RECURRENT INSTITUTIONAL OUTBREAKS OF ACUTE INFECTIOUS NONBACTERIAL GASTROENTERITIS: EPIDEMIOLOGY AND ETIOLOGY1

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Abstract
The epidemiology of two well defined outbreaks of acute infectious nonbacterial gastroenteritis occurring in the same institution was studied, and attempts were made to detect etiologic agents. Observed epidemiologic patterns suggested either person to person spread or a common source exposure with subsequent person to person transmission. Susceptibility to disease in both outbreaks among all age groups was noted, although younger residents were affected more frequently in the second outbreak. Some persons experiencing disease in the first outbreak were also ill during the second outbreak, thus indicating either short term immunity or antigenically distinct etiologic agents. Although no known enteropathogens could be demonstrated from either outbreak, the syndrome was induced in a human volunteer using a bacteria-free diarrheal stool filtrate derived from one of the outbreaks. The illness was subsequently reproduced by the administration of a similar filtrate prepared from the ill volunteer. Experimentally induced disease was similar to naturally occurring illness in terms of incubation period, clinical signs and symptoms, and duration.

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