The pathology of rotavirus-associated deaths, using new molecular diagnostics.
Rotavirus, the most common cause of severe, dehydrating gastroenteritis among children worldwide, annually causes approximately 500,000 deaths among children aged <5 years. The primary site of rotavirus infection is the small intestine. Pathologic investigations of patients who died of rotavirus infection are limited to data from a few reported autopsies, and dehydration with electrolyte imbalance is believed to be the major cause of death. Several recent reports suggest that children who died during a rotavirus illness were viremic before death, because rotavirus was detected at several extraintestinal sites. We report 3 rotavirus-associated deaths among children, 2 of whom had evidence of rotavirus genome in extraintestinal tissues detected by use of novel molecular diagnostic methods. The part played by rotavirus in fatal cases is unclear and requires additional investigation of diarrhea-associated deaths, because a better understanding might alter the approach to treatment and the need for antiviral therapy.
Lynch
Maureen
M
Viral Gastroenteritis Section, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. lynchm@mater.ie
Shieh
Wun-Ju
WJ
Tatti
Kathleen
K
Gentsch
Jon R
JR
Ferebee-Harris
Tara
T
Jiang
Baoming
B
Guarner
Jeannette
J
Bresee
Joesph S
JS
Greenwald
Margaret
M
Cullen
Steve
S
Davies
H D
HD
Trevenen
Cynthia
C
Zaki
Sherif R
SR
Glass
Roger I
RI
D001933:Brain Stem / Q000201:enzymology / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009336:Necrosis; D012401:Rotavirus / Q000235:genetics / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000401:mortality* / Q000473:pathology / Q000821:virology