Vesiculo-bullous lesions of the oral mucosa

Oral mucosa frequently manifests a variety of lesions that are fluid-filled and raised. When such lesions are ovoid and about 0.5 cm, these are generally referred to as bullae (AU)

Genital ulcers: etiology, clinical diagnosis, and associated human immunodeficiency virus infection in Kingston, Jamaica

Individuals presenting consecutively with genital ulcers in Kingston, Jamaica, underwent serological testing for human immunodeficiency virus (HIV) infection , chlamydial infection, and syphilis. Ulcer material was analyzed by the multiplex polymerase chain reaction (M-PCR) analysis DNA from herpes simplex virus (HSV), Haemophilus ducreyi, and Treponema pallidum was detected in 158 (52.0 percent), 72 (23.7 percent), and 31 (10.2 percent) of 304 ulcer specimens. Of the 304 subjects, 67 (22 percent) were HIV-seropositive and 64 (21 percent) were T. pallidum-seroactive. Granuloma inguinale was clinically diagnosed in nine (13.4 percent) of 67 ulcers negative by M-PCR analysis and in 12 (5.1 percent) of 237 ulcers positive by M-PCR analysis (P = .03). Lymphogranuloma venereum was clinically diagnosed in eight patients. Compared with M-PCR analysis, the sensitivity and specificity of a clinical diagnosis of syphilis, herpes, and chancroid were 67.7 percent, 53.8 percent, and 75 percent and 91.2 percent, 83.6 percent, and 75.4 percent, respectively. Reactive syphilis serology was 74 percent sensitive and 85 percent specific compared with M-PCR analysis. Reported contact with a prostitute in the preceding 3 months was associated with chancroid (P = .009), reactive syphilis serology (P = .011), and HIV infection (P = .007). The relatively poor pleads for syndromic management of genital ulcers in Jamaica. Prevention efforts should be intensified.(Au)

The age of infection with varicella-zoster virus in St. Lucia, West Indies

Sera from an age-stratified sample of 1810 people from the Caribbean island of St. Lucia were tested for antibodies against varicella-zoster virus. The results indicate that very few infections occur in childhood which agrees with clinical survey data from other tropical countries, but contrasts with the observed high case rate in children in temperate countries. The alternative hypothesis which may explain these results are discussed, and it is suggested that high ambient tempertaures interfere with the transmission of the virus. Irrespective of the cause the pattern of varicella incidence observed has important implications for any vaccination policy adopted in tropical countries (AU)

Electron microscopy of herpes simplex hepatitis with hepatocyte pulmonary embolization in kwashiorkor

We report a case of herpes simplex hepatitis in a child with edematous malnutrition. Electron microscopy showed virus in parenchymal cells. With pulmonary embolization of necrotic, infected hepatic cell fragments. Systemic dissemination of herpes simplex may be related both to the profound immunoincompetence associated with kwashiorkor and to a reduction in the circulating and fixed polyanions that normally inhibit viral attachment to cells.(AU)

Seroprevalence of toxoplasma gondii, rubella virus, cytomegalovirus herpes simplex virus (TORCH) and syphilis in Jamaican pregnant women

Seroprevalence of toxoplasma gondii, rubella virus, cytomegalovirus, herpes simplex virus infections (TORCH) and syphilis were determined in order to assess the immune/susceptibility status in Jamaican pregnant women in 1986. The positive rates were 57 percent (T. gondii), 69 percent (rubella), 97percent (CMV), 91 percent (HSV), and 4.9 percent (syphilis), respectively. The rate of reactivity for rubella was over 50 percent in all parishes, the highest being 85 percent in St. Thomas. The seroprevalence of T. gondii was lowest in Trelawny (37.5 percent). There were no significant differences in seropositivity of CMV and HSV infections between women from various parishes. The importance of seroprevalence of the TORCH group of agents and syphilis on perinatal morbidity and mortality in Jamaican women is discussed, and appropriate recommendations for prevention and control of congenital infections in Jamaica are suggested. (AU)

Herpes simplex virus infections in immunocompromised Jamaican patients

Data are presented on 13 immunocompromised patients with herpes simplex virus (HSV) infection. Eleven patients had recurrent HSV infection. Eight had genital herpes, 3 had disseminated infection and two had localised extragenital infection. Nine patients had confirmed recurrent HSV-type 2 infection. The benefits of recent antiherpetic therapy in the prevention of recurrent HSV infections in immunocompromised Jamaican patients are discussed (AU)

Genital herpes in Jamaica: a clinical and pathological study (1982-1984)

Five hundred and four patients with suspected genital herpes simplex virus (HSV) infection were investigated in Jamaica between 1982 and 1984. Of these, 100 (19.8 percent) were virologically confirmed. There were 12 patients with primary/first episode, 45 recurrent and 6 "provoked' type of genital herpes simplex virus infections. Genital herpes in women was more severe than in men. Eighty-eight per cent of genital herpes was confirmed by virus isolation. Forty HSV isolates were identified as HSV type 2. There was a sero-response in 75 percent primary, 18 percent recurrent and 17 percent provoked type of genital herpes. Virus isolation is the most sensitive and specific test for the diagnosis of genital herpes simplex virus infection. The measurement of serum anti herpes simplex complement-fixing antibodies was not useful in the diagnosis of suspected patients with genital ulcers and their contacts. The infectiousness of the virus, clinical manifestations, complications such as neonatal herpes infections, psychosocial problems and methods of prevention are issues that clinicians should discuss with patients with genital herpes (AU)

Influenza virus infections in Jamaica between 1977 and 1985

Data on influenza virus infections between 1977 and 1985 in Jamaica are presented. The occurrence of influenza varied each year. The peak incidence correlated generally with the peak occurrence of acute respiratory illness each year. The influenza-associated neurological (17 percent) and cardiac (9.7 percent) manifestations were seen during the period of study. Antigenic variants of influenza viruses circulating in Jamaica were similar to those recorded world-wide. Continuous virological and non-virological surveillance are vital in determining the impact of influenza on associated mortality and morbidity in a developing country like Jamaica. (AU)

Chromatographic separation of herpes simplex virus

Experiments were designed to differentiate between isolates of herpes simplex virus (HSV) that are the aetiological agents of human encephalitis (neurotropic HSV) and those that were originally isolated from non-encephalitic cases (non-nueroropic HSV). Results showed that the nuerotopic HSV studied could be eluted from DEAE-cellulose columns with potassium phosphate buffer of ionic strength 0.1M or 0.15M at pH 7.0 as dertermined by mouse patogenicity and cytopathic effects. On the contrary, the eluates of the non-neurotropic HSV showed no viral patogenicity or cytopathic effects under similar conditions. Column chromatography and analysis of eluants for viral pathogenicity is a simple method for recognizing differences between neurotropic and non-neurotropic HSV. Taxonomically, this work raises the question as to whether or not HSV should be sub-classified into types designating their neuropathogenicity (AU)

Antibodies to herpes simplex virus (types 1 and 2) in Jamaican patients with cervical dysplasia and neoplasia

Antibody activity to Herpes simplex virus (HSV) types 1 and 2 was measured in sera from women with cervical dysplasia (19 cases), squamous-cell carcinoma, stages 0-4 (54 cases), other genital tumours (15 cases) and matched controls (60 cases) by the indirect immunofluorescent (IFA) test. The frequency of HSV-2 antibody activity was significantly greater in women with cervical cancer than in those with other genital tumours and in matched controls (p<0.05). No significant difference was observed for the HSV-2 antibody activity between women with cervical dysplasia and matched controls. The mean antibody titres to HSV-1 and HSV-2 were significantly higher in cancer cases than the respective titres in control groups (p<0.05). The cervical cancer cases were also analysed according to their clinical stage (Stages 0-4), and there was no significant variation either in frequency of antibody activity, or mean HSV-2 antibody titres. These preliminary findings suggest that there may be an association between HSV-2 and squamous cell carcinoma of uterine cervix in Jamaican women but further studies are required for meaningful conclusions to be drawn (AU)

Two cases of herpes simplex encephalitis at the University hospital of the West Indies

Two antigenically distinct herpes simplex viruses (HSV) are described. They were isolated from clinically diagnosed cases of acute encephalitis in a 10-year-old boy and a 36-year-old man. These viruses were identified as HSV by standard complement-fixation neutralized and cytopathology in different host systems. However, these isolates differ from classical HSV in the following aspects: (1) inability to infect adult Swis albino mice; (2) stability to organic solvents; (3) inability to be neutralized by hyperimmune sera to HSV-1; (4) requirement of chromatography on DEAE-cellulose to render them susceptible to DNase. In contrast, freezing and thawing alone were sufficient to render the HSV-1 susceptible to DNase. Further investigations will be necessary to determine whether the differences observed between the HSV-1 and the neurotropic strains provide sufficient basis for the establishment of a new sub-group for the encephalitic strains (AU)

Comparison of two human pathogenic strains with a commensal strain of Herpes Simplex virus isolated at the University Hospital of the West Indies

Comparision has been made between two human "neuropathogenic" and one "commensal" strains of herpes simplex virus. These terms are assigned to these viruses on the basis of their origin. The first two were related from patients with encephalitis and the third from a benign recurrent lesion. A number of physiochemical characteristics of these three strains were studied. The major differences observed between the "pathogens" and the "commensal" virus are: 1. The ability of the commensal herpes virus to infect adult mice while the pathogenic herpes could not. 2. The commensal herpes virus could not be neutralized by the hyperimmune sera of the pathogenic herpes and vice versa, although all crossreacted in complement fixation tests. 3. The commensal virus was significantly inactivated by chloroform, while the pathogens were not significantly affected under the same conditions. 4. Freezing and thawing followed by differential centrifugation rendered the commensal herpes vulnerable to inactivation of DNAse. Inactivation of the pathogens by this enzyme could only be acheived after chromatography on the anion exchanger, Diethyl aminoethyl. 5. The absorbtion spectrum gave a maximum peak at wave lenghts between 260-270 mu for the pathogenic virus. The peak absorption of the commensal herpes was at 280 mu. The peak at 260-270 mu by the pathogens is most likely due to the presence of nucleic acid. The peak absorption of the commensal virus is similar to that given by a typical protein. The relatively high concentration of protein which accompanies the commensal virus might account for the behaviour of this virus. 6. The "pathogenic" and "commensal" strains could be distinguished with respect to susceptibility to interferon. The commensal strain being more susceptible and also more effective in inducing interferon synthesis. 7. The method of comparision used in this investigation, and the results which reflect the marked difference between the strains of herpes simplex studied here produce some methods which may be used for differentiating between pathogenic and commensal strains of herpes simplex virus. It would appear that the methods used here are valuable to the study of viral genetics and the physiochemical study of herpes viruses. Evidence has been presented to show that there is molecular structural difference between the pathogenic and the commensal strains of herpes simplex virus. Such a difference or such differences may provide tools to probe into the pathogenic physiology of infected cells, or help to elucidate the factors responsible for neurotropicity and commensalism in herpes virus. The author is convinced that the differences cited above are genetically based. However, until further investigations are carried out, it is a subjective choice whether to consider the differences as sufficient basis for the subgrouping of herpes simplex virus. No claim is made that the distinction cited are attributes of other strains associated with encephalitis or limited lesions of recurrent herpes (AU)