5th day convulsions of the newborn infant in rotavirus infections

The pathogenesis of fifth day fits in newborns has not yet been explained. From 1989-1991 we observed an epidemic occurrence of 21 cases in 1917 hospitalized newborn children. After finding rotavirus in the faeces of several cases we suspected a coincidence. We tested the faeces of 19 fifth day fitters as well as 30 healthy newborns (4.-6. day of life) for rotavirus infection. The results of all clinically indicated rotavirus examinations in neonates of 4 to 6 days of age from 1989-1991 were analysed. In 6 rotavirus positive fifth day fitters we performed an immunologic and electron microscopic examination of cerebrospinal fluid. 18 of 19 examined children with fifth day fits (95%) had rotavirus in the faeces. Within the healthy control group we found 12 of 30 (40%, Chi-square 12.46, p < 0.001) and in the group of sick neonates without convulsions 98 of 202 (48.5%, Chi-square 12.44, p < 0.001). This shows a statistically significant coincidence of rotavirus positive faeces with fifth day fits. Rotavirus was not present in cerebrospinal fluid. We suggest a causal relation between fifth day fits and rotavirus infections. Pathogenetic details remain unclear.