Biomedical subjects
Publications and source records attributed to L Hanna.
Formalinized antigen suspensions prepared by differential centrifugation from crude infected yolk sacs and stored at 4 degrees C were satisfactory antigens during at least 36 weeks when used in chlamydial micro-immunofluorescence procedures.
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A reproducible method was developed to determine the ability of chlamydial antigens to stimulate lymphocytes from volunteers. In tests repeated 4 to 14 times, the cells from a given volunteer gave a relatively narrow range of responses, but there were great differences in the mean response of different volunteers. In the entire group of 52 volunteers, lymphocyte stimulation was significantly associated with the presence of antibody, but in a given individual results of one test did not aid in predicting the results of the other. A majority of persons with either antichlamydial antibody or elevated lymphocyte stimulation, or both, did not have a history of signs or symptoms within a spectrum of chlamydial diseases. This may reflect the great frequency of asymptomatic infection with these organisms. The lymphocytes of some individuals were stimulated to a significantly greater degree by antigens of one chlamydial species (Chlamydia trachomatis or C. psittaci) than by the other. These and other cell-mediated reactions in human chlamydial infections, and their possible medical significance, are under continued study.
Cervical abnormalities accompanied by Papanicolaou Class II or Class III cytologic results are commonly encountered in gynecologic office practice. Chlamydiae are a common cause of genital tract infection, with or without manifest symptoms or signs. An immunofluorescence method was used to determine the presence of antichlamydial antibodies in cervical secretions. Eleven of 15 patients in whom such antibodies were found (73.3%) had Papanicolaou Class II or Class III smears, in contrast to only 3 of 18 patients (16.7%) without antichlamydial antibodies. The determination of antichlamydial antibodies in cervical mucus was highly reproducible, and specimens were readily collected in the office, without the need of prompt laboratory procedures. In selected patients, tetracycline treatment of early chlamydial infection resulted both in the disappearance of the antibody from cervical secretions and in the reversion of the Papanicolaou smear from Class II or Class III to Class I.
Lesions on fingers or hands caused by Herpesvirus hominis have in the past been attributed to inoculation with virus-containing oropharyngeal secretions. Often these "herpetic whitlows" were caused by H. hominis type 1 and occurred in medical personnel. A recent series of 13 recurrent "herpetic whitlows" yielded 11 isolates of H. hominis type 2 and only two of H. hominis type 1. None of the subjects was engaged in patient care, and none had oral or facial herpetic lesions. Nine of the 11 infections due to H. hominis type 2 were in females, and more than half were associated with genital herpetic lesions. Herpetic finger or hand lesions in adults appear to be a common part of genital virus infections caused by H. hominis type 2 and are not associated with infections acquired in hospitals or during primary gingivostomatitis.
In Tunisia (North Africa), trachoma remains a common eye disease. Most cases are caused by immunotype A of Chlamydia trachomatis. In a small proportion of cases (less than 10%), type-specific antibodies to both immunotype A and immunotype B exist in the serum of patients. These types do not crossreact, and occasionally sequential acquisition of antibodies has been demonstrated. Thus, individuals in one endemic area of trachoma may be infected with two immunotypes of C. trachomatis. The epidemiological and immunological implications of this new finding are briefly discussed.
We studied two population groups (more than 1,600 patients) to determine the prevalence and clinical associations of genital tract infections with chlamydiae and herpesviruses. Base-line isolation rates for asymptomatic women having routine pelvic examinations were much lower than rates for symptomatic women. In both groups, chlamydiae were more prevalent than herpesviruses. Chlamydial infection was associated much more commonly with cervicitis (36.6%) than with vaginitis only (4.1%). Among 282 symptomatic men, the cultures of 19.9% yielded chlamydiae, and 4.3%, herpesviruses. Chlamydiae were recovered from 35.5% (27 of 76) of specimens from men with nongonococcal urethritis, and from an even larger proportion, 57% (24 of 42), of the specimens from men with frank discharge.
There is a greatly increased interest in Herpesvirus hominis infections especially those of type 2 associated with genital lesions or neonatal disease. Physicians are eager to confirm the clinical impression with a specific virologic diagnosis such as isolation of the agent and its typing, and type-specific antibody responses. Procedures are reviewed here which permit such studies in general microbiology laboratories equipped for simple cell culture and immunofluorescence. This paper recounts experience with several laboratory methods and evaluates their efficiency and practicability in a general laboratory. Virus isolation was optimal if specimens were obtained from visible lesions early in their evolution and it often provided a specific diagnosis, including typing of the isolate by immunofluorescence, within 24 to 48 h. Estimation of serum antibodies to herpes simplex virus type 1 and 2 by indirect immunofluorescence was more sensitive and perhaps also more specific than by microneutralization test. A pilot study of herpes simplex virus antibody titers in mothers and in the cord blood of the offspring suggested the need to evaluate a possible protective role of high titer antibody in the fetus.
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