Studies on a skin test for western equine encephalitis; preliminary evaluation in man.
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Biomedical subjects
Publications and source records attributed to E H LENNETTE.
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The general procedures used in the diagnosis of neurotropic viral diseases are outlined and are discussed with specific reference to western equine encephalitis. Cerebrospinal fluid is considered practically worthless as a starting material, in attempts to isolate the causal agent. The material of choice in attempting to recover the virus is central nervous system tissue, available only in instances of fatal infection. In the usual case, the diagnosis depends upon serologic or immunologic methods. These methods are aimed at detecting the presence of specific antibodies and of increases in the content of antibodies in the blood during the course of the illness. The in vitro complement fixation test is considered a better diagnostic tool than the in vivo neutralization test, since rises in titer are more readily detectable by the former technique than by the latter.
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Approximately one-third of the laboratory-confirmed cases of Western equine encephalitis occur in children under the age of 10. The present paper describes three instances of Western equine encephalomyelitis virus infection in infants under one year of age, together with the resultant sequelae. The difficulties associated with diagnosis of central nervous system disturbances in very young children are discussed, and it is pointed out that in view of the frequent occurrence of clinical infections with the arthropod-borne encephalitis viruses these agents should be given serious consideration as a cause of acute central nervous system infection in childhood and as the possible etiology for obscure, severe neurological disturbances in the pediatric age groups.
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