1086 CORONAVIRUS-LIKE PARTICLES AND NEONATAL GASTROINTES-TINAL DISEASE

Coronavirus-like particles (CVLP) are associated with gastrointestinal (GI) symptoms (sx) in mammals, including man. We report an intensive care nursery (NICU) outbreak of GI sx associated with CVLP, identified by electron microscopy, in the stools of affected infants. Immune aggregation of stool CVLP occurred with sera of CVLP positive (+) infants only. Prevalence of stool CVLP, ascertained by 8 NICU-wide surveys over 40 weeks, fell from 67% to less than 10%, paralleling prevalence changes in the community. Most infants surveyed were premature. Overall, 36% (32/88) of all infants were CVLP +. Prenatal or intrapartum acquisition was suggested by the finding that 34% (11/32) of the CVLP + infants were examined within 72 hours of birth. CVLP + infants were more likely to have GI sx within 7 da of survey (p<.005), including water loss stools (p<.005), and the following sx persisting for more than 2 days: gastric retention (p<.001), bilious gastric aspirates (p<.02), abdominal distention (p<.01) and gross or occult blood in the stool (p<.005). CVLP + infants were also more likely to have multiple sx and to have feeds discontinued for more than 3 days due to GI sx. We conclude that stool Coronavirus-like particles are associated with clinically significant GI disease in the newborn.