Studies on the virus of epidemic parotitis (mumps) and the immunity reactions to It in man and experimental animals
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Abstract
No clinician has any difficulty in making a
diagnosis in a typical case of mumps. The gross
swelling of the parotid glands and the pain that
accompanies eating and swallowing are so characteristic of the disease that laboratory aids to diagnosis are quite unnecessary.
Mumps, however, is a generalised infection and the parotid glands are not always affected; other organs may be involved and the complications of benign meningo-encephalitis, orchitis, pancreatitis and oophoritis are all well recognised. In the past these complications were only recognised as manifestations of a generalised mumps virus infection when there was clear evidence of parotitis. During i ; j the last ten years new techniques of the propagation j of the virus in the chick embryo have made it possible to evolve serological and cultural methods of diagnosis and to show that occasionally individuals may suffer from illnesses due to this virus without any Involvement of the parotid glands whatever.
A benign "aseptic" meningitis is perhaps the commonest form of this type of infection and is accompanied by the appearance of specific antibodies to the mumps virus in the blood stream. The differential diagnosis on clinical grounds lies between non-paralytic poliomyelitis, benign lymphocytic Meningitis and other forms of "aseptic" meningitis.
There is, therefore, a considerable need for a diagnostic serological test in complicated cases of mumps. |Several tests have in fact been evolved and their relative values have been outlined and analysed by different workers. However, the conclusions !reached have often been contradictory, so that I opinion is still divided on the practical utility of the tests especially for diagnosis in the early .stages of the disease.
It has been known for a long time that an attack of mumps ensures a life-long immunity analogous to that after infection with the viruses of small pox or of yellow fever. Routine use of the serological tests has revealed that persons exposed to the mumps virus may suffer from 'subclinical' infection only and become resistant to further exposures to the virus. Both these groups of cases demonstrate a rise of the specific antibody content in the blood. But what determines the immunity state and differentiates it from susceptibility is not yet known.
The mumps virus is generally regarded as homogeneous and in the literature there is almost complete unanimity that there is little difference between the strains so far examined. This finding is remarkable and is in contrast with other haernagglutinating viruses; the influenza and the Newcastle disease viruses which belong to this group, are extremely plastic and antigenically variable. Recent serological work has revealed a relationship between the rnumps and the Newcastle disease viruses which may be explained by the sharing of a common antigen or antigens. It is not however known iwhether all the mumps strains contain this antigen.
Strains of the mumps virus when freshly isolated in Edinburgh were found to show at least minor differences of antigenic structures and in one of these strains considerable difference of habit of growth in eggs was noted. The fact that strain differences, however small, do occur is of importance when interpreting serological findings or when preparing diagnostic antigens. Moreover, in the latter case, the use of more than one strain or a 'local' strain is known to improve the accuracy of the serological reactions.
As an essential preliminary, a review of the literature as well as the recent serological observations on the immunity reactions in mumps are presented in this thesis. References relevant to the methods used in the experiments are reviewed at the beginning of each chapter. In addition to the review, an account is given of detailed studies made on the nature of the virus and on its modes and rates of reproduction in embryonated eggs. Serological methods, including those of complement fixation tests, have been adopted and extensively used to investigate the phases of the virus growth and the appearance and fluctuations of antibodies in man and in small laboratory animals. The pathological effects that the virus produces in some of these animals have been studied.
The incidence of antibodies to the Newcastle disease virus in sera of individuals during an attack of mumps and after the recovery from infection was also investigated with a view to deciding whether the known antigenic relationship between the two viruses was constant.
A separate section has been included on the electron microscopy of different strains of the mumps virus.. A short review of the principle, and the application of this instrument in the study of the viruses, the hazards of the preparation of specimens, and the interpretation of the findings has also been outlined.
Mumps, however, is a generalised infection and the parotid glands are not always affected; other organs may be involved and the complications of benign meningo-encephalitis, orchitis, pancreatitis and oophoritis are all well recognised. In the past these complications were only recognised as manifestations of a generalised mumps virus infection when there was clear evidence of parotitis. During i ; j the last ten years new techniques of the propagation j of the virus in the chick embryo have made it possible to evolve serological and cultural methods of diagnosis and to show that occasionally individuals may suffer from illnesses due to this virus without any Involvement of the parotid glands whatever.
A benign "aseptic" meningitis is perhaps the commonest form of this type of infection and is accompanied by the appearance of specific antibodies to the mumps virus in the blood stream. The differential diagnosis on clinical grounds lies between non-paralytic poliomyelitis, benign lymphocytic Meningitis and other forms of "aseptic" meningitis.
There is, therefore, a considerable need for a diagnostic serological test in complicated cases of mumps. |Several tests have in fact been evolved and their relative values have been outlined and analysed by different workers. However, the conclusions !reached have often been contradictory, so that I opinion is still divided on the practical utility of the tests especially for diagnosis in the early .stages of the disease.
It has been known for a long time that an attack of mumps ensures a life-long immunity analogous to that after infection with the viruses of small pox or of yellow fever. Routine use of the serological tests has revealed that persons exposed to the mumps virus may suffer from 'subclinical' infection only and become resistant to further exposures to the virus. Both these groups of cases demonstrate a rise of the specific antibody content in the blood. But what determines the immunity state and differentiates it from susceptibility is not yet known.
The mumps virus is generally regarded as homogeneous and in the literature there is almost complete unanimity that there is little difference between the strains so far examined. This finding is remarkable and is in contrast with other haernagglutinating viruses; the influenza and the Newcastle disease viruses which belong to this group, are extremely plastic and antigenically variable. Recent serological work has revealed a relationship between the rnumps and the Newcastle disease viruses which may be explained by the sharing of a common antigen or antigens. It is not however known iwhether all the mumps strains contain this antigen.
Strains of the mumps virus when freshly isolated in Edinburgh were found to show at least minor differences of antigenic structures and in one of these strains considerable difference of habit of growth in eggs was noted. The fact that strain differences, however small, do occur is of importance when interpreting serological findings or when preparing diagnostic antigens. Moreover, in the latter case, the use of more than one strain or a 'local' strain is known to improve the accuracy of the serological reactions.
As an essential preliminary, a review of the literature as well as the recent serological observations on the immunity reactions in mumps are presented in this thesis. References relevant to the methods used in the experiments are reviewed at the beginning of each chapter. In addition to the review, an account is given of detailed studies made on the nature of the virus and on its modes and rates of reproduction in embryonated eggs. Serological methods, including those of complement fixation tests, have been adopted and extensively used to investigate the phases of the virus growth and the appearance and fluctuations of antibodies in man and in small laboratory animals. The pathological effects that the virus produces in some of these animals have been studied.
The incidence of antibodies to the Newcastle disease virus in sera of individuals during an attack of mumps and after the recovery from infection was also investigated with a view to deciding whether the known antigenic relationship between the two viruses was constant.
A separate section has been included on the electron microscopy of different strains of the mumps virus.. A short review of the principle, and the application of this instrument in the study of the viruses, the hazards of the preparation of specimens, and the interpretation of the findings has also been outlined.
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