New concepts in viral gastroenteritis

The use of negative contrast electronmicroscopy of stool suspension in the investigation of the aetiology of childhood gastroenteritis has led to the recognition of a number of candidate viral agents. There is convincing evidence that rotavirus is the single most important cause of community acquired gastroenteritis, and is responsible for some nosocomial outbreaks. The epidemiology of rotavirus acquisition, differential clinical susceptibilities of young and older infants, pathogenesis of disease, mechanisms of immunity and breast milk protection, and the role of different viral serotypes are aspects as yet poorly understood; and attempts to propagate human rotavirus in tissue culture have met with only limited success. Moreover, the aetiologically unaccountable one third of cases of infantile diarrhoea, and the association of enteritis with up to six other virus-like particles add to the complexity of the problem. This review considers the available data from human and animal studies, and based on the experience of ourselves and others comments on the present state of knowledge and trends in continuing research.