ROTAVIRUS INFECTION AND BRADYCARDIA-APNEA-EPISODES IN THE NEONATE

Rotavirus (RV), a common cause of infectious enteritis in young childr en including neonates, has not been associated with central nervous sy mptoms in standard text-books. However, involvement of the CNS has bee n reported recently in case reports and small series. From 786 neonata l admissions in 1991 we retrospectively analysed the records of 215 in patient neonates (68 preterm and 147 term infants) who developed diarr hoea during their stay on the neonatal ward and in whom stools were in vestigated for RV antigen by ELISA. All 215 neonates were continuously monitored for bradycardia-apnoea-episodes (BAE) at least 2 days befor e and during the entire diarrhoeal period. In neonates with RV antigen in stools (n = 114) we found a higher incidence of BAE compared to ne onates with RV negative stools (33% vs 8%, P < 0.001 for bradycardia; 7% vs 0%, P < 0.05 for apnoea). Furthermore, bradycardia episodes of R V positive neonates were more often followed by cyanosis (11 vs 0%, P < 0.05) and intervention was more often necessary (31 vs 14%, P < 0.05 ) than in the RV negative neonates. Conclusion RV infection was associ ated with a high incidence of BAE in neonates with diarrhoea during th e acute phase of disease suggesting CNS involvement.