The prevalence of human rotavirus enteritis in children admitted to the gastroenteritis ward of the Kuala Lumpur General Hospital was studied in 1982. Human rotavirus in the stool of the patients was detected by enzyme-linked immunosorbent assay. The survey showed that rotavirus enteritis in children were observed throughout the year, with two broad peaks of rotavirus infection occurring around March and September. The lowest incidence was recorded in July, however, no prolonged period of low prevalence of rotavirus enteritis was observed. The average prevalence for the whole of 1982 was 40% of the total diarrhoeal cases. No significant relationship was noted between the prevalence of the disease and rainfall.
A hypothesis suggested in this paper is that pigbel, or enteritis necroticans was a common disease in mediaeval Europe when human habitats, food hygiene, protein deficiency and periodic meat feasting formed the basics of village life as they do in many Third World cultures today. Based on the Papua New Guinea experience with pigbel, it is suggested that health authorities should look closely at the epidemiology of the acute surgical abdomen in such communities. Enteritis necroticans may be the important predisposing lesion to mid-gut volvulus, jejunal and ileal ileus and other forms of small bowel strangulation in communities where protein deprivation, poor food hygiene, epochal meat feasting and staple diets containing trypsin inhibitors co-exist. Such human habitats occur in Central South America, Western Pacific, Asian and South-East Asian cultures. Isolated outbreaks of necrotising enteritis have been reported from Uganda, Malaysia and Indonesia but as yet no systematic epidemiological studies of the prevalence of small bowel strangulations have been described in the surgical literature of Third World countries. Now that enteritis necroticans is preventable by vaccination such studies should be undertaken.