[The incidence of HBsAg in different population groups of Moldavia in 1991 compared to 1973]

AgHBs incidence in various population groups from the Iaşi region was relatively high in 1991, ranging from 3.8% in blood donors to 75.0% in patients with severe acute virus hepatitis. As compared to the incidence values recorded in 1973, 18 years ago, in the population of the same territory, some mutations were observed, the most important being the more then threefold reduction of the AgHBs incidence in blood donors. In subjects with liver diseases and in risk groups, the frequency of AgHBs carriers maintains at a high level.

[Incidence of HBsAg among different population groups in Moldavia in 1991 compared with 1973]

AgHBs incidence in various population groups from the Iassy region was relatively high in 1991, ranging from 3.8% in blood donors to 75.0% in patients with severe acute virus hepatitis. As compared to the incidence values recorded in 1973, 18 years ago, in the population of the same territory, some mutations were observed, the most important being the more then threefold reduction of the AgHBs incidence in blood donors. In subjects with liver diseases and in risk groups, the frequency of AgHBs carriers maintains at a high level.

Studies of bacterial, rotaviral and Cryptosporidium etiology of acute diarrheal diseases in hospitalized children

657 hospitalized children with acute diarrheal disease were studied for bacterial and rotaviral etiology. Cryptosporidium presence was followed in 123 children. Intestinal pathogens were detected in 195 (29.6%) cases: 132 (20.3%) enterobacteria, 47 (7.1%) rotaviruses, 4 (3.2%) Cryptosporidium sp. and 12 (1.8%) combined infections. Among enterobacteria, E. coli was the most frequent (10% cases) with enteropathogenic (EPEC), enterotoxigenic (ETEC), enterohemorrhagic (EHEC) and enteroinvasive (EIEC) groups. Other isolated pathogens were Salmonella--21 (3.1%), C. jejuni/coli--13 (1.9%), Shigella--3 (0.9%), Y. enterocolitica O3--1 (0.1%). Among opportunistic pathogenic enterobacteria, the following were isolated: Kl. pneumoniae--24 (3.7%), Enterobacter species--4 (0.6%), Providencia alcalifaciens--1 (0.1%). Aeromonas hydrophila was isolated in 1 child. Combined infections were detected in 12 children: 10--enterobacteria + rotaviruses associations and 2--pathogenic enterobacteria associations.

[The presence of enterovirus in species of shellfish and fish]

Enteroviruses were isolated from 12% of the digestive tract samples collected from Anodonta cygnea (9.4%) and Dreysena polymorpha (13.2%) shell species and from 8.4% of the branchiae sample from fish species Rutilus rutilus, Perca fluviatilis and Silurus glanis. The isolated belonged to the following antigenic types: ECHO 2 and 7, Coxsackie B 2, 4 and 6, and poliovirus 1 and 2.

[Clinico-epidemiologic and laboratory studies of patients with primary hepatocellular carcinoma]

The investigations carried out in 92 patients with confirmed diagnosis of primitive hepatocellular carcinoma (HCC) have demonstrated that in almost half of them hepatitis was present in their antecedents, indicating the intervention of hepatitis virus in the etiology of this disease. In this context, the primary prophylaxis of primitive HCC is mainly based on the prophylaxis and control of viral hepatitis. As the interval detection-death was in most cases very short (1-2 month), the secondary prophylaxis consisting in performing more of the investigations recommended for the early diagnosis of primitive HCC is essential.

[Enzymatic aspects of severely acute diarrheal disease in infants]

Acute dehydration of diarrhoea of the breast-fed child is a type of hypovolemic shock which, by its severity and frequency is one of the major emergencies of pediatrics. The liver, as the site of many metabolic processes is mainly affected in the frame of the multiple-tissue involvement which is characteristic for this condition. The authors carried out a study of several enzymes (total LDH and the thermally-labile fraction, gluthamatdehydrogenase, gammaglutamyltranspeptidase, acid and alkaline phosphatase) in 27 breast-fed children. Determination of the enzymes was done on hospitalization, and 10 days later. The study showed that all the enzymes that were evaluated had moderate increases in 40.7-71% of all cases. The increases were significant (p less than 0.001). After 10 days the enzyme titers showed a tendency to become normal again, and slightly higher values were found in only 15-12% of all cases. Minimal hepatopathy can be considered, associated to the clinico-biological evolution of this severe conditions of the breast-fed child pathology.

[Virologic research on the quality of 2 sources of drinking water from zone "I"]

Enteroviruses were isolated from 4.6% out of the examined tap water samples. No relation could be established between viral pollution and classic quality indexes of water.

[Presence of the rotavirus antigen in newborn infants at maternity hospitals in Moldavia]

Studies conducted on 417 feces samples collected from newborn infants from seven maternity homes revealed the presence of rotavirus in 1.2 to 9.5% of the subjects. The infants get infection during the first 24 to 48 hours of life (1.8%) and the positivity rate reaches a peak the 7th day (9.7%). Enteroviruses were found in 3.4% and enterobacteria in 11.8% of the samples.

[Mixed viral-bacterial infections in infants with gastroenteritis]

Fecal specimens from 84 children with gastroenteritis were submitted to virological and bacteriological analysis. Enteroviruses other than poliovirus were found in 8.3%, rotavirus in 4.8% and enterobacteria in 1.9% of the investigated subjects. Mixed infections were detected in 8.4% of the cases.

[Detection of the rotavirus group antigen by a screening test using the ELISA-IC kit in subjects with acute gastroenteritis, at the pediatric services of Moldavia]

The rotaviral antigen was detected by a screening test using the ELISA-IC kit in 17.6% out of 415 children with acute gastroenteritis. The highest frequency (28.9%) was found in children hospitalized in pediatric services with a diagnosis of diarrhoeic disease associated to acute respiratory infection. The rotavirus infection incidence was about three times higher during the cold season than during summer (30.4% versus 10.5%). The 6-11 month age group was the most severely affected.

[Risk of transmission of enterovirus from the surface of toilets]

Experimental studies using dyes and microbial agents as indicators showed that a viral contamination of the various surfaces of the water closets is possible through the droplets formed when one flushes the W.C. pan. An investigation conducted in several public water closets allowed to reveal the presence of enteroviruses in 2.8% to 5.8% of the samples collected from various surfaces of the water closets. The results of the investigations showed that the hinged seats were contaminated the most frequently (6.8% of the samples).

Surveillance of enterovirus circulation in children communities

In three children communities covered by a virological study enteroviruses could be isolated from 19.3% of the stool samples, 52.3% of the sewage samples and 9.7% of the samples taken from different objects and surfaces. The isolates belonged to 14 enterovirus serotypes, Coxsackie viruses being predominant. There was a good concordance between the serotypes of enteroviruses shed in the stools and those isolated from the environment. The high epidemiological potential of enteroviruses calls for a surveillance of their circulation in children communities, preferably by the virological monitoring of sewage.

Coxsackie A virus-associated herpetiform angina

Virological investigations were performed in 25 herpangina cases that occurred in a large urban centre in the summer season of 1982. Twelve Coxsackie A virus strains (10 Coxsackie A5 strains, one Coxsackie A4 and one Coxsackie A6 strain) could be isolated from 9 (36.0%) of the patients.

Enterovirus contamination of swimming pool water; correlation with bacteriological indicators

The investigation of swimming pool water samples revealed the presence of enteroviruses (in 28.4% of the samples), as well as of coliforms, fecal streptococci, staphylococci and Candida albicans (in proportions ranging from 37.0 to 86.9% of the samples). A direct correlation could be established between the extent of viral and microbial pollution and the length of stagnation of the swimming pool water.

Preliminary data on the survival length of enteroviruses in nonalcoholic beverages. Inactivating action of some medicinal herb infusions

Vaccinal poliovirus type 1, Coxsackie B3 virus and echovirus type 1 survived in mineral water, camomile infusion and coffee for over 20 days. In contrast, Chinese tea, lime and mint infusions had a possibly transient inactivating effect on the same enterovirus strains. There was a direct relationship between the concentration of the infusions and their inactivating action. The vaccinal poliovirus was more sensitive than Coxsackie and echoviruses to the inactivating action of the infusions.

[Studies regarding the chronicization potential of viral hepatitis in children]

Out of 205 children, former patients with viral hepatitis, investigated after the end of the follow-up period by clinical and laboratory examinations, 9 (4.4%) presented mild or moderate pathological alterations. At the second control, carried out after an another interval de 1-1½ years, the pathological alterations were refound only in 2 of the former patients, suggesting that all the others presented lasting forms of acute viral hepatitis evolving towards healing. The presence of AgHBs and the alteration of proteinogramme in the acute phase of VH can serve as criteria of unfavourable prognosis of the disease evolution and impose a preferential follow-up of this category of patients.

[Epidemiological investigations among the viral hepatitis contact in a close children collectivity]

The results of the clinico-epidemiological and laboratory (TGP, tymol and HBsAg) investigations carried out in 164 contacts of an icteric case of viral hepatitis from a creche type children collectivity are presented. A wide spread of the infection, expressed by subclinical forms of disease identified on the basis of the alterations of TGP and their dynamics (27.4%) was pointed out. The increased incidence of HBsAg carriers and the correlation with the TGP increased values allowed the conclusion that the infection was caused by the hepatitis virus type B. The epidemiological investigation established that the infection was transmitted by direct contact favoured by children's close physical contact.

[The hand, foot and mouth disease. Clinical premiere in our country]

In May 1981 the hand, foot and mouth disease was diagnosed for the first time in Ramaia in a 4 year old child. The onset of the disease was characterized by moderate fever, coryza and spontaneous endobuccal pains followed at a short interval of time by the simultaneous of a papulo-vesicular eruption on hands and feet. The eruption was prevalent on the hands and feet fingers as well as on the palmar and plantar regions. Isolated aphthous lesions were seen on the vestibular mucosa. Morphologically, the intraepidermic site of the lesion with an advanced acantholytic process in the vesicular area was noticed. In the superficial and deep tissue perivascular infiltrate with mononucleares were present.

Investigations on the efficacy of two schemes of standard gammaglobulin administration in the prevention of viral hepatitis

Prophylactic administration of standard gammaglobulin (G) to over 5,000 children led to a more than 6-fold decrease in the incidence of icteric viral hepatitis (V.H.) as compared with the control group and to the disappearance of the autumn--winter epidemic peak. A 3-fold decrease in the incidence of subclinical forms was also achieved. In another group of 5,000 children G was only given to contacts in epidemic foci; the incidence of icteric V. H. was similar to that recorded in controls, while subclinical forms were 2 times more frequent in children having received G after the infectant contact.