A study of infections and illnesses in a day nursery based on inclusion-bearing cells in the urine and infectious agent in faeces, urine and nasal secretion

During an epidemic-free period of nearly 2 years infections and illnesses were followed in a group of small children (2-3 1/2 years) in a day nursery. The incidence of illness was fairly low, 6.3 per child and year. The viral infections were followed by means of the inclusion reaction in the urine and isolation of virus, and the bacterial by culture of nasal secretion. In 60% of the cases the viral infection was accompanied by illness. In 57 cases of illness there were 27 (47%) with merely virus and/or inclusion reaction, 8 (14%) in which bacteria alone were discovered, and 22 (39%) with both. The viral infections were the decisive ones in about 80% of the illnesses. Enteric respiratory viruses of 10 types were detected. 16 (73%) of the 22 children had such an infection on at least one occasion, and spread within the group occurred on infection with echovirus 9, coxsackievirus B4 and reovirus. Enteric viruses accounted for 29% of the viral infections. Streptococci and Mycoplasma pneumoniae played no part in the bacterial infections, which were entirely dominated by pneumococci. Cytomegaloviruria was found in 13 (72%) of 18 children examined. No spread was detected within the group. Rotavirus was on no occasion found in faeces.

Virus infections in children with acute lymphoblastic leukaemia

The pattern of virus isolation and illness was studied in 64 children with acute lymphoblastic leukaemia (ALL) during periods of apparent infection and when the children were well. The virus isolation rate of 2.2 viruses per child a year is similar to that previously found in normal children. In only 32% of children with symptoms were viruses found and 14.5% had viruses isolated when asymptomatic. The children with ALL appear to be more vulnerable to multiple virus infections and to excrete the virus for longer periods. This may be due to failure of production of both local and systemic antibodies. The failure in the past to recognise the true importance of virus infections in ALL may have been due to inadequate diagnostic techniques.