Biomedical subjects
Publications and source records attributed to I D Gust.
During the period October 1968 to March 1969 echovirus type 18 was isolated from 83 patients investigated at Fairfield Hospital for Communicable Diseases, Melbourne. The illnesses most commonly associated with these isolations were aseptic meningitis, and fever with rash.We believe that this is the first report of an epidemic due to echovirus type 18 and the first occasion on which this virus has been shown to produce disease in adults.
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Worldwide influenza pandemics have occurred at irregular and unpredictable intervals throughout history and it is confidently expected that they will continue to occur in the future. It is now recognised that these pandemics result when avian influenza A viruses succeed in adaptation to and transmission between humans. The impact of pandemic influenza is substantial in terms of morbidity, mortality and economic cost and there is the potential for serious social disruption. Influenza vaccines remain the most effective defence against influenza but will be in short supply during a pandemic, as will the new specific anti-influenza drugs, due to the lead-time required for production and rapid spread of the virus. To minimise the impact of pandemics it is imperative to maximise the availability of both vaccines and antivirals and to ensure that they are used optimally. This requires planning at both the international and national levels. The World Health Organization has, therefore, developed a staged plan for responding to a pandemic threat which is based principally on its surveillance program. It has also prepared guidelines to assist national agencies in their planning. However, there may be further options for increasing our preparedness which should also be considered.
Immune mechanisms in hepatitis B virus (HBV) infection were investigated in 16 persons with and without hepatitis using tests for HBS Ag, anti-HBS, anti-HBC and 125I-labeled HBS Ag binding lymphocytes (ABL) in peripheral blood. Anti-HBC, which is an evidence of a recent or current HBV infection, was detected in all HBS Ag positive sera. High counts of ABL correlated with the presence of anti-HBS in serum but not with anti-HBC or with HBS Ag. In patients with chronic hepatitis, and in asymptomatic carriers of HBS Ag, there was a trend towards low counts of ABL, which may represent partial tolerance ot HBS Ag in carriers of this particle. Further work on ABL for HBS Ag and HBC Ag should enhance our understnading of immunologic responses to the antigens of the hepatitis B virus.
The prevalence of delta infection was studied in 3986 individuals seropositive for hepatitis B surface antigen (HBsAg), who were seen in Melbourne between 1971 and 1985. The group comprised 2004 patients with acute hepatitis B, 1820 asymptomatic HBsAg carriers, 139 HBsAg carriers with evidence of chronic liver disease, and 23 carriers who had suffered more than two separate attacks of acute hepatitis. Markers of delta infection were found almost exclusively among intravenous drug abusers and their close contacts. Studies of stored sera suggest that delta infection was introduced into this group about 1970. In carriers with no evidence of chronic liver disease, the prevalence of delta infection was highest among intravenous drug abusers (19.2%). In carriers with evidence of chronic liver disease, delta markers were present in 20.1% and all 23 carriers with recurrent acute hepatitis had evidence of infection with the delta virus.