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[Viral encephalitis (etiology, pathogenesis, classification)].

The existing classifications of viral encephalitis are based on mixed, heterogenous principles. The author on the grounds of comparing modern data, related to the etiology, pathogenesis, predilectiveness, gives his suggestions as to a new classification of viral encephalitis. This classification is structured according to the pathogenetical principles, with a consideration of the different variants of the dynamics and polymorphism of separate nozological forms, depending upon the interrelationships of the viral and the immunity factors.

Clinical Trials as Topic

Equine viral encephalitis.

The most important neurotropic viral infections of the horse are the arthropod-borne encephalitides. These include Venezuelan encephalitis (VE), eastern encephalitis (EE) and western encephalitis (WE), which are found in the Americas, and Japanese B encephalitis which occurs in the Far East. All the viruses cause encephalitis in man. Between 1969 and 1972 an epidemic of VE occurred in Central America. In 1971 the disease was reported in Texas, where it was brought under control by the vaccination of susceptible horses with an attenuated live virus vaccine and by the reduction of the mosquito population with insecticides sprayed from aircraft. A high titre viraemia occurs with VE virus in the horse and epidemics are maintained by a mosquito/horse cycle; infection of man and other species is incidental. EE and WE have been recognised as separate diseases since 1933 and in the U.S.A. horses are protected by routine vaccination. Epidemics of these diseases are routine vaccination. Epidemics of these diseases are now uncommon. In contrast with VE, both EE and WE viruses are maintained by a bird/mosquito cycle. The viraemia in the horse is generally considered insufficient to infect mosquito vectors; the horse is a "dead end host". Several species of mosquito can act as vectors of VE, WE and EE. The extension of other arthropod-borne diseases to areas originally outside their geographical distribution (e.g. bluetongue in sheep) serves to illustrate the potential of VE, WE and EE to cause disease on other continents.

Animals

Quantitative determination of the disintegration of nerve cells in the cortex caused by viral encephalitis (17 D-yellow fever) (Preliminary communication).

The counting of nerve cells give an answer to the question whether there is a significant loss of cells in the cortex in the course of viral encephalitis. For normal animals, average cell numbers of 275.42 were counted; for infected animals divided into two groups depending on the severity of illness, 144.95 and 192.87 cells, respectively (p = 0.0001).

Animals

Arboviruses in New York State: an attempt to determine the role of arboviruses in patients with viral encephalitis and meningitis.

In a reveiw of 2,963 patients with signs of infections of the central nervous system in New York State in 1966--1977, arboviruses were found to be the confirmed or presumptive etiologic agents in 60 patients. California encephalitis (CE) virus was the most common (44 patients), followed by Powassan (POW) virus (8), St. Louis encephalitis virus (7), and eastern equine encephalitis (EEE) virus (1). Most patients (47) were children. The incidence of encephalitis was higher in patients with arbovirus findings than in infections with any other of the common neurotropic viruses. The disease was fatal in two patients, one infected with POW virus, the other with EEE virus. Most patients with CE virus infections resided in suburban areas. All POW infections were contracted in six rural counties known for their recreational facilities.

Adolescent

Bound and free light chains in serum from patients affected with various neurological diseases.

Six immunological parameters, of which the most important are the quantitative distribution of the free light chains, and the kappa-lambda ratios of both bound and free light chains, were investigated in serum of patients affected with various neurological disorders and compared to controls. Subacute sclerosing panencephalitis and viral encephalitis, which are diseases characterized by hyperimmunisation against definite antigens, are accompanied by a considerable quantitative increase in free light chains; in subacute sclerosing panencephalitis serum there is an increase of both free kappa and lambda chains, whereas in viral encephalitis serum the increase of free light chains were restricted to lambda chains. There is a good correlation between the kappa-lambda ratio of, on the one hand, bound light chains and, on the other hand, free light chains for controls and subacute sclerosing panencephalitis; but in multiple sclerosis, amyotrophic lateral sclerosis and viral encephalitis, the ratios for bound light chains are totally different from ratios for free light chains. A general kappa increase, which we earlier reported for bound light chains in 16 cases of multiple sclerosis, was not confirmed by the investigation of an additional 26 cases: kappa decrease was also noticed in a considerable number of cases.

Amyotrophic Lateral Sclerosis

Herpes simplex encephalitis.

In this paper seven cases of severe viral encephalitis seen over a four year period at the Princes Alexandria Hospital, Brisbane, are presented. Four of these cases were proven cases of Herpes simplex encephalitis on the basis of viral culture, and three were probable cases of Herpes simplex encephalitis on the basis of rising serum antibody titres. A summary of the clinical aspects and laboratory investigations of the cases is followed by a brief discussion of the diagnostic and therapeutic problems of this condition.

Adolescent

Subpopulation of peripheral blood lymphocytes in human encephalitis caused by group B arboviruses (Dengue, West Nile and Japanese B encephalitis.

Sera from twenty patients with clinically diagnosed viral encephalitis were studied during the acute and convalescent phases of illness for evidence of group B arboviral infection by demonstrating a rise in the titre of haemagglutination inhibiting (HI) antibodies. The immune status of these individuals was studied by quantitating peripheral T, T and 'null' lymphocytes. The percentage of total T cells in arboviral encephalitic (AE) group decreased significantly while that of B cells and 'active' T cells remained unaltered when compared to that of normal individuals. The null cell percentage, on the other hand increased significantly in the AE group. The absolute number of circulating T and B cells did not alter in the AE group while that of null cells rose significantly. The percentage and concentration of T. B and null cells during the convalescent phase of AE did not differ significantly when compared to those of the acute phase.

Acute Disease