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Rotavirus in nasopharyngeal secretions of children with upper respiratory tract infections
DIAGNMICROBIOLINFECTDIS 1986;4:87~8
87
Rotavirus in Nasopharyngeal Secretions of Children With Upper Respiratory Tract Infections Michael Fragoso, Ashir Kumar, and Dennis L. Murray
Nasopharyngeal secretions from 30 infants and children presenting with respiratory tract infection, were tested for rotavirus antigen. Two of 30 children with signs and symptoms of seromucoid nasal secretions, cough, and low grade fever were positive for the antigen. Nasopharyngeal secretions may play a role in the spread of this infection.
INTRODUCTION It is well known that respiratory symptoms are frequently observed in infants and children suffering from rotavirus-associated gastroenteritis (Rodriguez et al., 1977). In the past, several investigators were unable to detect rotavirus antigen in nasopharyngeal (NP) secretions (Goldwater et al., 1979; Tallett et al., 1977). Recently Santosham et al. (1983) detected rotavirus antigen in respiratory secretions of children with pneumonia admitted to a hospital in the Republic of Panama. We report herein the findings of a pilot project undertaken (March, 1984 to May, 1984) to determine if rotavirus can be detected in the NP secretions of children presenting with symptoms of respiratory tract infections. The study was conducted at an outpatient clinic in Lansing, Michigan.
RESULTS AND DISCUSSION Nasopharyngeal secretions obtained from 30 infants and children between the ages of 9 months to 12 yr were assayed for rotavirus by the enzyme-linked immunosorbent assay (ELISA) technique using the Rotazyme kit (Abbot Diagnostics, North Chicago, IL) [Kumar et al., 1984]. Nasopharyngeal secretions were collected and stored according to the procedures described by Santosham et al (1983). Stool specimens were also tested by Rotazyme on a few patients with associated diarrhea. Presenting features of these children included nasal discharge, cough, congestion, and fever. None of the children were in respiratory distress or had pneumonia. Rotavirus was detected in NP secretions in two of 30 patients and in stool specimens in five of nine patients who also had diarrhea. One of the patients with rotavirus antigen in NP secretions was a 12-yr-old white young boy who had nasal congestion, excessive nasal secre-
From the Department of Pediatrics and Human Development, Michigan State University, East Lansing, Ml. Address reprint requests to: Ashir Kumar, M.D., Department of Pediatrics/Human Development, B240 Life Sciences Building, Michigan State University, East Lansing, Ml 48824o1317. Received May 1, 1985; revised and accepted July 8, 1985. Science Publishing Co.. Inc. 52 Vanderbilt Avenue.New York, NY 10017 © 1966 Elsevier
0732-8893/86/$03.50
88
M. Fragoso et al.
tions, and low grade fever of 1 wk duration. He had d e v e l o p e d vomiting (one to two times per day) 2 days before the visit but there was no diarrhea. Examination revealed a young boy with s e r o m u c o i d discharge from the nose and slight erythema of the pharynx without l y m p h a d e n i t i s . The patient was managed s y m p t o m a t i c a l l y and recovered over the next 4 days. The other patient with NP secretions positive for rotavirus antigen was a 8-month-old black child who had nasal congestion and cough for 6 clays. One day before the clinic visit, he d e v e l o p e d vomiting (three to four times per day), cough, fever, and three to four loose stools. Examination revealed a febrile, alert child who had copious mucous discharge from the nose. Stool was also positive for rotavirus antigen in this child. The patient was managed with decongestants and antipyretics; his s y m p t o m s resolved over 1 wk. The Rotazyme kit is certainly sensitive and relatively specific for detection of rotavirus antigen in stool specimens beyond the newborn period. Although at present no data are available regarding sensitivity and specificity of the Rotazyme kit for the detection of rotavirus antigen in NP secretions or other body secretions, Santosham et al. (1983) have used a method based on the ELISA technique to detect rotavirus in NP secretions in their laboratory and found it valuable. Our data and data from Santosham et al. (1983) demonstrate that rotavirus antigen is present in the respiratory secretions of infants and children. Usual isolation precautions obtained for a patient with gastroenteritis involve only enteric precautions. These precautions may not be adequate to control the spread of rotavirus infection as the virus may be present in respiratory secretions as well. Mere presence of rotavirus antigen in NP secretions, however, does not necessarily indicate presence of live rotavirus in the secretions. Further studies u p o n a large number of children, determining the sequence and duration of viral excretion in NP secretions and in stool specimens, will answer some of the questions regarding e p i d e m i o l o g y and transmission of this agent. Technical assistance provided by John Harris is appreciated. Rotazyme kit was a gift from Abbot Diagnostics, North Chicago, I].
REFERENCES
Goldwater PN, et al. (1979) Rotavirus and the respiratory tract. Br Med I 4:1551. Kumar A, et al. (1984) Clinical features and laboratory diagnosis of rotavirus-associated gastroenteritis in infants and children. J Diar Dis Hes 2:142. Rodriguez WJ, et al. (1977) Clinical features of acute gastroenteritis associated with human rotavirus like agent in infants and young children. J Pediatr 91:188. Santosham M, et al. (1983) Detection of rotavirus in respiratory secretions of children with pneumonia. J Pediatr 103:583. Tallett S, et al. (1977) Clinical, laboratory and epidemiologic features of a viral gastroenteritis in infants and children. Pediatrics 60:217.
87
Rotavirus in Nasopharyngeal Secretions of Children With Upper Respiratory Tract Infections Michael Fragoso, Ashir Kumar, and Dennis L. Murray
Nasopharyngeal secretions from 30 infants and children presenting with respiratory tract infection, were tested for rotavirus antigen. Two of 30 children with signs and symptoms of seromucoid nasal secretions, cough, and low grade fever were positive for the antigen. Nasopharyngeal secretions may play a role in the spread of this infection.
INTRODUCTION It is well known that respiratory symptoms are frequently observed in infants and children suffering from rotavirus-associated gastroenteritis (Rodriguez et al., 1977). In the past, several investigators were unable to detect rotavirus antigen in nasopharyngeal (NP) secretions (Goldwater et al., 1979; Tallett et al., 1977). Recently Santosham et al. (1983) detected rotavirus antigen in respiratory secretions of children with pneumonia admitted to a hospital in the Republic of Panama. We report herein the findings of a pilot project undertaken (March, 1984 to May, 1984) to determine if rotavirus can be detected in the NP secretions of children presenting with symptoms of respiratory tract infections. The study was conducted at an outpatient clinic in Lansing, Michigan.
RESULTS AND DISCUSSION Nasopharyngeal secretions obtained from 30 infants and children between the ages of 9 months to 12 yr were assayed for rotavirus by the enzyme-linked immunosorbent assay (ELISA) technique using the Rotazyme kit (Abbot Diagnostics, North Chicago, IL) [Kumar et al., 1984]. Nasopharyngeal secretions were collected and stored according to the procedures described by Santosham et al (1983). Stool specimens were also tested by Rotazyme on a few patients with associated diarrhea. Presenting features of these children included nasal discharge, cough, congestion, and fever. None of the children were in respiratory distress or had pneumonia. Rotavirus was detected in NP secretions in two of 30 patients and in stool specimens in five of nine patients who also had diarrhea. One of the patients with rotavirus antigen in NP secretions was a 12-yr-old white young boy who had nasal congestion, excessive nasal secre-
From the Department of Pediatrics and Human Development, Michigan State University, East Lansing, Ml. Address reprint requests to: Ashir Kumar, M.D., Department of Pediatrics/Human Development, B240 Life Sciences Building, Michigan State University, East Lansing, Ml 48824o1317. Received May 1, 1985; revised and accepted July 8, 1985. Science Publishing Co.. Inc. 52 Vanderbilt Avenue.New York, NY 10017 © 1966 Elsevier
0732-8893/86/$03.50
88
M. Fragoso et al.
tions, and low grade fever of 1 wk duration. He had d e v e l o p e d vomiting (one to two times per day) 2 days before the visit but there was no diarrhea. Examination revealed a young boy with s e r o m u c o i d discharge from the nose and slight erythema of the pharynx without l y m p h a d e n i t i s . The patient was managed s y m p t o m a t i c a l l y and recovered over the next 4 days. The other patient with NP secretions positive for rotavirus antigen was a 8-month-old black child who had nasal congestion and cough for 6 clays. One day before the clinic visit, he d e v e l o p e d vomiting (three to four times per day), cough, fever, and three to four loose stools. Examination revealed a febrile, alert child who had copious mucous discharge from the nose. Stool was also positive for rotavirus antigen in this child. The patient was managed with decongestants and antipyretics; his s y m p t o m s resolved over 1 wk. The Rotazyme kit is certainly sensitive and relatively specific for detection of rotavirus antigen in stool specimens beyond the newborn period. Although at present no data are available regarding sensitivity and specificity of the Rotazyme kit for the detection of rotavirus antigen in NP secretions or other body secretions, Santosham et al. (1983) have used a method based on the ELISA technique to detect rotavirus in NP secretions in their laboratory and found it valuable. Our data and data from Santosham et al. (1983) demonstrate that rotavirus antigen is present in the respiratory secretions of infants and children. Usual isolation precautions obtained for a patient with gastroenteritis involve only enteric precautions. These precautions may not be adequate to control the spread of rotavirus infection as the virus may be present in respiratory secretions as well. Mere presence of rotavirus antigen in NP secretions, however, does not necessarily indicate presence of live rotavirus in the secretions. Further studies u p o n a large number of children, determining the sequence and duration of viral excretion in NP secretions and in stool specimens, will answer some of the questions regarding e p i d e m i o l o g y and transmission of this agent. Technical assistance provided by John Harris is appreciated. Rotazyme kit was a gift from Abbot Diagnostics, North Chicago, I].
REFERENCES
Goldwater PN, et al. (1979) Rotavirus and the respiratory tract. Br Med I 4:1551. Kumar A, et al. (1984) Clinical features and laboratory diagnosis of rotavirus-associated gastroenteritis in infants and children. J Diar Dis Hes 2:142. Rodriguez WJ, et al. (1977) Clinical features of acute gastroenteritis associated with human rotavirus like agent in infants and young children. J Pediatr 91:188. Santosham M, et al. (1983) Detection of rotavirus in respiratory secretions of children with pneumonia. J Pediatr 103:583. Tallett S, et al. (1977) Clinical, laboratory and epidemiologic features of a viral gastroenteritis in infants and children. Pediatrics 60:217.