Low rates of antigen detection and virus isolation from the peripheral blood leukocytes of dengue fever patients.

We evaluated direct fluorescent antibody (FA) testing of peripheral blood leukocytes (PBL) from patients in Puerto Rico with serologically and/or virologically confirmed dengue fever as a possible rapid diagnostic test and compared rates of dengue virus isolation from PBL with the rates from plasma or serum using the mosquito inoculation technique. Dengue antigen was detected in the PBL of only 1 of 19 patients with confirmed dengue. Virus was isolated from 3 of 19 PBL specimens and from 6 of 19 acute-phase serum or plasma samples.

The absence of dengue virus in the skin lesions of dengue fever.

Patients with confirmed dengue infection were studied in an attempt to elucidate the cause of the eruption of dengue fever. Punch biopsies of lesional skin were obtained and processed for the presence of viral antigen and immune globulins by the direct fluorescent antibody test. Another biopsy specimen and the acute sera were processed for virus isolation.

A case of natural concurrent human infection with two dengue viruses.

The first documented case of concurrent human infection with 2 dengue viruses is reported. Dengue 1 and 4 viruses were isolated from the serum of a 16-year-old male during the 1982 outbreak in Puerto Rico. The illness was mild and does not support the hypothesis that double infection with dengue viruses leads to more severe hemorrhagic disease.

A search for the source of Campylobacter jejuni in milk.

Samples of milk from 1501 cows with mastitis were negative for Campylobacter jejuni. The faeces of 74 healthy Friesian cows were screened for C. jejuni: 13% of the samples were positive during the summer when the cows were on pasture, and 51% were positive in the winter when the cows were housed.

Acute hemorrhagic conjunctivitis in Puerto Rico, 1981-1982.

In late 1981, the Western Hemisphere's pandemic of acute hemorrhagic conjunctivitis spread to Puerto Rico. Over 6,000 cases of conjunctivitis were reported to the Puerto Rico Department of Health from November 1981 to March 1982. Enterovirus 70 was isolated from one of 19 eye-swab specimens tested, and 10 of 13 (77%) individuals with acute hemorrhagic conjunctivitis had neutralizing antibody titers to enterovirus 70 of greater than or equal to 1:4.

Single intubation test for investigation of malabsorption and diarrhoea.

A one session multipurpose intubation method for the investigation of diarrhoea and malabsorption is described. It enables tests for bacterial colonisation, infestations, and luminal cytology of the small intestine to be combined with a pancreatic exocrine function test and a jejunal biopsy during the same intubation. The technique has proved acceptable, reliable, diagnostically valuable, and convenient for use on outpatients.

Dengue fever in the United States. A report of a cluster of imported cases and review of the clinical, epidemiologic, and public health aspects of the disease.

In the United States during 1981, fourteen state health departments reported a total of 44 imported cases of dengue fever. Most originated in the Caribbean, where dengue type 4 has reached pandemic proportions. Because the mosquito vector for dengue is abundant throughout the southeast and imported cases continue to occur, the possibility exists for indigenous dengue transmission.

Fluorescent antibody techniques applied to the identification of dengue virus in infected tissue.

We evaluated an indirect fluorescent antibody (FA) method for the detection of dengue virus antigen in infected mouse tissues. The biotin-avidin system [unlabeled antiviral antibody, biotinyl-anti-IgG and fluorescein conjugated avidin D(biotin-avidin system)] theoretically enhances the sensitivity of the FA method by amplifying the number of fluorescein particles attached indirectly to antigen. Using antibody endpoint titers in dengue-infected suckling mouse brain as an assay for sensitivity, we compared this three-step technique with the standard direct and two-step indirect FA techniques.

The heat-sensitivity of Campylobacter jejuni in milk.

It is now established that milk can be a vehicle for the spread of enteritis due to Campylobacter jejuni. By determining the lethal effect of heat on six isolates it has been shown that C. jejuni is unlikely to survive pasteurization.

Correction of equinus in cerebral palsy by the Murphy procedure of tendo calcaneus advancement: a preliminary communication.

The biomechanics of the Murphy procedure for correction of equinus in cerebral palsy are presented. A series of 79 surgical procedures on 48 patients, with a follow-up period of from one to four years, is reviewed. Correction of equinus was succeswful in 89-9 per cent of the procedures.