Control of measles encephalitis in the rat by CD4+ T-cell
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Cd4 t cell
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Marmosets infected intracerebrally with the wild Edmonston strain of measles virus developed encephalitis, demonstrated histologically and by the fluorescent-antibody technique. The infection remained clinically silent over a 14-day observation period. Animals infected intracerebrally with the JM strain of wild measles virus had only mild encephalitic changes but died of the visceral form of measles infection. Marmosets inoculated with measles vaccine had no encephalitis and remained clinically well. Marmosets appear to be a sensitive indicator of the viscerotropic and neurotropic properties of measles virus.
Morbillivirus
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Morbillivirus
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The number of lymphocytes actively synthetizing RNA was assessed in the peripheral blood stream by staining the blood smears with buffered toluidine blue. In patients with measles, chickenpox and German measles the percentage of activated lymphocytes was several times higher than in healthy subjects of corresponding age. In encephalitis associated with German measles the activation of lymphocytes was equally high as in uncomplicated German measles. On the other hand, in encephalitis associated with measles and chickenpox the number of activated lymphocytes was as low as in healthy subjects and differed markedly from uncomplicated cases of the disease. In the case of encephalitis associated with German measles the percentage*** of activated lymphocytes gradually declined, while in encephalitis associated with measles and chickenpox it remained low. A slight increase was observed only during the second week of the disease in patients not treated with corticosteroids, in the remainder after termination of corticosteroid therapy. These findings confirm the different pathogenesis of different types of exanthematous parainfectious encephalitis.
Chicken Pox
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The literature on encephalitis associated with measles is meager and rather indefinite. The ideas with regard to encephalitis have undergone considerable change in the past few years as a result of the intensive study of epidemic encephalitis. There are numerous references to involvement of the central nervous system during or shortly after an attack of measles. In most instances the authors apparently regarded these symptoms as incidental. Only rarely were the symptoms referable to the central nervous system grouped and designated as a definite clinical entity. It has been recognized for a long time that the various acute infections, as measles, scarlet fever, pneumonia and pertussis, may be followed by encephalitis, most of which have manifested themselves in the form of a cerebral hemiplegia. Particular attention was called to these points by Abt1in 1906. While we have seen a few instances of encephalitis following various of the acute
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Abstract In the 15‐year period 1948–1962 4874 patients were hospitalised in the City and County of Copenhagen with measles. All the case reports have been studied concerning complications and mortality rate, special attention being paid to the incidence and the prognosis of encephalitis. The patients surviving from encephalitis have been followed‐up. The most severe complications were, as expected, pneumonia and encephalitis. Pneumonia was found in 1268 patients; 12 of these patients died. Encephalitis was found in 68 cases, among which six deaths. Before the new therapeutic principles dating from the great polio epidemic in 1952, five of 21 patients died from encephalitis, but after that time only one of 47 patients died. Of the survivors from encephalitis 59 (95%) were followed‐up 3–16 years after the disease: three suffered from grave defects, 16 had mild defects and 40 had recovered completely. The frequency of encephalitis was 0.43%‰ of the notified cases of measles in the period of investigation. Among the admitted patients 22 died (4.5%‰). The mortality rate in the notified cases was only 0.14%‰. Encephalitis is a rare complication in measles and, concerning mortality rate and sequelae, is not so severe as considered previously.
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Encephalitis is the most frequent neurological complication of measles virus infection. This review examines the pathophysiology of measles infection and the presentations, diagnosis and treatment of the four types of measles-induced encephalitis including primary measles encephalitis, acute post-measles encephalitis, measles inclusion body encephalitis and subacute sclerosing panencephalitis. The early symptoms of encephalitis may be non-specific and can be mistakenly attributed to a systemic infection leading to a delay in diagnosis. This review provides a summary of the symptoms that should cause health care workers to suspect measles-induced encephalitis.
Subacute sclerosing panencephalitis
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Subacute sclerosing panencephalitis
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A case of measles encephalitis in a man aged 18 years was described. Attention is called to the relatively rare occurrence of such neurological complications in measles, diagnostic difficulties and good therapeutic results after corticosteroids and antiviral drugs. For reducing the incidence of measles and its neurological complications the author suggests the usefulness of protective re-vaccination against measles.
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