Clinical virology in family practice: epidemiological and clinical observations of an outbreak of Coxsackievirus B type 1 infection in a kibbutz.

In the late summer and early fall of 1975, a febrile illness broke out in Kibbutz Tsorah, a communal settlement situated in the Jerusalem District, affecting 148 (33 percent) of its 446 members. Sickness was recorded in 107 (54 percent) of 198 children under 14 years of age and in 41 (17 percent) of the remaining 248 members of the kibbutz. In addition to fever, gastrointestinal and upper respiratory symptoms were predominant. Pleurodynia and myocarditis were also observed, but only in 11 (7 percent) and 5 (3 percent) patients, respectively, all adults. Coxsackievirus B type 1 was isolated from 20 (53 percent) of 38 stool specimens received. A fourfold or higher rise in titer of neutralizing antibody to one of the isolates was demonstrated in 52 (74 percent) of 70 paired sera. The epidemiologic and clinical aspects of the outbreak are discussed. The importance of correlating laboratory findings with clinical and epidemiologic observations and the importance of collaborating with the laboratory virologist in the daily practice of the family physician are stressed.