Etiology and Pathogenesis of Viral Gastroenteritis

摘要

This paper addresses the etiology, epidemiology, and pathogenesis of human viral gastroenteritis. Effort has been devoted to the development of immunoassays to detect etiologic agents, with the preparation and use of monoclonal antibody reagents where possible. A monoclonal antibody based enzyme immunoassay (EIA) for rotavirus detection was developed, which greatly improves the sensitivity and specificity of diagnosis in neonatal and adult stool specimens over that previously available with polyclonal antibodies. Our older radio-immunoassay procedure for Norwalk virus was adapted to an EIA format, permitting a more convenient and more sensitive assay for epidemiological studies. We demonstrated an immunological relatedness between Norwalk virus and the enteric human calicivirus. Epidemiological studies with collaborating colleagues revealed: the role for Norwalk virus in outbreaks of clam and oyster associated gastroenteritis; and a role for Norwalk virus in 3 to 10 percent of travelers' diarrhea in several countries. Another collaborative study demonstrated the localization of rotavirus by string capsule; this was in contrast to the absence of bacterial enteric pathogens isolated from the same site.