Nosocomial transmission of rotavirus infection.

Children admitted to the infant ward between November 30, 1983, and May 5, 1984, were sampled for rotavirus antigen at admission and at 4-day intervals during subsequent hospitalization. Rotavirus was detected in 51 of 315 infants, 24 at the initial sampling and 27 after 72 hours of hospitalization (nosocomial cases). Forty-one of the cases were symptomatic and 10 were asymptomatic. Nosocomial rotavirus was detected in 5, 13 and 24% of children in the hospital for 4 to 8, 9 to 13 and greater than 13 days, respectively. Attending physicians clinically entertained the diagnosis of rotavirus infection in 58% of community-acquired cases but in only 22% of nosocomial cases. Subgrouping of 24 of the rotavirus isolates with monoclonal antibodies indicated that two-thirds of the isolates were Subgroup II, and the remainder were a mixed subgroup, with similar prevalences in the nosocomial and community-acquired cases. Only 11 of 27 instances of nosocomial rotavirus acquisition were epidemiologically associated with a rotazyme-positive roommate and in 4 of these instances different subgroups were present in the 2 roommates. These data suggest that infected roommates appear not to be a major source for direct transmission of nosocomial rotavirus infection.