Epidemiologic implications of Creutzfeldt-Jakob disease in a 19 year-old girl.

A histopathologically-verified, clinically typical case of Creutzfeldt-Jakob disease (CJD) is described in a 19 year-old girl. Only 3 previous cases of CJD have been reported in adolescents, and one of these was iatrogenically transmitted, while another was familial. Epidemiologic investigation of the present case excluded a familial component, and provided no evidence for iatrogenic or natural case-to-case transmission, or of other environmental sources of viral contamination. Young patients such as this one serve to emphasize the obscurity that still surrounds the epidemiology of CJD, and invite serious reconsideration of the possibilities of transmission by undetected virus carriers, or of the agent as a natural resident of human cells, replication of which might be triggered by non-infective (e.g., traumatic or mutational) environmental events.

[Symptoms of human trypanosomiasis at the first diagnostic phase in the People Republic of Congo (author's transl)]. / La trypanosomiase humaine au moment du dépistage en république Populaire du Congo: distribution des signes cliniques.

A study of clinical symptoms of trypanosomiasis has been carried out on 317 patients diagnosed actively in the field by lymphatic gland puncture and fluorescent antibody test in two foci of People's Republic of the Congo. The presence and frequency of the signs have been evaluated according to the focus, age, sex, period, the level of disturbance of C.S.F. and the results of parasitology. Thus, the authors demonstrate that: --9 p. 100 of patients show symptoms; --symptomatology of the woman is richer than that of the man; --several symptoms are closely related to age (fever, glands hypertrophy, cramps, anorexia, liver and spleen enlargement, impotence). They point out moreover: --the precocity of nervous signs which often are shown by patients without any disturbance of C.S.F.; --the lack of correlation between apparent severity of the infection and the level of disturbance of C.S.F.; --the variation of frequency of adenopathy according to kinetics of endemic and the level of immunity of the populations. Finally, the results obtained in the field are compared with those given by health care deliveries.

[Post-therapeutic evolution of patients presenting an immunological suspicion of trypanosomiasis without parasitological proof in support of it (author's transl)]. / Evolution après traitement des suspects immunologiques de trypanosomiase non confirmés parasitologiquement.

The authors have recently preconised systematic treatment of every human being who is fluorescent positive. The evolution of antibodies of 26 subjects parasitologically negative and positive only in FAT test is described here after treatment with Arsobal. Statistically the antibodies decrease progressively like antibodies of Sleeping Sickness patients of first period usually did. Therefore it is possible to conclude that immunological suspects who were treated were realy sick and rightly cured.

[Indirect immunofluorescence in the therapeutic surveillance of trypanosomiasis (preliminary note)]. / L'immunofluorescence indirecte dans la surveillance thérapeutique des trypanosomes (note préliminaire).

The authors have studied the evolution of fluorescent antibodies in the serum and the C. S. F. of treated Sleeping Sickness patients regularly examined when coming to Brazzaville for their periodical controls. They have observed more than 200 patients who were followed during three years. The authors demonstrated that curing patients show the following particularities: -- serum becomes negative less rapidly than C. S. F., -- delay of negativation of the serum varies according to the stage of the disease, -- the C. S. F. positive in fluorescence becomes negative in less than twelve months. On the other hand, relapsing patients show some striking differences, such as: -- C. S. F. remains always strongly fluorescent positive, -- the serology remains positive too, but can present some fluctuations. Some very particular cases such as "nuclear fluorescence only" or discrepancy between IFAT and clinico-parasitological data are then analysed. From a practical point of view, it appears that, as often as not, the evolution of fluorescent antibodies in serum and in C. S. F. allows to prognose either the cure or the relapse less than one year after treatment.