseases (National Institute of Allergy and Infectious Diseases, National Institutes of Health) were examined in a double blind, placebo-controlled study of 40 newborn infants in Caracas, Venezuela. The children were observed for the first few days after birth in the hospital nursery and by home visits for 10 days after vaccination to detect any adverse reactions. No reactions could be attributed to the vaccine. Serologic responses to the vaccine were evaluated in paired sera obtained at birth (cord blood) and 4 weeks after vaccination. Serologic responses to the vaccine were not observed by complement fixation, neutralization or a rhesus rotavirus VP7 epitope-specific competition assay. However, such responses were found in 9 of 14 tested infants by an immunoglobulin A-specific enzyme-linked immunosorbent assay. Seventeen of the 20 vaccinees also shed rhesus rotavirus vaccine in stool during the postvaccination period.
Asunto(s)
Infecciones por Rotavirus/prevención & control , Vacunas contra Rotavirus , Rotavirus/inmunología , Vacunas Virales/inmunología , Anticuerpos Antivirales/análisis , Método Doble Ciego , Estudios de Evaluación como Asunto , Estudios de Seguimiento , Humanos , Recién Nacido , Rotavirus/aislamiento & purificación , Vacunas Atenuadas , Venezuela , Vacunas Virales/efectos adversosRESUMEN
We have used a recently developed monoclonal antibody enzyme-linked immunosorbent assay (K. Taniguchi, T. Urasawa, Y. Morita, H. B. Greenberg, and S. Urasawa, J. Infect. Dis. 155:1159-1166, 1987) for serotyping rotaviruses recovered from 134 Venezuelan infants over a period of 15 months. One hundred and nine of the specimens were typed with the following distribution: serotype 1, 48%; serotype 2, 16%; serotype 3, 22%; and serotype 4, 14%. Three specimens reacted with two different monoclonal antibodies. In addition, 6 specimens (5%) containing enough outer capsid antigen could not be typed; partial RNA sequence analysis of the glycoprotein gene from three of these six strains failed to reveal sequence differences with prototype strains that could be serotyped with the monoclonal antibodies. Variations in the recovery rates of the different serotypes were observed. Serotypes 2, 3, and 4 predominated at the beginning of the study, and serotype 1 predominated at the end of the study. Diarrheal illness appeared to be more prolonged in infants shedding rotavirus serotypes 1 and 3 than in those shedding serotypes 2 and 4.
Asunto(s)
Gastroenteritis/microbiología , Rotavirus/aislamiento & purificación , Secuencia de Bases , Preescolar , Humanos , Lactante , Recién Nacido , Datos de Secuencia Molecular , ARN Viral/análisis , Rotavirus/clasificación , Rotavirus/genética , Serotipificación , Venezuela , Proteínas Virales/genética , Proteínas Estructurales ViralesRESUMEN
The efficacy of the rhesus rotavirus vaccine candidate MMU-18006 was evaluated in a longitudinal double-blind field trial in Caracas, Venezuela. 247 infants aged 1-10 months were studied and followed for up to 1 year (201 completed the 1-year surveillance): 123 received a dose of 10(4) plaque-forming units of the vaccine orally and 124 received placebo. 21 episodes of rotavirus diarrhoea were detected, 16 in the controls and 5 in the vaccines: vaccine efficacy against any rotavirus diarrhoea was thus 68%. In the 1-5-month-old group the vaccine efficacy was 93%; only 1 episode of rotavirus diarrhoea was detected in 68 vaccinees and 15 such illnesses were observed in 65 controls (p less than 0.0001). For the entire study group vaccine efficacy was 100% against the most severe rotavirus diarrhoeal episodes.
Asunto(s)
Diarrea Infantil/prevención & control , Infecciones por Rotavirus/prevención & control , Vacunas contra Rotavirus , Vacunación , Anticuerpos Antivirales/análisis , Ensayos Clínicos como Asunto , Diarrea Infantil/microbiología , Método Doble Ciego , Humanos , Lactante , Distribución Aleatoria , Rotavirus/inmunología , Vacunas Virales/inmunologíaRESUMEN
The incidence of diarrhea, respiratory disease, and skin infections was prospectively determined after the introduction of a system which distributed unlimited quantities of high quality fresh water to each of the 150 housing units on Tupile, an island devoid of fresh water located off Panama's Caribbean coast and inhabited by 1,500 Cuna Indians. Tupile residents used 7.1 liters of water/person/day compared to the 2.3 usage rate of inhabitants on Achutupo, the control island. Despite ready availability of water in each household, Tupile residents continued to store water in contaminated vessels prior to use. Forty percent of stored water samples tested on Tupile and 45% on Achutupo were contaminated with E. coli organisms. There were 4.7 episodes/child year (E/Y) of acute diarrhea on Tupile compared with the 3.5 rate on Achutupo. The rotavirus infection rate on Tupile was 0.8 E/Y compared with 0.2 E/Y on Achutupo. Infection rates for Norwalk virus, respiratory syncytial virus and Coxsackie B 1-6 viruses were similar on both islands. Respiratory disease rates were high on both islands (2.2 E/Y on Tupile, 2.7 E/Y on Achutupo). Achutupo had much higher rates of impetigo and scabies (0.6 E/Y and 2.5 E/Y, respectively) than Tupile (0.2 E/Y and 1.4 E/Y). Provision of the water distribution system had a beneficial effect on the incidence of water-washed diseases (impetigo and scabies), but at best had no effect on diarrheal disease.
Asunto(s)
Diarrea/epidemiología , Enfermedades Respiratorias/epidemiología , Enfermedades de la Piel/epidemiología , Abastecimiento de Agua , Niño , Humanos , Indígenas Centroamericanos , Panamá , Infecciones por Rotavirus/epidemiología , Escabiosis/epidemiología , Microbiología del AguaRESUMEN
For better understanding of the role of humoral immunity in ameliorating infections with rotavirus (RV) and Norwalk virus (NW), 305 Cuna Indians living on two isolated islands located off Panama's Carribean coast were surveyed daily for diarrhea over a seven-month period. Nine (8%) of 108 persons with a baseline RV antibody titer of greater than 1:4 developed RV infection compared with 70 (46%) of 151 persons with a baseline RV antibody titer of less than 1:4 (P less than .001). Thirty-eight (25%) of 151 persons of all ages with baseline RV antibody titer of less than 1:4 had at least one episode of RV diarrhea compared with 6 (6%) of 108 persons who had baseline RV antibody titers of greater than 1:4 (P less than .001). Thirty-two (47%) of 68 persons of all ages who had a baseline NW antibody titer of less than 1:100 developed NW infection compared with 30 (13%) of 237 persons with a baseline NW titer of greater than 1:100 (P less than .001). The high NW and RV infection rates and the excellent levels of protection provided by specific preexisting humoral antibody to these agents should promote activities aimed at developing vaccines for preventing these infections.
Asunto(s)
Gastroenteritis/inmunología , Infecciones por Rotavirus/inmunología , Virosis/inmunología , Factores de Edad , Anticuerpos Antivirales/inmunología , Diarrea/inmunología , Humanos , Inmunidad , Indígenas Centroamericanos , Virus Norwalk/inmunología , Panamá , Rotavirus/inmunologíaRESUMEN
Serum antibody titrations against the heat-labile enterotoxin (LT) of Escherichia coli were carried out on Panamanians, U.S. citizens resident in the Panama Canal Zone, Apache Indians living on the reservation in Whiteriver, Arizona, and Peace Corps volunteers before they traveled overseas. Antibody titers to Norwalk virus were also carried out on serum from Panamanian and Canal Zone residents. A high prevalence of low-titer LT antibodies was found in infants and adults from Panama, the Canal Zone, and Whiteriver. Panamanian children aged 1 to 5 years had the highest LT antibody titers. Peace Corps volunteers had a low prevalence and titer of LT antibodies. Prevalence and titer of antibodies to Norwalk virus were generally higher in Panamanians compared with Canal Zone residents of the same age. In the populations we studied, various modes of transmission and mechanisms of immunity likely explain the differences which we observed in antibody prevalence and titer to these two enteric pathogens.
Asunto(s)
Anticuerpos Antibacterianos/análisis , Anticuerpos Antivirales/análisis , Toxinas Bacterianas , Proteínas de Escherichia coli , Escherichia coli/inmunología , Virus Norwalk/inmunología , Adolescente , Adulto , Factores de Edad , Niño , Preescolar , Enterotoxinas , Humanos , Indígenas Norteamericanos , Lactante , Panamá , Zona del Canal de Panamá , Estados Unidos/etnología , VoluntariosRESUMEN
To determine whether residents of developing countries are unlikely to acquire travelers' diarrhea, 64 Panamanians of widely divergent socioeconomic strata were studied during a 15-day tour through Mexico. Twenty-three (36%) tourists experienced 27 episodes of travelers' diarrhea that were caused by seven different pathogens. The most commonly identified etiologic agents were rotavirus (26%), Norwalk virus (15%), and Campylobacter fetus (11%), whereas enterotoxigenic Escherichia coli was not frequently associated with travelers' diarrhea. Acquisition of travelers' diarrhea was correlated directly with high socioeconomic status. Varying levels of immunity to enteropathogens that are endemic in Panama may explain the different isolation rates of pathogens.
Asunto(s)
Países en Desarrollo , Diarrea/epidemiología , Viaje , Adolescente , Adulto , Anciano , Campylobacter fetus/aislamiento & purificación , Niño , Diarrea/microbiología , Escherichia coli/aislamiento & purificación , Heces/microbiología , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Virus Norwalk/aislamiento & purificación , Panamá/etnología , Rotavirus/aislamiento & purificación , Factores SocioeconómicosRESUMEN
Se estudian los microorganismos enteropatogenos relacionados a diarrea aguda del lactante en muestras de heces tomadas al azar a lo largo de un periodo de 7 meses, durante el ano de 1979, encontrandose E. coli enteroxigenico (14,4%), rotavirus (9,2%) y shigelas (2,6%), en un grupo de 76 ninos.Dentro de este mismo grupo de 25 ninos (8%) y 1 de 25(4%) mostraron ascaris y amebas respectivamente.Los rotavirus se encontraron solo en los meses frios. Los E. coli enterotoxigenicos tanto en los meses frios como calidos. En el 73, 8% de los casos no pudo aislarse un microorganismo sugerente de enteropatogenicidad
Asunto(s)
Diarrea Infantil , Escherichia coli , RotavirusRESUMEN
A serological survey of a random sample of 541 of the population of St Lucia was undertaken. The prevalence of antibodies to dengue, herpes virus, VZ, rotavirus, rubella and syphilis is described and compared with other communities.
Asunto(s)
Anticuerpos Antivirales/inmunología , Adolescente , Adulto , Factores de Edad , Anciano , Barbados , Niño , Preescolar , Citomegalovirus/inmunología , Virus del Dengue/inmunología , Femenino , Encuestas Epidemiológicas , Herpesviridae/inmunología , Herpesvirus Humano 3/inmunología , Herpesvirus Humano 4/inmunología , Humanos , Técnicas Inmunológicas , Lactante , Masculino , Persona de Mediana Edad , Rotavirus/inmunología , Virus de la Rubéola/inmunología , Serodiagnóstico de la Sífilis , Indias OccidentalesRESUMEN
Serum samples from children and adults from several countries were tested by radioimmunoassay for antibody to the Norwalk virus. Antibody was commonly found in adults from all the countries tested. Antibody appears to be acquired more rapidly in children from underdeveloped countries than in children from the United States.
Asunto(s)
Anticuerpos Antivirales/análisis , Gastroenteritis/epidemiología , Virosis/epidemiología , Virus no Clasificados/inmunología , Adolescente , Adulto , Factores de Edad , Bangladesh , Bélgica , Niño , Preescolar , Ecuador , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Nepal , Rotavirus/inmunología , Estados Unidos , YugoslaviaRESUMEN
A population of 24 infants and young children followed prospectively during the first 3 years of life was studied for the occurrence of rotavirus infection by using enzyme-linked immunosorbent assay to detect virus in stools. Infection with rotavirus was associated with 26 (14.2%) of 183 selected diarrheal episodes. Twenty of the 24 infants and young children had diarrhea associated with rotavirus on at least one occasion and six had two such episodes. Rotavirus infection was documented in over 50% of the dehydrating episodes studied, thus further indicating the importance of rotavirus in this population.
Asunto(s)
Diarrea/epidemiología , Virosis/epidemiología , Preescolar , Diarrea/etiología , Ensayo de Inmunoadsorción Enzimática , Guatemala , Humanos , Lactante , Recién Nacido , Rotavirus , Población Rural , Virosis/complicacionesRESUMEN
Human milk contains antibodies to a variety of enteropathic agents. We utilized the method of enzyme-linked immunosorbent assay to investigate anti-rotavirus secretory IgA in 113 human milk and colostral specimens from a rural area in Guatemala, 32 colostral specimens from an urban area of Costa Rica, and 12 from an urban area of the United States. Anti-rotavirus SCIgA was found in all colostral samples and in 94% of the milk specimans. Both the absolute concentration of anti-rotavirus SCIgA and concentration relative to total SCIgA were highest in colostrum, falling to lower but detectable levels from one week to two years after birth. No significant differences were noted in the results from the specimens from the three different geographic areas. The possible role of this antibody in immunity to rotavirus infections is discussed.