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      An outbreak of rotavirus-associated neonatal necrotizing enterocolitis *

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          Abstract

          An outbreak of necrotizing enterocolitis and hemorrhagic gastroenteritis occurred in two nurseries during 25 days in August 1982. Eleven of the 40 patients in these nurseries during that time developed disease (attack rate 27.5%). In seven of the 10 patients with gastrointestinal disease, stool samples tested for human rotavirus were positive by ELISA, whereas in 20 unaffected infants, no stools tested demonstrated HRV ( P=0.0001). Eleven staff members had serologic evidence of recent HRV infection. Comparison of risk factors traditionally associated with the development of NEC between the affected and unaffected infants revealed no significant differences. Rotavirus infection was the only finding that was highly correlated with this epidemic.

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          Most cited references 32

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          Association of coronavirus infection with neonatal necrotizing enterocolitis.

          From the clustered occurrence of numerous cases of necrotizing enterocolitis in newborns, it was possible to associate this disease significantly with infection due to coronavirus-like agents. Prematurity or low birth weight did not seem to affect the development of the disease, at least during the present epidemic. However, associated gas-producing bacteria could influence its severity and play a role in the appearance of pneumatosis. In many aspects the human disease is reminiscent of experimental necrotizing enterocolitis obtained by infection of germ-free newborn animals, as reported in the literature.
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            Acute necrotizing enterocolitis in infancy: a review of 64 cases.

            Sixty-four cases of necrotizing enterocolitis are reviewed. The diagnosis was based on tissue examination in 57 and on the clinical syndrome, including pneumatosis, in 7. Three factors are important in the development of the disease: injury to the intestinal mucosa, bacteria, and feedings. The indications for surgical intervention are pneumoperitoneum, signs of peritonitis, and intestinal obstruction. The importance of stress in the etiology of the disease is confirmed by the high incidence of perinatal complications, particularly hypoxia. The mortality was high, but results are improving with the institution of early aggressive treatment.
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              ASYMPTOMATIC ENDEMIC ROTAVIRUS INFECTIONS IN THE NEWBORN

              Between May 1, 1976, and May 14, 1977, 343 (32·5%) of 1056 5-day-old babies in newborn nurseries excreted rotaviruses. The infection-rate was highest during winter (49%). 76% of infected babies at this time were bottle-fed. 41% of neonates excreted low amounts of virus (108 particles/g fæces); older children tended to excrete >1010 particles/g fæces. Infected breast-fed babies excreted less virus than those who were bottle-fed. Stools of breast-fed babies often contained clumps of complete "smooth" rotavirus particles. When the newborn nurseries were transferred to a newly built hospital wing, infection appeared in the new wards, including those admitting only new patients, within a short period. Infection was either mild (8%) or symptomless (92%), and even babies with symptoms required no treatment.
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                Author and article information

                Journal
                J Pediatr
                J. Pediatr
                The Journal of Pediatrics
                Published by Mosby, Inc.
                0022-3476
                1097-6833
                27 September 2006
                September 1983
                27 September 2006
                : 103
                : 3
                : 454-459
                Affiliations
                [a ]Department of Pediatrics, Section of Pediatric Infectious Diseases, University of Colorado School of Medicine, Denver, Colo.
                [b ]Section of Neonatology, University of Colorado School of Medicine, Denver, Colo.
                [c ]Division of Pediatric Infectious Diseases, Johns Hopkins Medical School, Baltimore, Md., USA
                [d ]Indiana University School of Medicine, Indianapolis, Ind. USA
                Author notes
                [1 ]Reprint requests: Harley A. Rothart, M.D., Pediatric Infectious Diseases, University of Colorado School of Medicine, Campus Box C-227, Denver, CO 80262.
                Article
                S0022-3476(83)80427-2
                10.1016/S0022-3476(83)80427-2
                7131059
                6310072
                Copyright © 1983 Published by Mosby, Inc.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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