Perinatal 'TORCH' infections identified by serology: correlation with abnormalities in the children through 7 years of age.

A matched case-control methodology was used to assess the risk for a wide range of abnormalities in children associated with serological evidence for 'TORCH' infections in the mothers. Specimens were selected from the large bank of sera from the approximately 54,000 pregnant women who participated in the Collaborative Perinatal Project. There was no clear association between any of the antigens studied and any specific damage to the child. These 'negative' findings are consistent with the absence of frequent significant effects due to these agents in the second and third trimesters of pregnancy.

Toxoplasmosis: maternal and pediatric findings in 23,000 pregnancies.

An analysis of the antibody titers to toxoplasmosis for 22,845 pregnant women in the Collaborative Perinatal Project was conducted in relation to clinical and laboratory findings in the mothers and children through 7 years of age. More than 900 observations were considered for each mother and child. The major findings were in the children and included a predicted doubling in the frequency of deafness among children born to women with antibody to toxoplasmosis, a predicted 60% increase in microcephaly, and a 30% increase in low IQ (less than 70) in association with the presence of high maternal antibody titer (256 to 512) to toxoplasma. A serologically defined high-risk group of mothers was identified on the basis of high indirect hemagglutination antibody levels or seroconversions and increased IgM toxoplasma antibody levels (indirect fluorescent antibody greater than or equal to 32, enzyme-linked immunosorbent assay greater than or equal to 0.7). Of the 15 pregnancies in this group, two children had congenital toxoplasmosis and three were stillborn.

Antibody to human and simian retrovirus, HTLV-I, HTLV-II, HIV, STLV-III, and SRV-I not increased in patients with multiple sclerosis.

We have tested sera from patients with multiple sclerosis, matched controls, and those with other neurological diseases, as well as sera from patients with the acquired immunodeficiency syndrome and controls and patients with tropical spastic paraparesis (TSP) and controls for antibody to human T-lymphotropic virus type I (HTLV-I), HTLV-II, human immunodeficiency virus (HIV), simian T-lymphotropic virus type III, or simian retrovirus type I by immunofluorescent activity test, and for HTLV-I and HIV by the ELISA method. Sera from patients with multiple sclerosis and matched controls, and from patients with optic neuritis and Parkinson's or other neuromuscular diseases did not have antibody to any of the retroviruses tested. Specimens from TSP patients and some controls contained HTLV-I antibody. We conclude from our study that only TSP patients had serological evidence of infection with one of the retroviruses studied.

Serologic studies of MS patients, controls, and patients with other neurologic diseases: antibodies to HTLV-I, II, III.

We have studied the frequency of human retrovirus antibody (HTLV-I, II, III) in the serum and CSF of patients with MS, matched controls, and patients with optic neuritis, idiopathic and postencephalitic Parkinson's disease, neuropathies, polymyositis, ALS, and postpoliomyelitis. Except for the postpoliomyelitis samples, all samples were collected prior to 1980. Contrary to a previous published report, no significant levels of antibody to HTLV-I, II, or III were found in the MS patients or controls. No retrovirus antibody was detected in patients with the other neurologic diseases.

HIV and HTLV-I antibody studies: pregnant women in the 1960s, patients with AIDS, homosexuals, and individuals with tropical spastic paraparesis.

To investigate the possible occurrence of human immunodeficiency virus (HIV) or human T-cell lymphotropic virus, type I (HTLV-I) infections in the United States prior to 1979-1981, when acquired immune deficiency syndrome (AIDS) was first recognized, we tested sera from 310 pregnant women who participated in the Collaborative Perinatal Project during the period 1959-1964 for HIV and HTLV-I antibody. These samples included sera from 53 pregnant women who were intravenous drug users. The remainder were from women who had cervical epithelial abnormalities, who developed cervical carcinomas, who had had children with erythroblastosis fetalis, who had had children that developed malignant neoplasms early in life, or normal pregnant women. None of the 310 women had confirmed HIV or HTLV-I antibody. The rate of false-positive reactions with the HIV enzyme-linked immunosorbent assay (ELISA) antibody test in these long-frozen samples was similar to that observed in fresh sera. HIV antibody was detected in homosexual patients with AIDS; HTLV-I antibody was not detected in any of these sera. HTLV-I antibody was detected in 17 of 20 patients with tropical spastic paraparesis (TSP) and in two of seven patients with other neurological diseases diagnosed as transverse myelopathy and multiple sclerosis, and in none of nine normal controls; HIV antibody was not detected in any of these sera patients. Thus, we conclude that there was no serological evidence of infection with HIV or HTLV-I in the pregnant women studied; however, HIV antibody was present in all AIDS patients tested, and HTLV-I antibody was found in the majority of patients with TSP.

Rapid latex agglutination test for rubella antibody.

The latex agglutination card test (Rubascan) for the detection of rubella antibody was compared with the standard hemagglutination inhibition and enzyme-linked immunosorbent assay tests. There was complete agreement with sera which had hemagglutination inhibition titers of >/=16. Sera with low levels of antibody which were positive in the enzyme-linked immunosorbent assay, however, gave negative latex agglutination results approximately 25% of the time (false negatives), whereas sera which were negative in the enzyme-linked immunosorbent assay gave false-positive results in about 3% of the cases. The use of capillary "finger stick" plasma instead of venous sera resulted in additional false-negative latex agglutination tests among patients with very low antibody titers. Because of the simplicity of the method, it should be possible to use this test in physicians' offices and in large immunization campaigns. Care should be taken to become completely familiar with the procedures and reading of the agglutination patterns. Control sera should always be used. Interpretation of results should take into consideration the rates of false-negative and false-positive results noted above. These rates apply to sera with little or no antibody. In particular, negative tests should be confirmed with more specific methods in critical cases, such as pregnant women exposed to rubella or women of childbearing age who are being considered for immunization. There was no problem with the latex agglutination findings for sera with higher titers. Since results are available in 8 min, physicians should be able to counsel their patients rapidly and immunize, if necessary, while the patient is still present.

Evaluation of commercially available diagnostic test kits for rubella.

Three standard hemagglutination-inhibition (HAI) methods were compared with 11 commercially available diagnostic test kits for determination of immunity and serologic diagnosis of rubella using a panel of 100 sera. The three standard HAI methods involved removal of serum inhibitors with kaolin, heparin-MnCl2, or dextran sulfate-CaCl2. The HAI kaolin (Flow Laboratories, McLean, Virginia) and Rubelisa (Microbiological Associates Bioproducts, Walkersville, Maryland) kits gave the best specificity as judged by the absence of false-positive results. Rubacell (Abbott Laboratories, Chicago, Illinois), Rubindex (Ortho Diagnostics, Raritan, New Jersey), Fiax (International Diagnostic Technology, Santa Clara, California), and Rubesure (Calbiochem-Behring, La Jolla, California) gave the best sensitivity as judged by the absence of false-negative results. The kits with the highest degree of both specificity and sensitivity were HAI kaolin (Flow), HAI heparin-MnCl2 (Flow), Rubacell (Abbott), and Rubindex (Ortho). In paired sera from five patients with clinical rubella, seroconversions were shown by seven of the kits. One of the kits, Cordia R (Cordis Laboratories, Miami, Florida), showed no significant rise in antibody titer with one pair of sera. Antibody titers in the same serum varied widely between the different kits.