Rotavirus associated diarrhoea during infancy in the city of S. Luís (MA), Brazil: a two-year longitudinal study

A total of 479 diarrhoeic children and 337 children without diarrhoea (controls) less than 5 years old were investigated in a two-year study in the city of S. Luís (MA), with the purpose to determine the incidence, the age distribution and the seasonality of rotaviruses, as well as to establish the severity of the disease in this region between the North and the Northeast of Brazil. rotavirus incidence was highest in children of the 1st. year of life, showing an average of 25% per year among the diarrhoeic patients attending the two main hospitals and three health units at the periphery of the city. It was shown that rotaviruses are significant enteropathogens in children less than 18 months old. Frequency of rotaviruses droped in diarrhoeic patients 18 to 23 months old to only 4%, the same percentage observed in children of the control group. A typical seasonal distribution of rotaviruses was not seen during the two years of study. There was a peak in the incidence of rotaviruses in 1986, during the rainy season, and two peaks in 1987, one in the rainy season and one in the dry season. It was also shown that severity of diarrhoea in rotavirus positive cases was higher than in the negative cases. Rotavirus diarrhoeic patients had more loose stools per day, and higher frequencies of vomiting and fever, resulting more often (> 2 times) in moderate or severe dehydration. Finally, it is concluded that the introduction of immunoprophylaxis may reduce significantly the high mortality rates in early childhood observed in S. Luís.Um total de 479 casos de diarréia aguda e de 337 crianças sem diarréia (controles) foi investigado em um estudo longitudinal de 2 anos na cidade de São Luís (MA) em crianças menores de 5 anos de idade, a fim de estabelecer a incidência e a distribuição etária e sazonal de rotavírus, bem como determinar a severidade da doença nesta região do Brasil. A incidência de Rotavírus apresentou os maiores índices durante o primeiro ano de vida das crianças, com média anual de 25% entre os pacientes atendidos nos principais hospitais pediátricos da cidade e em Unidades de Saúde da periferia. O estudo mostrou que a relevância dos rotavírus como agentes etiológicos da diarréia aguda na infância já acaba aos 18 meses de idade das crianças desta região, quando os valores de positividade caem a apenas 4%, como no grupo controle. A distribuição bimensal de rotavírus não apresentou perfil tipicamente sazonal, ocorrendo 1 pico de incidência no ano de 1986, durante a estação chuvosa, e 2 picos no ano de 1987, dos quais um na estação chuvosa e outro, durante a época seca do ano. O estudo também mostrou que a doença diarreica é mais severa entre os casos positivos para rotavírus do que entre negativos, apresentando maior freqüência de evacuações diárias, de vômitos e febre, levando ao índice acima de 2 vezes maior de casos de desidratação moderada ou severa. Finalmente, é feita uma análise em relação ao efeito que a imunoprofilaxia poderá ter sobre os elevados índices de mortalidade infantil registrados nesta região do país

A comparative trial of rhesus monkey (RRV-1) and bovine (RIT 4237) oral rotavirus vaccines in young children

Heterologous live, oral rotavirus vaccines of rhesus monkey (RRV-1) and bovine (RIT 4237) origin were tested for immunogenicity, excretion of virus, and clinical reactions in six- to eight-month-old infants. Antibody response, indicating infection with the vaccine virus, was detected in 21 (88%) of 24 children receiving the RRV-1 vaccine and in 18 (75%) of 24 receiving the RIT 4237 vaccine. Excretion of virus in the stools within one week after vaccination was demonstrable in 84% of the RRV-1 and in 21% of the RIT 4237 vaccinees. RRV-1 vaccination was associated with a febrile response (over 38 C) that clustered on days 3 or 4 postvaccination in 64% of the recipient children. In addition, 20% of the RRV-1 vaccinees had watery stools on days 4 or 5. Fever on days 3 and 4 and loose stools were not seen in the RIT 4237 vaccinees. We concluded that in young children the RRV-1 (rhesus monkey) rotavirus vaccine is more immunogenic than the RIT 4237 (bovine) rotavirus vaccine, but vaccination with RRV-1 is associated with significant adverse reactions. © 1986 by The University of Chicago. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe