Etiological Aspects of Gastro-Enteritis: Part I

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Abstract
The author reviews the recent literature relating to infantile gastro-enteritis, and discusses the etiology of 148 cases admitted to hospital in the London Borough of Kensington during the yrs. 1938-40. The case-mortality of the series was 44%. 20 additional fatal cases were examined. The observations confirm certain of the main conclusions which have been reached by others workers. The seasonal incidence suggests that these cases form an etiological group which has not disappeared along with food-borne "summer diarrhea," and their association in time with the season of respiratory disease suggests that they may be spread by the respiratory route. Breast-feeding was beneficial and the benefit appeared to extend beyond the actual period of feeding. High incidence was associated with density of population, and the disease thus occurred in the town rather than in the country, and especially in hospital wards. The gross discrepancies in the case-mortality of gastro-enteritis in different places and at different times indicate that mild and severe forms of the disease exist, the severe type being responsible for the cases in the series now reported. In the 2d paper, the author reviews the literature relating to the bacteriology of gastro-enteritis and the evidence (which is considerable) supporting a possible virus etiology. His findings with respect to the occurrence of parenteral infections (pneumonia, otitis media, etc.) lead him to conclude that there is no causal relation between these infections and the gastro-enteritis. Cases with parenteral infection had milder enteritis than those without, and the type of parenteral infection had no effect on the mortality. The sulfonamide prepns then available (1938-40) did not affect the course of illness, but seven of eleven desperately ill infants recovered after blood-transfusion. The author discusses epidemic neonatal diarrhea, which he does not believe to be a separate disease.