Investigation of an Outbreak of Adult Diarrhea Rotavirus in China

In 1987 an epidemic of diarrhea associated with adult diarrhea rotavirus (ADRV) occurred in Qinhuangdao City, China, affecting more than 200 persons and causing 2 deaths. The outbreak was introduced by a person returning from an epidemic area and was spread initially to his family members and subsequently to the entire community. Adults were at greater risk of diarrhea than children 0-4 y of age and, the duration of illness increased significantly with increasing age. ADRV was identified by ELISA and electron microscopy. The electropherotypes of all positive specimens were identical, consistent with the single point-source introduction of the virus. Seroconversion was detected in 6 of 7 ill persons with a blocking ELISA. Both asymptomatic infection and person-to-person spread identified in this epidemic suggest that current emphasis on preventing waterborne transmission may not control the introduction of ADRV into new areas. The predisposition of adults for more severe disease with ADRV is similar to the pattern observed with other enteric viruses such as the Norwalk agent and hepatitis A.