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VIRUS PARTICLES IN GASTROENTERITIS
1497 100 ml., arterial pH 7-38, and calculated plasma-osmolarity 381 mosmol per litre. Urine analysis showed massive glycosuria but not ketonuria. The patient was treated with intravenous saline solution and intramuscular insulin. By the second day she was awake, and neurological examination was normal. Blood-glucose levels ranged between 180 and 80 mg. per 100 ml., and glycosuria was less than 10 g. in 24 hours. She remained symptom-free on a subcutaneous dose of 30 units insulin daily. We think that intramuscular insulin is a major advance in management of hyperosmolar as well as ketoacidotic coma.
Department of Internal Medicine, Hospital General de Galicia, University of Santiago de Compostela, Spain.
M. NOYA M. LEMA A. ALVAREZ-PRECHOUS J. C. DE OYA.
VIRUS PARTICLES IN GASTROENTERITIS
Fig. 2-Particles partly penetrated by negative stain, showing double-layered capsid. x
SIR,-We should like
present evidence substantiating by a different technique, the findings of Dr Bishop and he] colleagues (Dec. 8, p. 1281). During the past few month: we have been examining, by electron microscopy, negatively stained preparations from fseces of patients, som( diagnosed as having acute gastroenteritis, or " diarrhoe2 and vomiting ", and some with " non-gastro " illnesses, Suspension of faeces (about 20% v/v) were made in phosphate-buffered saline and centrifuged for 30 minutcs a1 7000 r.p.m. to deposit bacteria and debris. The supernatant fluids were then centrifuged at 50,000 r.p.m. in 5 ml. swing-out tubes for 1 hour, and the deposits were resuspended in 0-2 ml. water. Electron microscope grids bearing carbon membranes were touched to a drop of this suspension, allowed almost to dry, dipped thrice intc distilled water, and, after blotting, negatively stained foi 5 seconds in 2% w/v potassium phosphotungstate. Excess stain was removed with blotting paper and the grids examined in the electron microscope. In some of these specimens particles 75-84 nm. in
296,000.
to
diameter, closely resembling reoviruses, were discovered (see figs. 1 and 2). One specimen contained both these particles and adenoviruses, and from one containing these particles echovirus type 11 and Escherichia coli type 026 No identifiable pathogen was isolated were also isolated. from the rest of the " results were: Patients’
gastroenteritis
"
specimens.
The
5 years and under Over 5 years
ages:
Total
specimens "
Gastroenteritis
"
specimens Reovirus-like present
76
32
44
15 93
14 19
1 74
particles
Non-gastro " specimens Reovirus-like particles
1 10 present The " non-gastro " patient having these particles was a small-for-dates baby one month old, whose progress had been unsatisfactory.
These particles appear to be commoner at some times of the year. 9 of our last 18 recent specimens from acute gastroenteritis contained them, often in great numbers. Attempts to demonstrate by electron microscopy agglutination by pooled antisera to reoviruses types 1, 2, and 3 have given equivocal results; the particles tend in any case to lie in groups, and globulin molecules are hard to discern with confidence in the dense layer of negative stain between adjacent viruses of fairly large size. We think it may be premature to place these reoviruslike particles in any particular subgroup until we know more about them. Some appeared to have a two-layered capsid (fig. 2), like the classical reoviruses. Regional Virus Laboratory, Birmingham Hospital, Bordesley Green East, Birmingham 9.
East
T. H. FLEWETT A. S. BRYDEN HEATHER DAVIES.
TOTAL LEAD IN DRINKING-WATER
SIR,-Recent analyses of the total lead content of running
drinking-water delivered through lead pipes have given values up to 5-5 p.p.m., or 55 times the World Health Organisation limit. This includes lead in suspension as well as that in solution. It appears that particles of scale washed from the pipe-wall into suspension are principally responsible for these results. In one case, analysis of pipescale fragments has demonstrated 164,000 p.p.m. of lead
(16-4%). Fig. 1-Reovirus-like particles. Reduced by two-thirds from x 296,000.
One would think that the time is ripe for the constitution a new W.H.O. standard to take account of the total lead content of drinking-water.
of
Department of Internal Medicine, Hospital General de Galicia, University of Santiago de Compostela, Spain.
M. NOYA M. LEMA A. ALVAREZ-PRECHOUS J. C. DE OYA.
VIRUS PARTICLES IN GASTROENTERITIS
Fig. 2-Particles partly penetrated by negative stain, showing double-layered capsid. x
SIR,-We should like
present evidence substantiating by a different technique, the findings of Dr Bishop and he] colleagues (Dec. 8, p. 1281). During the past few month: we have been examining, by electron microscopy, negatively stained preparations from fseces of patients, som( diagnosed as having acute gastroenteritis, or " diarrhoe2 and vomiting ", and some with " non-gastro " illnesses, Suspension of faeces (about 20% v/v) were made in phosphate-buffered saline and centrifuged for 30 minutcs a1 7000 r.p.m. to deposit bacteria and debris. The supernatant fluids were then centrifuged at 50,000 r.p.m. in 5 ml. swing-out tubes for 1 hour, and the deposits were resuspended in 0-2 ml. water. Electron microscope grids bearing carbon membranes were touched to a drop of this suspension, allowed almost to dry, dipped thrice intc distilled water, and, after blotting, negatively stained foi 5 seconds in 2% w/v potassium phosphotungstate. Excess stain was removed with blotting paper and the grids examined in the electron microscope. In some of these specimens particles 75-84 nm. in
296,000.
to
diameter, closely resembling reoviruses, were discovered (see figs. 1 and 2). One specimen contained both these particles and adenoviruses, and from one containing these particles echovirus type 11 and Escherichia coli type 026 No identifiable pathogen was isolated were also isolated. from the rest of the " results were: Patients’
gastroenteritis
"
specimens.
The
5 years and under Over 5 years
ages:
Total
specimens "
Gastroenteritis
"
specimens Reovirus-like present
76
32
44
15 93
14 19
1 74
particles
Non-gastro " specimens Reovirus-like particles
1 10 present The " non-gastro " patient having these particles was a small-for-dates baby one month old, whose progress had been unsatisfactory.
These particles appear to be commoner at some times of the year. 9 of our last 18 recent specimens from acute gastroenteritis contained them, often in great numbers. Attempts to demonstrate by electron microscopy agglutination by pooled antisera to reoviruses types 1, 2, and 3 have given equivocal results; the particles tend in any case to lie in groups, and globulin molecules are hard to discern with confidence in the dense layer of negative stain between adjacent viruses of fairly large size. We think it may be premature to place these reoviruslike particles in any particular subgroup until we know more about them. Some appeared to have a two-layered capsid (fig. 2), like the classical reoviruses. Regional Virus Laboratory, Birmingham Hospital, Bordesley Green East, Birmingham 9.
East
T. H. FLEWETT A. S. BRYDEN HEATHER DAVIES.
TOTAL LEAD IN DRINKING-WATER
SIR,-Recent analyses of the total lead content of running
drinking-water delivered through lead pipes have given values up to 5-5 p.p.m., or 55 times the World Health Organisation limit. This includes lead in suspension as well as that in solution. It appears that particles of scale washed from the pipe-wall into suspension are principally responsible for these results. In one case, analysis of pipescale fragments has demonstrated 164,000 p.p.m. of lead
(16-4%). Fig. 1-Reovirus-like particles. Reduced by two-thirds from x 296,000.
One would think that the time is ripe for the constitution a new W.H.O. standard to take account of the total lead content of drinking-water.
of