Application of electronmicroscopy, enzyme immunoassay, and RT-PCR to monitor an outbreak of astrovirus type 1 in a paediatric bone marrow transplant unit

During 1997, an extensive outbreak of astrovirus occurred in a unit where p aediatric patients were being treated for leukaemias and inherited immune d eficiency disorders. Prolonged shedding of virus for many months following infection was demonstrated in th ree patients who had undergone bone marrow transplantation. Comparison of reverse transcription-polymerase chain reac tion (RT-PCR), enzyme immunoassay (EIA), and electronmicroscopy (EM) to mon itor the outbreak showed that many subclinical infections, mainly in childr en aged > 3 years could only be detected by RT-PCR. Use of RT-PCR revealed that several patients were infected earlier and shed virus for longer than by using EM or EIA. The virus responsible for the outbreak was identified a s HAstV-1 and was shown to have a sequence that differed from a strain obta ined in 1988. J. Med. Virol. 57:313-321, 1999. (C) 1999 Wiley-Liss, Inc.