1374 SERUM-IMMUNOGLOBULINS IN CHILD ADMITTED WITH INTRACTABLE DIARRHEA CONTRACTED ON VISIT TO
..=not
PUNJAB
detectable.
maternal IgG had waned. If his deficiency is acquired, is it possible that his traveller’s diarrhoea, associated with severe smallintestinal enteropathy, has permanently affected his humoral immunity? If so, this would have considerable implication for the cycle of chronic diarrhoea and malnutrition in the developing world. Although the number of children is small, they were all well in Britain and rapidly became severely ill on travelling to their ancestral homeland. The risks of such travel for children, particularly for infants, should be carefully considered by parents when they plan such a journey. Careful investigation of such children may give us useful insights into the interrelationship between chronic diarrhoea and malnutrition of relevance to the developing world. PAUL HUTCHINS PRAVIN HINDOCHA ALAN PHILLIPS Elizabeth for Children, Hospital Queen JOHN WALKER-SMITH London E2 8PS
vomited bright red blood before reaching hospital. The child had laboured breathing. The respiratory rate was 35/min but there was no cyanosis or anaemia. He was afebrile. Throat examination did not reveal any abnormality except that the mucosa was coated with blood, but no active bleeding site was visible. The child was coughing and retching and vomited blood with clots three times after admission. Systemic examination was non-contributory. The speech was normal and the child denied inhaling a foreign body. About 6 h after admission, he had a severe bout of retching and vomited out the 6-7 cm headless body of a leech engorged with blood. The child became comfortable and no further bleeding occurred after expulsion of the leech. The head of the leech could not be identified in the throat or larynx on re-examination. The family came from Pule Khumri, a village about 100 km north of Kabul. The boy’s father told us that the source of water in the village is a pond which is heavily infested with leeches. Leech infestation is rampant in the Badghis Province of north-west Afghanistan, and medical problems with live foreign bodies are not uncommon. In Afghanistan water is often drunk straight from ponds and wayside drainage nallahs which are loaded with visible and invisible hazards to human
health. Institute of Child Health,
Kabul, Afghanistan
MEHARBAN SINGH AHMAD FARID NAIM
Nations agencies have made clean water supplies
..=not
PUNJAB
detectable.
maternal IgG had waned. If his deficiency is acquired, is it possible that his traveller’s diarrhoea, associated with severe smallintestinal enteropathy, has permanently affected his humoral immunity? If so, this would have considerable implication for the cycle of chronic diarrhoea and malnutrition in the developing world. Although the number of children is small, they were all well in Britain and rapidly became severely ill on travelling to their ancestral homeland. The risks of such travel for children, particularly for infants, should be carefully considered by parents when they plan such a journey. Careful investigation of such children may give us useful insights into the interrelationship between chronic diarrhoea and malnutrition of relevance to the developing world. PAUL HUTCHINS PRAVIN HINDOCHA ALAN PHILLIPS Elizabeth for Children, Hospital Queen JOHN WALKER-SMITH London E2 8PS
vomited bright red blood before reaching hospital. The child had laboured breathing. The respiratory rate was 35/min but there was no cyanosis or anaemia. He was afebrile. Throat examination did not reveal any abnormality except that the mucosa was coated with blood, but no active bleeding site was visible. The child was coughing and retching and vomited blood with clots three times after admission. Systemic examination was non-contributory. The speech was normal and the child denied inhaling a foreign body. About 6 h after admission, he had a severe bout of retching and vomited out the 6-7 cm headless body of a leech engorged with blood. The child became comfortable and no further bleeding occurred after expulsion of the leech. The head of the leech could not be identified in the throat or larynx on re-examination. The family came from Pule Khumri, a village about 100 km north of Kabul. The boy’s father told us that the source of water in the village is a pond which is heavily infested with leeches. Leech infestation is rampant in the Badghis Province of north-west Afghanistan, and medical problems with live foreign bodies are not uncommon. In Afghanistan water is often drunk straight from ponds and wayside drainage nallahs which are loaded with visible and invisible hazards to human
health. Institute of Child Health,
Kabul, Afghanistan
MEHARBAN SINGH AHMAD FARID NAIM
Nations agencies have made clean water supplies
