OUTBREAKS OF NOSOCOMIAL ROTAVIRUS GASTROENTERITIS IN A PEDIATRIC WARD

Faecal samples were collected from patients with gastro-enteritis duri ng two winter seasons on a paediatric ward. Three outbreaks of nosocom ial rotavirus gastro-enteritis were identified by latex agglutination and the virus strains were characterized by polyacrylamide gel electro phoresis of the genome nucleic acid and by subgrouping and serotyping enzyme-linked immunosorbent assays (ELISA). One outbreak was caused by serotype I rotavirus, one by serotype 2 and the remaining outbreak wa s caused by a mixture of serotypes 1 and 4. Identical electrophoretic patterns of the rotavirus genome in each outbreak combined with the EL ISA results indicate that these three outbreaks were hospital-acquired cases. The index cases in the three outbreaks were community-acquired and one of two index cases in the second outbreak was hospital-acquir ed. On each occasion, susceptible roommates were easily infected from the index cases and then cross-infection occurred in the paediatric wa rd. Possible vehicles were the medical staff, especially doctors, pare nts of infected patients and infected patients who were moved to other rooms. One patient who had been treated with a series of antitumour t herapies excreted rotaviruses in faeces for a long time period and pro bably played a role as a source of the outbreak,Moreover, some patient s still excreted rotaviruses in their normal stool week after recovery from gastro-enteritis. These findings indicate that continual examina tion of stool samples for rotaviruses until they are negative may be i mportant to prevent the spread of rotavirus infection. Conclusion Nucl eic acid analysis and serotyping ELISA are useful tools for analyzing nosocomial rotavirus gastro-enteritis and important to prevent the spr ead of rotavirus infection in institutions.