Management of 41 persons exposed to a rabid dog: unplanned experience with human diploid vaccine.

Thirty-six persons -- veterinarians, technicians and students at a veterinary clinic -- were unwittingly exposed to a rabid dog over a period of 21/2 days. One veterinarian received a penetrating bite, two other individuals were grabbed by the dog but the skin was not penetrated, and many were exposed to saliva or urine or both. In addition, the owner of the dog and his wife and three children, while not bitten, were exposed to saliva. The diagnosis was made post mortem when specimens of the dog's brain were examined by indirect fluorescent antibody testing. All but one of the students had been vaccinated against rabies with hamster kidney vaccine, but eight members of the veterinary college's staff had not been so vaccinated. Treatment started with duck embryo vaccine; if necessary, rabies (human) immune globulin was also given. When one student reacted severely to the first dose of duck embryo vaccine permission was sought to bring a human diploid vaccine into Canada. In five patients the human diploid vaccine was substituted for the duck embryo vaccine because of severe reactions to the latter. Twenty-five staff members and the family of five received both vaccines. Reactions to the human diploid vaccine were minor and transient. Recommendations include the early licensing of the human diploid vaccine in Canada.

Role of coxsackievirus B4 in the pathogenesis of acute glomerulonephritis.

Coxsackievirus B(4) was isolated from the throat, nose, blood, stools and urine of a 9-year-old boy with acute glomerulonephritis and a pneumonitis. Neutralization test showed a greater than fourfold rise in the antibody titre to coxsackievirus B(4). The antistreptolysin O titre was elevated, but the complement component was within the normal range. The importance of the coxsackievirus B(4) in the pathogenesis of acute glomerulonephritis is clearly indicated; however, further investigations are needed to understand the details of the virus-kidney interaction.

Herpes simplex encephalitis: two fatal cases.

The clinical and pathological features of the first two reported cases of herpes simplex encephalitis occurring in Saskatchewan are presented. The clinical history of an acute onset, an early organic mental syndrome followed by coma, neurologic disturbances, rapid progression and death suggests the diagnosis. The acute, diffuse, inflammatory process with predominant involvement of the temporal lobes of the cerebral hemispheres and the presence of intranuclear inclusions in nerve and glial cells are illustrated. The viral particles were found in electron micrographs from the brain tissue of both patients. The definitive diagnosis was established by the isolation, from postmortem brain tissue, of the herpes simplex virus, which was grown in tissue culture and shown to be pathogenic in suckling mice.