Adult Leukaemias and Diagnostic X Rays

Abstract

Discussion R.S.V. was first found in human beings by Chanock et al. (1957), who isolated it from two children with pneumonia.Since then its association with many cases of bronchiolitis has been shown by workers in America, and Peacock and Clarke (1961) have recorded its isolation from two cases in this country.To ensure isolation, specimens should not be frozen before being cultured, and a special strain of tissue culture cells known to be sensitive to R.S.V. must be used.These factors would account for failure to isolate it from the infants in the Birmingham outbreak of 1956-7.All specimens were frozen several times before they were put on to tissue cultures and those used were probably insensitive to R.S.V.But the fact that 68.7% of the 32 convalescent sera tested have shown significant, and mostly very considerable, rises in complement-fixing antibody to R.S.V. indicates that it was the primary cause of the bronchiolitis in the majority of the infants in this outbreak.As might be expected, better serological responses were given by the older infants, though one only 2 months old attained a titre of 1/256.The reactions shown by the infant of 3 weeks with titres of 1/16 in both sera must have been due to maternal antibody, as were possibly those shown by the two with titres of 1/4 and 1/8 in their paired sera; otherwise this common difficulty in interpreting serological reactions in the very young was refreshingly absent.Respiratory infection, often of the common-cold type, is frequently present in other members of the household when an infant goes down with bronchiolitis.R.S.V. in older children and adults, many of whom have demonstrable antibodies, usually produces a common- cold type of infection.It is possible that further investigation of winter respiratory infections will show that epidemics of infantile bronchiolitis occur when the prevailing virus in the general population is R.S.V., while the sporadic cases may be associated with other types of respiratory virus.Summary Stored sera collected during an investigation of epidemic infantile bronchiolitis in 1956-7 have been investigated for evidence of respiratory syncytial virus infection.The original investigation had failed to show any evidence of a virological cause for the condition.Out of 32 pairs of sera tested for complement-fixing antibodies to respiratory syncytial virus, 22 have been found to show significant rises of titre.Thus it is shown that respiratory syncytial virus must have been the main aetiological factor in the outbreak.