Detection by Immune Electron Microscopy of 27-nm Viral Particles Associated with Community-Acquired Diarrhea in Children

Vial, Pablo A.; Kotloff, Karen L.; Tall, Ben D.; Morris, J. Glenn; Levine, Myron M.

The proportion of diarrheal illnesses of unknown origin that were associated with small round virus (SRV, 23-38 nm) particles among children <2 years old attending an outpatient clinic in Baltimore was determined. During a 9-month period, stool specimens from 188 patients with acute diarrhea and 108healthy age-matched control children were examined for enteric bacterial pathogens, protozoa, enteric adenovirus, and rotavirus. An enteropathogen was identified in 75 patients (40%) and in 21 controls (20%). A random sample of specimens without an identifiable pathogen wasthen examined for SRV particles by immune electron microscopy (IBM) using commercial human gamma globulin. Viruses of 26-30 nm diameter that were not enteroviruses were detected in specimens from 9 (12.5%) of the 7l patients and 1 (1.8%) of the 53 control subjects (P < .04). Of6 patients with available acute and convalescent sera, 4 demonstrated a significant immune response when tested by IBM. All patients experienced a mild, self-limited (1–3 days) illness. These findings suggest that SRV may be endemic in the Baltimore community and may result in clinically significant diarrheal illnesses.