Biomedical subjects
Publications and source records attributed to J W Moodie.
The virological quality of sewage effluent treated by a pilot reclamation plant on the Cape Flats was evaluated. The potable water produced by the treatment was repeatedly shown to be free of virus contamination.
Negative staining electron microscopy was used to examine culture fluids from the H9/HTLV-III cell line after concentration by centrifugation. Characteristic retrovirus-like particles bearing distinctive envelope projections were seen. The virion envelope was frequently extended in the form of a bleb or a tail. These particles were morphologically virtually indistinguishable from similar preparations of Friend murine leukaemia virus. H9/HTLV-III culture fluids contained, in addition, numerous comet-shaped particles with a dense head and flared tail. These particles were clumped by the addition of anti-HTLV-III-positive serum suggesting that they may represent intermediate forms of the virus.
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Of 81 adult patients with community-acquired pneumonia, bacterial infections were found in 37%, mycoplasma and viral infections in 21%, and tuberculosis in 6%; no pathogen could be identified in 46% of cases. More than one agent was identified in 12% of patients. Streptococcus pneumoniae, the most common pathogen, was found in 63%, Haemophilus influenzae in 26,7%, Staphylococcus aureus in 6,7%, and other Gram-negative organisms in 10% of patients with proven bacterial pneumonia. Most clinical and radiographic features were of little value in differentiating between different aetiological agents, but Gram-stained sputum gave a valuable early guide to therapy in 60% of cases of proven bacterial pneumonia. Blood culture was positive in 13,6% of cases. All the organisms conformed to their usual sensitivity patterns. Since Strept. pneumoniae is the predominant pathogen, penicillin should be the drug of choice in the immediate 'blind' treatment of community-acquired pneumonia.
Unconcentrated cerebrospinal fluid (CSF) was mixed in a constant ratio with carrier ampholytes and spacer amino acids and analysed by isotachophoresis. Examination of the cerebrospinal fluids from 113 patients showed characteristic patterns for normal, acute viral and acute bacterial meningitis. CSF from cases of subacute sclerosing panencephalitis (SSPE) and multiple sclerosis (MS) differed from these and from each other in the gamma-globulin region. This technique provides useful information on the integrity of the blood-brain barrier and is able to determine whether immunoglobulins present arise within the central nervous system or enter through a damaged barrier.
Children with measles treated either in hospital or as outpatients were examined for clinical or laboratory evidence of oropharyngeal herpes simplex virus (HSV) infection. HSV was isolated from 43% of the hospitalized children and 37% of the outpatient children and an additional 9% of the hospitalized group had lesions without the virus being isolated. The incidence of both HSV isolation and clinical lesions in infected children was significantly greater in children hospitalized for measles than in a control group of children hospitalized for tuberculosis. Data from the outpatient group strongly suggest that malnourished children with measles are particularly susceptible to HSV infection. The immunosuppressed state of the children with acute measles was demonstrated by impaired lymphocyte transformation responses to phytohemagglutinin and the inability of their serum to support normal transformation responses by lymphocytes from normal individuals. However the extent of this immunosuppression was unrelated to the susceptibility of the children to HSV infection.
Subacute sclerosing panencephalitis can no longer be regarded as a rare disease in all parts of southern Africa. Information derived from a third postal survey added to that from our own experience in Cape Town has brought to light 116 cases; 61 of the patients came from the Cape Province, 40 from the Transvaal and the remaining 15 from the other regions. This unequal distribution and the high prevalence in the Coloured community are important factors in any attempt to understand the epidemiology and the pathogenesis of this serious complication of measles.
Experience with some of our patients suggests that the diagnosis of subacute sclerosing panencephalitis (SSPE) may be made early and confirmed by the demonstration of high levels of measles complement-fixing antibodies in the cerebrospinal fluid (CSF) and serum, in the absence of classic clinical, electroencephalographic or brain biopsy support for the diagnosis. It is not known when the measles-specific antibodies first appear in the CSF, but these 3 atypical cases suggest that they were present in high titre early in the disease.
A method for separating a component from a mixture of antigens is described. The component which may be a virus or subfraction of a virus, is isolated by driving the mixture by electrophoresis through a gel containing precipitating antibodies directed against the unwanted components. The method is illustrated by the isolation of hepatitis B antigen from whole serum and by the separation of wild cucumber mosaic virus from a strain of tobacco mosaic virus.
This preliminary study indicates that a high proportion of adult females in Cape Town are immune to rubella, and that, unlike the situation in the UK, natural rubella infections are common before 4 years of age. At least 10 children with the congenital rubella syndrome have been seen in the Cape Town group of teaching hospitals in a 5 1/2-year period since October 1971. Continuous serological surveillance is essential in order to implement the most effective programme of immunization in any particular area and also to be able to determine whether the vaccine is successfully preventing the birth of children with congenital rubella infection.
Immune complexes could be formed with hepatitis B Ag and anti-IgG serum after treatment of the antigen with detergent, CsCl or glycerol, but not before. It is suggested that an antigenic determinant specifically reacting with anti-IgG forms an integral part of hepatitis B Ag. This determinant is ordinarily obscured in the undamaged antigen.
Attempts to detect hepatitis B antigen in faeces and bile should take into account the degradation and disappearance of the surface antigens in an environment containing proteolytic enzymes in the presence of bile salts as in the intestinal lumen. The cores of the Dane particles are much more stable than the surface antigens and these may best be identified by immune electron microscopy using core antibody.
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