Publications

widespread outbreaks of clam- and oyster-associated gastroenteritis. role of norwalk virus.	consumption of raw shellfish has long been known to be associated with individual cases and sporadic outbreaks of enteric illness. however, during 1982, outbreaks of gastroenteritis associated with eating raw shellfish reached epidemic proportions in new york state. between may 1 and december 31, there were 103 well-documented outbreaks in which 1017 persons became ill: 813 cases were related to eating clams, and 204 to eating oysters. the most common symptoms were diarrhea, nausea, abdominal cr ...	1986	3005857
norwalk like viruses: study of an outbreak.	an outbreak of acute non-bacterial gastroenteritis is reported, during which a ward had to be closed, and stool samples from 15 patients showed a virus structurally similar to the norwalk agent.	1986	3006605
viral diarrhoea.	it is apparent from this review that great progress has been made over the past 10 years in defining the aetiology of viral diarrhoea. rotavirus is a major cause of gastroenteritis in children, particularly during the winter months. however, if bacteriological and virological data are pooled, our current aetiological knowledge reveals that a pathogen is not detected in 20 to 30% of cases in most perennial investigations. now that human rotavirus has been cultured, complete characterization may b ...	1986	3006951
radioimmunoassay for detection of the snow mountain agent of viral gastroenteritis.	the snow mountain agent (sma) is a norwalk-like viral agent of acute gastroenteritis that has been detected only by immune electron microscopy (iem). we established a solid phase microtiter radioimmunoassay (ria) for sma antigen employing pre-and post-challenge sera from volunteer studies as capture antibodies. sma was detected in 12 of 67 stool samples from volunteers who were ill after oral challenge with sma. all samples in which virus particles were detected by iem were positive by ria, but ...	1986	3009701
characterization of the snow mountain agent of viral gastroenteritis.	snow mountain agent (sma) is a 27- to 32-nm virus which is the etiologic agent of outbreaks of acute gastroenteritis in colorado and vermont. sma is morphologically similar to but antigenically distinct from the norwalk and hawaii agents of viral gastroenteritis but, like those agents, has not been cultivated in vitro. we purified and characterized sma directly from human stool specimens containing the virus. the density of the sma virion was 1.29 g/cm3 and 1.21 to 1.22 g/cm3 on potassium tartra ...	1986	3009862
an eight-year study of the viral agents of acute gastroenteritis in humans: ultrastructural observations and seasonal distribution with a major emphasis on coronavirus-like particles.	during an 8-yr period, 862 stool specimens from patients with gastroenteritis were examined by electron microscopy after negative staining with 2% phosphotungstic acid (ph 6.5). forty-one percent of the specimens submitted over an 8-yr period were determined to be positive for virus or viruslike particles belonging to one or more of seven morphologically distinct viral groups. coronavirus-like particles (cvlps) were present in 69.8% of the positive stool specimens. membranous profiles containing ...	1986	3011353
gastroenteritis outbreaks on two caribbean cruise ships.		1986	3012310
a foodborne outbreak of norwalk virus gastroenteritis. evidence for post-recovery transmission.	from november 10-16, 1982, 220 (57%) of 383 attendees at eight banquets for which food had been prepared at a single hotel restaurant and the employees of the hotel had onset of norwalk virus gastroenteritis. epidemiologic investigation of the three largest banquets confirmed consumption of potato and fruit salads (banquet a), coleslaw (banquet b), and tossed salad (banquet c) to be significantly associated with illness. between november 8-19, similar illness occurred in seven (54%) of 13 hotel ...	1986	3013001
leads from the mmwr. gastroenteritis on two caribbean cruise ships.		1986	3014174
pathogens that cause travelers' diarrhea in latin america and africa.	with the advent of rapid and convenient means of transportation, millions of persons travel each year from industrialized to developing countries in the tropics and subtropics. these travelers are at risk for a variety of infectious diseases that are endemic in these areas; the most frequently occurring of these is diarrhea. studies of groups of travelers to latin america and africa have found that approximately one-half develop diarrhea during their stay abroad. etiologic investigations of thes ...	1986	3014633
pediatric viral gastroenteritis.	rotavirus and norwalk agent cause most viral gastroenteritis in the pediatric population. infection results in osmotic diarrhea, which can cause dehydration and acidosis. oral rehydration therapy has been shown worldwide to be a safe and effective means of treating this disease. formula feeding should be resumed as soon as possible; breast feeding should be maintained throughout the illness. admission criteria are based on weight loss, serum sodium level and ability to rehydrate orally on an out ...	1986	3014849
human viruses in sediments, sludges, and soils.	recent studies have provided a greater understanding of the movement of viruses in the environment by their attachment to solids. these studies have focused on solids-associated viruses present in wastewater discharged into the ocean and on viruses in sludge and wastewater that may be retained in soil following their land disposal. such ocean or land disposal of wastewater and sludge may result in a discharge of one or more of 120 human enteric virus pathogens including those causing poliomyelit ...	1986	3015442
antigen detection in the diagnosis of norwalk virus gastroenteritis.		1986	3016117
clinical associations of norwalk-like virus in the stools of children.	from among 1,360 stool specimens examined during the 19-month period from march 1982 to september 1983, small round-structured viruses, morphologically indistinguishable from the norwalk agent, were detected by electron microscopy in 42 specimens from 28 children. diarrhoea was mild, and vomiting, although frequently observed, was not an invariable feature. mild pyrexia occurred in three patients. many cases occurred some time after admission to the ward; this and other features suggested a hosp ...	1986	3016227
enzyme-linked immunosorbent assays for snow mountain and norwalk agents of viral gastroenteritis.	enzyme-linked immunosorbent assays (elisas) for antigen detection and blocking elisas for serum antibody rises were developed for the snow mountain and norwalk agents of viral gastroenteritis. the elisas were as sensitive as the existing radioimmunoassays and were specific for the snow mountain or norwalk agent. the blocking elisas detected the same number of significant rises in antibodies to these agents as did the existing blocking radioimmunoassays.	1986	3020085
novel agents of viral enteritis in humans.	considerable information has recently emerged regarding certain "groups" of novel viruses associated with gastroenteritis in humans. the viruses reviewed here are 20-35 nm in diameter and can be detected in the stools of acutely ill individuals with gastroenteritis. these viruses can be conveniently divided into four "groups": norwalk-like agents, caliciviruses, astroviruses, and other small round viruses. the evidence for the etiologic association of these agents with gastroenteritis varies fro ...	1987	3027199
norwalk-like gastroenteritis epidemic in a toronto hospital.	an epidemic of gastroenteritis in a teaching hospital affected 57 patients and 69 staff over a 26-day period. the index case was a patient admitted with acute abdominal pain and diarrhea two days prior to the outbreak. the epidemic curve indicated person-to-person transmission. the incubation period, duration and types of symptoms were typical of norwalk gastroenteritis, and norwalk-like virus particles, serologically different from the prototype norwalk virus strain, were observed in 17 of 20 f ...	1987	3028187
foodborne snow mountain agent gastroenteritis in a school cafeteria.	in 1984, an outbreak of gastroenteritis occurred at a school with 1,860 students in brooklyn, ny. in a single-stage cluster sample of 375 students, 129 (34%) had illnesses that met our case definition of vomiting or diarrhea. the mean incubation period was 26 hours, and the mean illness duration was 24 hours. all case students had eaten in the cafeteria on at least one day between nov 13 and 16, compared with 174/214 (81%) noncase students (p = 10(-8), fisher exact test). foods implicated were f ...	1987	3029660
small round viruses: classification and role in food-borne infections.	since the first observation of norwalk virus in the electron microscope in 1972, many different small virus particles in the size range 20-40 nm have been described world-wide in association with outbreaks of gastroenteritis. progress characterizing these agents has been hampered by the relatively small numbers of particles present in clinical material and the lack of success in culturing them. although the relationship between some of these viruses remains confusing, a number of distinct groups ...	1987	3036438
the candidate caliciviruses.	the caliciviridae are a family of small (35-40 nm) rna viruses with a characteristic cupped morphology. they are unique in possessing only a single major structural polypeptide, of mr 60,000-71,000. the use of electron microscopy to investigate diarrhoeal diseases has revealed viral particles with the size and structure of the caliciviruses in the faeces of humans, domestic and farm animals, birds, reptiles and insects. in vivo experiments indicate that they are species specific and have confirm ...	1987	3036439
immunobiology of norwalk virus.	clinical immunity to norwalk virus in inoculated human volunteers appears to be unusual for gastroenteritis viruses, as certain individuals are repeatedly ill on long-term virus rechallenge and others remain persistently well. in these volunteers there is a paradoxical inverse correlation between the prechallenge serum (and jejunal fluid) norwalk antibody level (measured by radioimmunoassay) and resistance to illness, suggesting that non-immunological factors, perhaps genetic, may be important i ...	1987	3036440
viral diarrhea.	viral diarrhea is a frequent, self-limited illness that may occur sporadically or in epidemic fashion. nosocomial outbreaks have been reported. rotavirus and norwalk virus are the two most important agents causing this disease. clinical illness is usually mild but may be quite severe in selected infants or elderly or debilitated persons. specific diagnosis has been advanced by the use of immunoassays. treatment is supportive, and most patients recover completely. good hygienic measures are effec ...	1988	3074122
bismuth subsalicylate in the treatment and prevention of diarrheal disease.	bismuth subsalicylate (bss) has been used for more than 80 years to treat gastrointestinal symptoms although little clinical evidence was available until recently to substantiate its value and possible mechanisms of action. bss 4.2 g given over 3 1/2 hours was shown to reduce the number of stools passed and favorably alter subjective symptoms in patients with traveler's diarrhea. bss has also been shown to have beneficial effects on chronic infantile diarrhea. a small but discernible effect has ...	1987	3308391
the childhood health effects of an improved water supply system on a remote panamanian island.	the incidence of diarrhea, respiratory disease, and skin infections was prospectively determined after the introduction of a system which distributed unlimited quantities of high quality fresh water to each of the 150 housing units on tupile, an island devoid of fresh water located off panama's caribbean coast and inhabited by 1,500 cuna indians. tupile residents used 7.1 liters of water/person/day compared to the 2.3 usage rate of inhabitants on achutupo, the control island. despite ready avail ...	1985	4037183
food borne infection by a norwalk like virus (small round structured virus).	two outbreaks of gastrointestinal illness with identical symptoms occurred in parties attending banquets on consecutive evenings at a large hotel. the illness was typical of epidemic winter vomiting disease. small round structured viruses resembling those seen in the norwalk ohio outbreak were identified by electron microscopy in stools of victims from one episode. one food handler was found to be excreting the virus, and there was evidence of a poor standard of hygiene in the kitchen. a food hi ...	1984	6086727
[norwalk virus and acute gastroenteritis].		1984	6088049
viral gastroenteritis.		1984	6092272
serological responses among teenagers after natural exposure to norwalk virus.	twenty-one teenagers exposed to a contaminated water supply during an outbreak of gastroenteritis were tested for seroconversion to norwalk virus. serum specimens were collected within 72 hr of exposure and four weeks later. each of the 11 individuals who developed symptoms and five of the 10 who remained well had a whole-antibody response in serum. none of the remaining five teenagers became ill or seroconverted. neither seroconversion nor susceptibility to illness was associated with an absenc ...	1984	6092484
viral diarrhoeas.		1984	6096438
[epidemiologic and electron microscopic study of viral gastroenteritis in kagawa prefecture, japan, revealed three distinct causative agent groups].		1984	6096456
[viral etiology of gastroenteritis].		1984	6097282
[diarrhea in young calves. 6. determination of the pathogenicity of a bovine coronavirus and an unidentified icosahedral virus].		1984	6099109
norwalk virus and rotavirus in travellers' diarrhoea in mexico.		1982	6119475
[viral diarrhea].		1982	6191463
protective effect of anticholinergic drugs and psyllium in a nosocomial outbreak of norwalk gastroenteritis.	an outbreak of norwalk agent gastroenteritis occurred in a chronic-care hospital in tennessee in april 1981. fifty-five per cent of the elderly psychiatric patients and 61 per cent of the nursing employees on one floor became ill. infection was most likely to have spread from patient-to-patient by nursing employees. certain chronic medications seemed to protect patients from symptomatic infection. anticholinergic drugs appeared to mask the symptoms of this disease; psyllium ('metamucil') may hav ...	1983	6198366
enzyme-linked immunosorbent assay for the detection and identification of coxsackie b antigen in tissue cultures and clinical specimens.	an enzyme-linked immunosorbent assay (elisa) has been developed for the identification of coxsackie b antigens. this assay was capable of identifying and distinguishing all six coxsackie b serotypes at concentrations one hundredfold to ten thousandfold less than could be detected by complement fixation (cf) systems. in addition, the coxsackie b elisa correctly identified the presence of coxsackie b antigen in 19 of 21 tissue culture fluids and five of nine rectal swab specimens. two additional r ...	1980	6262456
a prospective study of rotavirus infection in infants and young children.	diarrhea in neonates, followed as a cohort, and their families was studied prospectively. the families were followed for an average of 16.3 months. stool and serum specimens were obtained at least every three months. stool specimens were examined for viruses by electron microscopy and cultured for enteropathogens, and serum specimens were tested for antibodies to rotavirus and norwalk virus. during the study, 237 episodes of gastroenteritis were observed in 104 infants and their 62 siblings. rot ...	1981	6268713
aetiology of viral gastroenteritis: a review.	over the past seven to eight years, several virus groups have been shown to be associated with gastroenteritis. they are adenoviruses, astroviruses, caliciviruses, coronaviruses. norwalk-like viruses and rotaviruses. in infants and young children, rotaviruses are the single most important aetiological agents of acute gastroenteritis in terms of numbers of cases and also of patients requiring admission to hospital. in older children and adults, the aetiology is less clear, but the present state o ...	1981	6272071
norwalk-related viral gastroenteritis due to contaminated drinking water.	an explosive outbreak of gastrointestinal illness clinically compatible with infection by an agent serologically related to norwalk virus agent occurred in an elementary school in may 1978. seroconversion by radioimmunoassay to the norwalk antigen was noted in two of three ill persons, but no viral particles were identified in stool. illness developed in 72% of students and teachers at the school, and 32% of household contacts of these ill persons. of household contacts of persons exposed at sch ...	1981	6272571
travelers' diarrhea in panamanian tourists in mexico.	to determine whether residents of developing countries are unlikely to acquire travelers' diarrhea, 64 panamanians of widely divergent socioeconomic strata were studied during a 15-day tour through mexico. twenty-three (36%) tourists experienced 27 episodes of travelers' diarrhea that were caused by seven different pathogens. the most commonly identified etiologic agents were rotavirus (26%), norwalk virus (15%), and campylobacter fetus (11%), whereas enterotoxigenic escherichia coli was not fre ...	1981	6273474
waterborne gastroenteritis due to the norwalk agent: clinical and epidemiologic investigation.	an outbreak of gastroenteritis occurred at a pennsylvania summer camp in july 1978. symptoms included abdominal pain (81 per cent), nausea (72 per cent), and vomiting (53 per cent); upper respiratory infection symptoms occurred in 35 per cent of the campers. illness was associated with consumption of five or more glasses of water or water-containing beverages. stool cultures from affected persons were negative for bacterial pathogens; however, a fourfold or greater rise to the norwalk agent was ...	1982	6274208
lymphocytotoxic and microbial antibodies in crohn's disease and matched controls.	patients with crohn's disease and age, sex and seasonally matched healthy controls were studied for cold lymphocytotoxic and a variety of microbial antibodies. lymphocytotoxic antibody titers were increased significantly in the crohn's patients compared to controls, but did not correlate with any of the microbial titers. antibodies to a pseudomonas-like bacterium and bacteroides vulgatus were also increased in the patients, but titers to chlamydia trachomatis, rotavirus and norwalk virus were no ...	1981	6275790
norwalk gastrointestinal illness: an outbreak associated with swimming in a recreational lake and secondary person-to-person transmission.	an outbreak of gastrointestinal illness in which headache, low grade fever and myalgia were common symptoms occurred among persons who visited a recreational park in macomb county, michigan, on july 13-16, 1979. the temporal clustering of onsets of 121 persons who were the first in their households to become ill suggested an incubation period ranging from 4-77 hours. a history of swimming in the park's lake was elicited with significantly greater frequency from these persons than from park visit ...	1982	6277184
norwalk virus enteric illness acquired by swimming exposure.	in an epidemic of gastrointestinal illness strongly associated with swimming at a recreational park in macomb county, michigan, in july, 1979, the authors demonstrated the value of serologic testing to detect norwalk virus infection. rises in antibody titer to norwalk virus were noted in all 11 individuals tested. electron microscopy on stools from 20 ill individuals revealed only one with norwalk virus-like particles. this particle was shown by radioimmunoassay and immune electron microscopy no ...	1982	6277185
foodborne norwalk virus.	on december 6, 1979, three luncheon banquets were served in a new jersey restaurant. thirty-eight of 41 members (92.7%) of the first group became ill as did 25 of 31 members (80.6%) of the second group. none of 12 members of the third group were ill. illness consisted primarily of diarrhea (76%), nausea, (73%), vomiting (67%), cramps (46%) and fever (18%); the median incubation period was 31 hours and median duration 24 hours. the same foods were served to all three groups, except that cole slaw ...	1982	6277186
[variation of diarrhea viruses detected in japan with special reference to spherical viruses other than rotaviruses (author's transl)].		1981	6278755
norwalk virus gastroenteritis following raw oyster consumption.	in january, 1980, six out of 13 persons (46%) attending a party in a small northwest florida town near the gulf of mexico became ill with norwalk virus gastroenteritis after eating raw oysters. symptoms experienced by the ill persons were principally nausea (100%), vomiting (83%) and diarrhea (50%) and were of brief duration. the symptom complex and epidemiology of norwalk virus infection closely resemble the gastrointestinal illness commonly referred to as the 24-hour intestinal flu or "stomach ...	1982	6278928
acquisition of serum antibody to norwalk virus and rotavirus and relation to diarrhea in a longitudinal study of young children in rural bangladesh.	serum antibodies to norwalk virus and to rotavirus were measured during longitudinal studies of infectious diseases and nutrition in rural bangladesh. initially, the prevalence of antibody to norwalk virus was 7% in children younger than six months and increased to 80% in children two to five years of age. the incidence of titer increases was highest in one- and two-year-olds and in children who had low or undetectable levels of antibody. some norwalk virus infections appeared to result in diarr ...	1982	6279734
viral gastroenteritis.		1982	6281591
[viral diarrhea].	viruses are one of the most frequent causes of acute infectious gastroenteritis. thus, rotaviruses are responsible for 40-60%--and in winter sometimes for over 90% - of diarrhoea in infants. these viruses may also cause disease in adults, but small viruses of a size of about 27 nm, such as the norwalk agent, play a much more important role. several other non-cultivable viruses such as adeno-, calici- and astroviruses have been implicated as a cause of infectious diarrhoea. knowledge of rotavirus ...	1982	6281877
[norwalk-like viruses as probable etiological agents in the epidemic of non-bacterial gastroenteritis (author's transl)].		1982	6282470
diarrhea due to norwalk virus in families.		1982	6282989
epidemiology of norwalk gastroenteritis and the role of norwalk virus in outbreaks of acute nonbacterial gastroenteritis.	outbreaks of norwalk gastroenteritis, which may involve persons of all ages, occur during all seasons and in various locations. waterborne, foodborne, and person-to-person modes of transmission have been described, and secondary person-to-person transmission is common. outbreaks generally end in about 1 week; longer outbreaks occur only when new groups of susceptible persons are introduced, usually in the setting of a persistent common source of infection. the illness is generally mild and chara ...	1982	6283977
antibodies to gastroenteritis viruses in cystic fibrosis patients.	infectivity of certain enteric viruses including rotavirus is profoundly affected by proteolytic enzymes. to test whether cystic fibrosis patients, possessing chronically decreased levels of pancreatic enzymes, show altered susceptibility to gastroenteritis viruses, we examined sera from patients and controls for antibodies to two major pathogens. in cystic fibrosis patients, normal rotavirus antibody levels were found and norwalk virus antibody prevalence was unchanged.	1982	6284870
detection by immune electron microscopy of the snow mountain agent of acute viral gastroenteritis.	an extensive outbreak of acute gastroenteritis of unknown etiology occurred at snow mountain, colorado, in december 1976. virus-like particles, 27 nm in diameter, were observed by electron microscopy in two of five stool specimens from individuals in the outbreak. oral administration of a filtrate from one of the specimens induced disease in nine of 12 normal volunteers. experimentally induced illness was similar to that observed during the outbreak. stool specimens examined by immune electron m ...	1982	6286787
gastroenteritis due to norwalk virus: an outbreak associated with a municipal water system.	an outbreak of gastroenteritis lasting for one week in august 1980 affected approximately 1,500 persons in a community in northern georgia. investigation included a telephone survey of the community, a survey of textile plant employees and junior high and high school students and staff, and a neighborhood door-to-door survey. an association between gastrointestinal illness and consumption of drinking water was shown for community residents, students, and school staff. attack rates (0-68%) determ ...	1982	6286788
the electron microscopical and physical characteristics of small round human fecal viruses: an interim scheme for classification.	many of the small round human fecal viruses implicated in outbreaks of nonbacterial gastroenteritis have been collected together and examined under the electron microscope. negatively stained preparations without the addition of antibody were used so that the surface morphology of the virus particles remained clearly visible. it was apparent that several viruses, previously thought to be simply antigenic variants within the norwalk group of viruses, show distinct morphological differences and qu ...	1982	6286860
immunoglobulin m responses to the norwalk virus of gastroenteritis.	eighty-seven serum specimens from 20 human subjects experimentally inoculated one or more times with norwalk virus were quantitatively examined for virus-specific immunoglobulin m (igm). a sensitive and specific radioimmunoassay for anti-norwalk virus blocking activity was applied to whole serum and to separate igm and igg fractions obtained by sucrose density gradient ultracentrifugation. the peak igm response occurred at about 2 weeks after illness, but igm was detectable at lower titers for u ...	1982	6288563
potassium tartrate-glycerol as a density gradient substrate for separation of small, round viruses from human feces.	cesium chloride density gradients are frequently used for virus concentration or purification in the preparation of human feces for examination by electron microscopy, disruption of some of the fecal viruses occurs if they are pelleted from the density gradient in an additional concentration step. this report highlights an important limitation imposed by the use of cesium chloride as a density gradient substrate in attempting to recover small, round, virus-like particles from feces and suggests ...	1982	6288767
viral diseases: infections of the gastrointestinal tract.	in the 1970s investigations generated a remarkable amount of information on the viruses responsible for acute gastroenteritis. the two viruses responsible for most cases occur in epidemiologically distinct clinical forms. although occasionally epidemic, rotavirus infections are usually sporadic and primarily affect infants and young children. this illness is characterized by severe diarrhea commonly lasting five to eight days and frequently associated with upper respiratory tract symptoms, fever ...	1982	6290133
acute viral enteritis and exacerbations of inflammatory bowel disease.	in order to determine whether or not acute viral gastroenteritis predisposes to exacerbations of inflammatory bowel disease, patients with crohn's disease and ulcerative colitis were observed longitudinally. assessment of disease activity was correlated with evidence for viral infection by serology and stool antigen testing. disease exacerbations were rarely associated with rotavirus, norwalk agent, or adenovirus infection, primarily because these infection rates were very low. however, the few ...	1982	6290307
seroepidemiology of heat-labile enterotoxigenic escherichia coli and norwalk virus infections in panamanians, canal zone residents, apache indians, and united states peace corps volunteers.	serum antibody titrations against the heat-labile enterotoxin (lt) of escherichia coli were carried out on panamanians, u.s. citizens resident in the panama canal zone, apache indians living on the reservation in whiteriver, arizona, and peace corps volunteers before they traveled overseas. antibody titers to norwalk virus were also carried out on serum from panamanian and canal zone residents. a high prevalence of low-titer lt antibodies was found in infants and adults from panama, the canal zo ...	1982	6290396
norwalk virus: a major cause of epidemic gastroenteritis.		1982	6291413
the frequency of a norwalk-like pattern of illness in outbreaks of acute gastroenteritis.	records of 642 outbreaks of acute gastroenteritis were reviewed to determine the proportion of outbreaks that were clinically and epidemiologically consistent with norwalk-like virus infection. using as our criteria stool cultures negative for bacterial pathogens, mean (or median) duration of illness 12-60 hours, vomiting in greater than or equal to 50 per cent of cases, and, if known, mean (or median) incubation period of 24-48 hours, we found that 23 per cent of waterborne outbreaks, 4 per cen ...	1982	6291414
community outbreak of norwalk gastroenteritis--georgia.		1982	6292685
an outbreak of norwalk gastroenteritis associated with swimming in a pool and secondary person-to-person transmission.	in june 1977 an outbreak of acute gastroenteritis affected 103 students and teachers at an elementary school in ohio. the illness typically lasted 24 hours or less and was characterized by vomiting (86%) and cramping (70%), but more than half of the persons involved also reported having nausea, diarrhea, and headache. similar illness frequently followed in household members (29%) of families with primary cases. investigation revealed that 70% of the children and teachers who swam in a pool at an ...	1982	6293305
an outbreak of acute nonbacterial gastroenteritis in a nursing home. demonstration of person-to-person transmission by temporal clustering of cases.	an outbreak of acute nonbacterial gastroenteritis occurred among residents and staff in a nursing home in baltimore, maryland, in december 1980. a total of 101 residents and 69 staff members were surveyed by questionnaire. the attack rate (defined as acute onset of vomiting or two or more loose stools per 24 hours) was 46% in each group. illness was brief and mild; no patients were hospitalized, and there were no deaths. person-to-person transmission was documented by temporal clustering of case ...	1982	6293306
new agents in diarrhea.		1982	6294627
norwalk gastroenteritis associated with a water system in a rural georgia community.	an outbreak of acute gastroenteritis occurred during january 4-9, 1982, in a rural community in north georgia. a systematic telephone survey revealed that 63% of persons living in homes served by the community water system had symptoms of acute gastroenteritis in contrast to 9% of persons in homes served by private wells or other sources (p less than .001). a fourfold rise in antibody titer to the norwalk virus occurred in 20 of 22 serum pairs obtained from ill persons. fecal coliforms (greater ...	1982	6295289
current concepts on etiology and pathogenesis of diarrhoea caused by viruses.		1982	6298950
diarrhea among infants and young children in canada: a longitudinal study in three northern communities.	diarrhea among neonates and their siblings was studied in 98 families living in winnipeg, manitoba, and in 31 native indian families and in 15 inuit (eskimo) families living in isolated settlements in northern canada. the rate of infection due to rotavirus in neonates was significantly higher and infection occurred more often in the first six months of life in the northern communities (range, 0.36 in winnipeg to 1.07 in eskimo point). no protective effect of breast-feeding was discerned, since i ...	1983	6302173
[infectious diarrhea of viral and bacterial etiology].		1982	6302816
infectious diarrhea. which culprit? what strategy?	the patient with diarrhea is generally looking for prompt relief, not a prolonged diagnostic workup. in many cases effective treatment can be initiated after careful review of the clinical symptoms and of the patient's recent travel or other activities. stool examination, sigmoidoscopy, or other studies may be necessary for definitive diagnosis or in refractory cases. drugs are useful to combat many of the causative organisms, but in mild, self-limited infections, supportive therapy may suffice. ...	1983	6304670
age-specific prevalence of antibody to rotavirus, escherichia coli heat-labile enterotoxin, norwalk virus, and hepatitis a virus in a rural community in thailand.	a serological survey in rural thailand demonstrated that inhabitants acquired antibody to rotavirus between the ages of 6 months and 6 years, to norwalk virus between the ages of 4 and 5 years, and to hepatitis a between the ages of 6 and 35 years. antibody of escherichia coli heat-labile toxin was most prevalent between 1 and 4 years and 18 and 25 years of age.	1983	6306049
the tecumseh study. xii. enteric agents in the community, 1976-1981.	enteric illnesses in residents of tecumseh, michigan, were studied from 1976 to 1981. the frequency of illness among adults and children increased each year in the late autumn, usually in november. this peak of illness preceded the main period of appearance of the rotaviruses, which were less regularly associated with another peak of illness. rotaviruses were identified in 3.8% of all stool specimens collected; in specimens from children under two years of age, the annual rate of rotavirus ident ...	1983	6310002
viral gastroenteritis.		1983	6312212
infectious diarrhea: an update.		1983	6315297
an outbreak of food-borne gastroenteritis in two hospitals associated with a norwalk-like virus.	two connected outbreaks of gastroenteritis in separate hospitals associated with a small round structured virus morphologically indistinguishable from the norwalk virus are described. the virus was most probably introduced on chicken sandwiches prepared by a member of the kitchen staff who was incubating the disease.	1983	6315816
[viral gastroenteritis].		1983	6320551
a community waterborne gastroenteritis outbreak: evidence for rotavirus as the agent.	a community waterborne nonbacterial gastroenteritis outbreak occurred in eagle-vail, colorado in march 1981. illness (defined as vomiting and/or diarrhea) was statistically associated with water consumption (chi 2 for linear trend = 7.07, p less than .005). five of seven persons associated with the outbreak were infected with rotavirus as shown by virus detection or serological methods. bacterial pathogens, giardia lamblia, and norwalk virus were excluded as responsible agents. rotavirus should ...	1984	6320684
norwalk gastroenteritis: a community outbreak associated with bakery product consumption.	from 23 to 26 august 1982, a gastrointestinal illness occurred among 129 of 248 (52%) persons interviewed who had attended four social events in the minneapolis-st. paul area. the median incubation period was 36 hours, and symptoms included diarrhea, nausea, headache, and vomiting. findings of a food-specific questionnaire given to attendants of the four events confirmed that consumption of cake and frosting was significantly associated with development of the illness (odds ratio, 7.9 to 48.3; p ...	1984	6322631
viral gastroenteritis and laboratory detection of rotavirus.	two major viruses have been clearly associated with gastroenteritis: the norwalk agent and the rotavirus. the former is associated with epidemic outbreaks in adults or schoolchildren, while the latter causes endemic illness in young children during winter. neither can be grown in routine cell cultures. both of these viruses, and others, can be detected in patients' stools by electron microscopy. enzyme linked immunosorbent assay (elisa) kits are commercially available for detection of rotavirus ...	1983	6326572
[value of fecal leukocyte studies in cases of acute diarrhea].	the usefulness of screening for presence of fecal leukocytes has been investigated prospectively in 87 ambulatory patients with diarrhea. this simple test has proved valuable in helping to select patients for whom laboratory studies of stools for etiologic agents are indicated.	1984	6328645
human viral gastroenteritis.		1984	6330511
abnormal gastric motor function in viral gastroenteritis.	nausea and vomiting occur commonly with gastroenteritis caused by parvovirus-like agents. infection results in histologic injury to the small bowel mucosa, but the gastric mucosa remains unaffected. we have studied gastric emptying of liquids serially in 10 volunteers before and after ingestion of the parvovirus-like agents, norwalk and hawaii viruses. the five subjects who developed illness all showed marked delays in gastric emptying, while the five well subjects had no alteration of emptying. ...	1980	6766695
the darwin outbreak of oyster-associated viral gastroenteritis.	approximately 60 persons attended a christmas dinner, at a darwin hotel, where oysters were served au natural as part of the menu. twenty-five of the 28 persons who ate oysters developed symptoms of food poisoning--an attack rate of 89%. of the 60 persons attending the dinner 44 were investigated. the incubation period and duration of illness were about 36 hours. diarrhoea occurred in 100% of patients, with colic and nausea in 88% and 80% respectively. half the patients complained of vomiting an ...	1980	6768972
oyster-associated gastroenteritis in australia: the detection of norwalk virus and its antibody by immune electron microscopy and radioimmunoassay.	following widespread outbreaks of oyster-associated gastroenteritis in australia during 1978 in which norwalk virus was implicated as the causative agent, collaborative studies were undertaken between laboratories in australia and the united states to confirm the etiology. immune electron microscopy (iem) techniques were used in australia and radioimmunoassay (ria) methods in the united states. norwalk virus was detected by iem in seven of 15 faecal samples, and four were positive by ria. a much ...	1980	6785390
proteins of norwalk virus.	the proteins of the norwalk virus were studied by polyacrylamide gel electrophoresis. highly purified specifically immunoprecipitated virions appeared to contain a single primary structural protein with a molecular weight of 59,000. in addition, a soluble norwalk viral protein with a molecular weight of 30,000 was identified in fecal specimens containing norwalk virus. the protein structure of the virion is similar to that of the calciviridae family.	1981	6785451
norwalk virus gastroenteritis in volunteers consuming depurated oysters.	following the widespread outbreaks of oyster-associated gastroenteritis which occurred throughout australia in 1978, several programmes were introduced to minimise the occurrence of further outbreaks. one programme included the depuration (purification) of oysters and the use of human volunteers to test-consume samples from batches of depurated oysters before their sale to the public. oysters from the georges river and brisbane waters were test-consumed from december, 1978, to august, 1979. none ...	1981	6789806
the 33- to 39-nm virus-like particles, tentatively designed as sapporo agent, associated with an outbreak of acute gastroenteritis.	an outbreak of nonbacterial gastroenteritis occurred in an orphanage in december 1979. of 54 residents, 43 were affected with acute gastroenteritis. diarrhea was the commonest symptom. the 33- to 39-nm virus-like particles, tentatively designated as sapporo agent, were detected in 17 (48.6%) of the patients' 35 fecal specimens. morphologically, it was difficult to distinguish the sapporo agent from other agents without geometrical pattern of the surface. antigenically, the sapporo agent related ...	1981	6799614
comparative study of the acquisition of antibody to norwalk virus in pediatric populations.	analysis by radioimmunoassay of pediatric sera from three populations showed that antibody to norwalk virus is acquired at a significantly earlier age in a less developed and tropical area (philippines) than in two more developed and nontropical countries (united states and taiwan).	1980	7216438
norwalk virus gastroenteritis aboard a cruise ship: an outbreak on five consecutive cruises.	an explosive outbreak of gastroenteritis caused by a parvovirus-like (pvl) agent (norwalk agent) affected 521 (64%) cruise ship passengers in 1977. the illness was characterized as mild-to-moderate and lasted one to two days. principal symptoms experienced by ill passengers were nausea, vomiting, and diarrhea; fever was reported for approximately 25% of the patients. the outbreak was compatible with a common-source exposure, but no such exposure was identified. on the next four cruises, passenge ...	1980	7457473
detection of norwalk virus and hepatitis a virus in shellfish tissues with the pcr.	a method for the detection of norwalk virus and hepatitis a virus from shellfish tissues by pcr was developed. virus was added to the stomach and hepatopancreatic tissues of oysters or hard-shell clams, and viral nucleic acids were purified by a modification of a previously described method (r.l. atmar, t.g. metcalf, f.h. neill, and m.k. estes, appl. environ. microbiol. 59:631-635, 1993). the new method had the following advantages compared with the previously described method: (i) more rapid sa ...	1995	7487032
monoclonal antibodies for detection of norwalk virus antigen in stools.	monoclonal antibodies against the prototype 8fiia strain of norwalk virus were prepared and applied to an enzyme immunoassay (eia) for detecting norwalk virus in stool specimens. the monoclonal antibodies immunoprecipitated a 58-kda protein which had been produced by in vitro transcription-translation of norwalk virus cloned cdna, and they reacted by eia with recombinant norwalk virus capsid protein at a sensitivity level of 1 ng/ml. the eia detected virus in all tested samples from 15 different ...	1995	7494063
[gastroenteritis outbreak associated with water consumption, possibly caused by norwalk or norwalk-like virus].	it is described an acute gastroenteritis outbreak of probable hydric transmission in ontinyent (valencia). it was declared on the 31st of january, 1992 and affected 3541 people according to the declaration done by the sanitary services who attended the patients. the clinical situation was characterized by the presence of profuse and watery diarrhoea, nausea, vomiting, abdominal pain and fever or febricula.	1995	7497350
small round structured viruses (srsv).		1993	7506612
gastroenteritis associated with oysters.		1994	7514927
comparison of the polymerase region of small round structured virus strains previously classified in three antigenic types by solid-phase immune electron microscopy.	we have used a reverse transcription-polymerase chain reaction with nested sets of primers to determine the nucleotide sequences of a 166 base pair segment of the rna polymerase region of seven strains of small round structured viruses (srsvs) from the united kingdom. these srsv strains were previously classified by solid-phase immune electron microscopy into three antigenic types--uk2, uk3 and uk4, which are comparable to the prototype strains norwalk virus, hawaii agent, and snow mountain agen ...	1994	7515226
development of a method for detection of enteroviruses in shellfish by pcr with poliovirus as a model.	the application of the pcr to complex samples is hindered by amplification inhibitors. we describe a reverse transcription-pcr-based method capable of inhibitor removal for the detection of enteroviruses in shellfish. initial virus extraction stages based on a modified polyethylene glycol precipitation technique (g.d. lewis and t.g. metcalf, appl. environ. microbiol. 54:1983-1988, 1988) were followed by virus purification with 1,1,2-trichloro,2,2,1-trifluoroethane and concentration by ultrafiltr ...	1994	7521997
viral gastroenteritis associated with a sandwich bar.		1994	7522804