Abstract

In 1989 a specialized hospital for the treatment of severely epileptic patients, was struck by what seemed an epidemic of respiratory- and gastro-intestinal disease. Six patients in one unit, and some of their nurses became ill. No cases outside the unit occurred. The National Institute for Public Health and Environmental Protection was asked to help in the analysis of the epidemic. No single causative agent could be identified. However, the most likely explanation of the clustering of cases seemed to be an infectious disease primarily involving the digestive tract. In these severly disabled patients vomiting probably led to aspiration of gastric contents and ultimately to aspiration pneumonia.