Viral isolation from cases of epidemic neuropathy in Cuba

• Published in: Archives of pathology & laboratory medicine (1976) Vol. 121; no. 8; pp. 825 - 833
• Main Authors: Más, P, Pelegrino, J L, Guzmán, M G, Comellas, M M, Resik, S, Alvarez, M, Rodríguez, R, Muné, M, Capó, V, Balmaseda, A, Rodríguez, L, Rodríguez, M P, Handy, J, Kourí, G, Llop, A
• Format: Journal Article
• Language: English
• Published: United States College of American Pathologists 01.08.1997
• Subjects: Adult; Animals; Animals, Suckling - virology; Antibodies, Viral - analysis; Antigens, Viral - analysis; Cell Culture Techniques; Cercopithecus aethiops; Cerebrospinal Fluid - virology; Coxsackievirus Infections - cerebrospinal fluid; Coxsackievirus Infections - epidemiology; Coxsackievirus Infections - etiology; Coxsackievirus Infections - pathology; Cuba - epidemiology; Cytopathogenic Effect, Viral; Disease Outbreaks; Enterovirus - immunology; Enterovirus - isolation & purification; Enterovirus - pathogenicity; Female; Humans; Immunohistochemistry; Male; Mice; Mice, Inbred BALB C; Middle Aged; Optic Neuritis - cerebrospinal fluid; Optic Neuritis - epidemiology; Optic Neuritis - pathology; Optic Neuritis - virology; Peripheral Nervous System - pathology; Peripheral Nervous System - virology; Peripheral Nervous System Diseases - cerebrospinal fluid; Peripheral Nervous System Diseases - epidemiology; Peripheral Nervous System Diseases - pathology; Peripheral Nervous System Diseases - virology; Rabbits; Vero Cells - virology; Cuba
• ISSN: 0003-9985; 1543-2165

To investigate the possibility of a viral agent in the central nervous system of patients with epidemic neuropathy. Virus isolation attempts, in cell cultures and suckling mice, from cerebrospinal fluid (CSF) of neuropathy patients and controls undergoing lumbar puncture for unrelated reasons. Serologic studies in patients, contacts, and controls. An epidemic of optic and peripheral neuropathy affected more than 50,000 people in Cuba in 1991 through 1993. Illness was associated with dietary limitations and increased physical demands accompanying the shortages of food and fuel experienced in Cuba since 1989. Most patients responded to parenteral vitamin therapy, and the epidemic began to subside when oral vitamin supplementation was begun for the entire Cuban population. Coxsackievirus A9 (five isolates) and a similar, less cytopathic virus (100 isolates) were recovered from 105 (84%) of 125 CSF specimens from neuropathy patients. The strains with light cytopathic effect were antigenically related to Coxsackieviruses A9 and B4 by cross-neutralization and immunoblotting assays. Virus persisted in CSF of some patients for 1 to 12 months. Cerebrospinal fluid from patients and both types of virus from cell culture produced illness, including complete posterior flaccid paralysis, in newborn mice, and virus was reisolated from the mice. Mouse tissues and sural nerve biopsy specimens from patients were stained by immunoperoxidase and colloidal gold techniques using hyperimmune rabbit antisera against the virus with light cytopathic effect. Coxsackievirus A9 or an antigenically related agent with a light cytopathic effect was present in CSF of 84% of 125 patients with epidemic neuropathy. The role of these agents, probably in combination with nutritional factors, in the pathophysiology of the disease requires further investigation.