RESUMO
In late 1981, the Western Hemisphere's pandemic of acute hemorrhagic conjunctivitis spread to Puerto Rico. Over 6,000 cases of conjunctivitis were reported to the Puerto Rico Department of Health from November 1981 to March 1982. Enterovirus 70 was isolated from one of 19 eye-swab specimens tested, and 10 of 13 (77%) individuals with acute hemorrhagic conjunctivitis had neutralizing antibody titers to enterovirus 70 of greater than or equal to 1:4. These data suggest that enterovirus 70 was the etiologic agent of the acute hemorrhagic conjunctivitis outbreak in Puerto Rico. In a study of a lower middle socioeconomic sector with relatively intense transmission, 152 of 670 (23%) persons reported illness consistent with acute hemorrhagic conjunctivitis. The highest attack rate was in the 5- to 14-year-old group (30%), and a disproportionate number of household index cases were in the predominantly school age group (5-19 years old). Twelve per cent (3/25) of asymptomatic household contacts of acute hemorrhagic conjunctivitis cases had sera with neutralizing antibody to enterovirus 70. Retrospective surveillance through ophthalmologists and neurologists identified one patient with a neurologic complication, a seventh nerve palsy temporally associated with recent enterovirus 70 infection. Household transmission was significantly associated with crowding and sharing of beds (p less than 0.05). This and other recent studies in Florida suggest that school age children play an important role in the transmission of acute hemorrhagic conjunctivitis. This study also suggests that asymptomatic enterovirus 70 infection is uncommon, and that in Puerto Rico, neurologic complications associated with acute hemorrhagic conjunctivitis were quite rare.
Assuntos
Conjuntivite/epidemiologia , Surtos de Doenças/epidemiologia , Adolescente , Fatores Etários , Idoso , Criança , Pré-Escolar , Conjuntivite/sangue , Conjuntivite/transmissão , Aglomeração , Enterovirus/isolamento & purificação , Métodos Epidemiológicos , Feminino , Hemorragia/epidemiologia , Hemorragia/transmissão , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Porto Rico , Estações do Ano , Fatores SexuaisRESUMO
Enterovirus 70 isolates obtained in Asia and the Americas between 1980 and 1981 from cases of acute hemorrhagic conjunctivitis were found to be very closely related by RNase T1 oligonucleotide fingerprinting. Two closely related isolates from the first acute hemorrhagic conjunctivitis epidemic (1969 to 1972) differed by many oligonucleotides from the 1980 to 1981 pandemic strains. The strong similarities of oligonucleotide patterns of isolates from the same epidemic but from distant regions of the world suggest that the genome of enterovirus 70 tends to be conserved during natural infection, a possible consequence of the transient nature of the disease.
Assuntos
Conjuntivite/microbiologia , Surtos de Doenças , Infecções por Enterovirus/microbiologia , Enterovirus/análise , Hemorragia/microbiologia , Oligonucleotídeos/análise , Doença Aguda , Bangladesh , Enterovirus/genética , Enterovirus/isolamento & purificação , Florida , Genes Virais , Honduras , Humanos , Japão , Marrocos , Oligonucleotídeos/genética , Paquistão , Tailândia , VietnãRESUMO
Paralytic poliomyelitis was observed in a child with a sex-linked defect in immunoglobulin synthesis. Evidence is presented that this was secondary to administration of oral, live poliovaccine. The demonstration of a familial sex-linked gammaglobulin deficiency and the failure to document a defect in cell-mediated immunity in this child extends the risk of vaccine associated poliomyelitis to virtually all forms of immunodeficiency. The critical host factors in the pathogenesis of poliovirus vaccine infection and in particular its unfavorable outcome appear to include either a deficiency in the humoral (B cell) system or in the cell-mediated (T cell) system.
Assuntos
Agamaglobulinemia/complicações , Poliomielite/etiologia , Vacina Antipólio Oral/efeitos adversos , Agamaglobulinemia/imunologia , Linfócitos B/imunologia , Criança , Pré-Escolar , Feminino , Humanos , Imunidade , Imunidade Celular , Imunoglobulinas/biossíntese , Lactente , Masculino , Poliomielite/imunologia , Poliomielite/microbiologia , Poliovirus/isolamento & purificação , Aberrações dos Cromossomos Sexuais , Linfócitos T/imunologiaRESUMO
Surveillance for nosocomial diarrhea due to a reovirus-like agent was maintained on the pediatric wards of a large metropolitan hospital in January and February, 1976, during a large community outbreak of that illness. During this period, 30 (27%) of 111 children under surveillance were admitted for dehydration secondary to diarrhea; 21 (70%) of these 30 children had RLA in stool samples obtained at admission. Ten (17%) of the 60 children admitted without diarrhea, hence at risk of acquiring nosocomial RLA infection, contracted the illness. With human RLA as an antigen, no hospital personnel had serologic (complement fixation test) evidence of infection. Early attempts to control the diarrhea at home and in the outpatient department by the use of oral fluid rehydration, isolation of patients with severe symptoms requiring hospitalization, and strict attention by hospital personnel to hand washing between examination of patients may limit nosocomial spread of the disease.