EPIDEMIOLOGY AND TRANSMISSION OF ROTAVIRUS INFECTIONS AND DIARRHOEA IN ST.LUCIA, WEST INDIES

During the 1977-1979 Schistosomiasis control project in St. Lucia researchers studied the prevalence of rotavirus infection in 229 children <3 years old (10 children later dropped out of the study) in 3 valleys with different levels of sanitation. Nurses from the Ministry of Health collected stool and sera samples which laboratory staff tested for rotavirus and antibodies 48% (106) had at least 1 rotavirus infection during the 2 years. 18 of them were reinfected once and 1 twice. Prevalence was highest in 1 year olds (18.1% 12-176 months; 18.9% 18-23 months). Rotavirus caused diarrhea in 47% of all diarrhea cases during the dry season (April-June) but only 3% during the rainy season (October-December). Only children 6-23 months old had significantly higher infection rates during the dry season. Breast fed children 0-11 months had a lower infection rate than those bottle fed or other wise fed. Crowding was the only consistent and significant social factor associated with rotavirus infection (p<.05). Rotavirus infection prevalence remained similar for the 3 different hygienic areas which demonstrated that improved sanitation only affected diarrhea not caused by rotavirus. The fact that children with rotavirus reinfections lived in crowded dwellings and that crowding was significantly associated with rotavirus infections suggested that air may have been responsible for transmitting rotavirus. Other studies are needed to see whether efforts to reduce diarrheal morbidity should center on improved sanitation or immunizations or both.