Prevalence of hepatitis B markers in Mauritania.
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Biomedical subjects
Publications and source records attributed to P Rollin.
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Seven cases of acute renal failure consecutive to haemorrhagic fever with renal syndrome (HFRS) due to the Hantaan virus or to a serologically related virus are reported. These cases were observed in north-eastern France between March, 1983 and January, 1984. All patients were of rural origin and had been in contact with field mice. The predominant initial clinical symptoms were signs of infection and diffuse muscle pain, without evidence of haemorrhage. However, massive proteinuria was noted, and acute anuric renal failure unaccompanied by oedema or arterial hypertension developed. Renal biopsy performed in 2 patients showed tubular and interstitial nephritis but no glomerular or vascular lesions. Two patients only required haemodialysis. All patients recovered within 2 to 8 weeks without sequelae. Antibodies directed against the Hantaan virus were detected by indirect immunofluorescence tests, and seroconversion could be demonstrated in 2 patients seen at a sufficiently early stage. The risk of epidemics suggested by this small outbreak of HFRS can only be evaluated after an exhaustive epidemiological study.
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A group of WHO Consultants who met in Geneva 16-18 September 1982, recommended, among other items, that "monoclonal antibody reactivity pattern of all viruses used for (rabies) vaccine production should be established" (WHO/Rab.Res./82.15) (1). Such a study has been undertaken in our WHO Collaborative Centre for Rabies in close collaboration with the WHO Collaborative Centre for Rabies of the Wistar Institute, and with monoclonal antibodies kindly supplied by T.J. Wiktor (2).
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The nucleocapsid antigen of 204 strains of street rabies virus, which originated in Europe, Africa and Asia, was analyzed by fluorescent antibody staining technique with a panel of 20 monoclonal antibodies specific for nucleocapsid of rabies and rabies-related viruses. A definite pattern of reactivity was observed with strains of the same geographic origin with the exception of strains originating from Madagascar, Thailand and Iran which were more diversified. Mice immunized with a vaccine prepared from a Pasteur PV-11 strain of virus were well protected against challenge with representative strains from Europe and Africa, and a partial protection was observed following challenge with strains from Madagascar and Thailand.
Two avirulent mutants of the CVS strain of rabies virus have been isolated on the basis of their loss of sensitivity to antiglycoprotein neutralizing monoclonal antibodies. With the exception of virulence, both retain general characteristics of the CVS strain of the rabies virus. After inoculation, they induce a strong and rapid immune response in adult mice. In this respect, however, they are quite different from the parental CVS strain. Surviving mice are protected against intramuscular challenge with 10(3.4 LD50 of a field isolate of rabies virus.
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Transplantation, to a normal recipient, of a cornea taken from a donor who died of rabies encephalitis constitutes an extremely serious exposure. Four cases, up to now are known of human to human transmission of rabies virus. In these four cases, the diagnosis of rabies in the donor has been made afterwards when to the recipient developed fatal rabies. We report here the first case of this type of exposure where the diagnosis of rabies in the donor could be made on the day following the transplantation thus allowing application, without delay, the recipient of a prophylactic therapy for inactivated rabies vaccine administered. No signs or symptoms of rabies appeared and, more than three months after the transplantation, the recipient is well and alive.
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