Immunoglobulin and C3 levels in maternal and cord blood in Jamaica

IgG, IgM, IgA and C3 were estimated by radial immunodiffusion (RID) in one hundred paired maternal and cord blood samples. The mean maternal IgG, and IgM, and IgA were 2112 mg/dl, 118 mg/dl and 251 mg/dl, respectively, while in corresponding infants, the mean levels were 2194 mg/dl, 36 mg/dl and 19 mg/dl. Mean cord serum C3 levels was 113 mg/dl, approximately half the maternal level (203 mg/dl). Variation in the gestational age, birth weight, duration of labour and maternal pre-eclamptic toxaemia did not significantly affect the immunoglobulin levels. Seven out of 36 (16 percent) cord blood with IgM level greater than 36 mg/dl showed either fourfold rise or high antibody titres against one of the TORCH (toxoplasma, rubella, cytomegalovirus and herpes simplex virus) agents. Screening of cord serum for IgM levels can be of particular value in detection of newborn infants with clinically apparent or inapparent intrauterine infections (AU)

Evaluation of an immunofluorescence test for the diagnosis of gonorrhoea

Sera from 336 Jamaicans were tested, using a mixture of local strains of N. gonorrhoeae as antigen in an indirect flourescent antibody test. (IFA) At 1:6 serum dilution, the sensitivity of test was high (100 percent in females with culture-proven gonorrhoea). Geometric mean titres in culture-negative females witha history of gonorrhoea contact were significantly higher than in females with non-gonococcal vaginitis (81 and 47 respectivity). There was no significant difference between the GMT of males with current uncomplicated gonorrhoea and controls (43 and 37 respectively). Absorption studies showed that N. gonorrhoeae-specific antibodies were present in 25 percent of culture-negative, 67 percent culture-positive patients and 20 percent of blood donors. The specificity of the test was markedly improved at 1:128 serum dilutions, when the predictive value of a positive result was 95 percent. We consider this IFA test to be a useful adjunct to the diagnosis of gonorrhoea. (AU)

Infectious meningitis at the University Hospital of the West Indies. Review of clinical and laboratory findings (1965-1980)

A retrospective study is reported on 215 cases of infectious meningitis seen during a 16-year period (1965-1980) at the University Hospital of the West Indies, Kingston, Jamaica. A detailed analysis was made of the aetiology, epidemiology, signs and symptoms, associated conditions, laboratory investigations, treatment regimes as well as outcome. The most common causative organism of bacterial meningitis was Streptococcus pneumoniae (29.3 percent), being seen in all age groups except in neonates. Haemophilus influenzae (23 percent) was the most frequent cause in pre-school children. Unusual pathogens constituted a major group of bacterial meningitis, accounting for 34 (21.3 percent). Of 11 neonates recorded, 7 (63.6 percent) belonged to this latter group. There were 48 (22.3 percent) cases of aseptic meningitis, 5 tuberculous and 2 cryptococcal. The overall mortality was 14.4 percent. The fatality rate in pneumococcal meningitis was 25.5 percent whereas in that caused by Haemophilus it was 2.7 percent. No deaths were recorded in the aseptic group. The gram stain was useful in 65 percent of cases of bacterial meningitis. One third of aseptic cases had 50 percent or more of neutrophils in the CSF. The highest CSF white cell count in aseptic and bacterial meningitis was 2,176 and 36,000 cells/mm3, respectively. The highest CSF protein level in bacterial and aseptic meningitis was 774 mg/100 ml and 150 mg/ml, respectively. Because of the high incidence of unusual pathogens, there is a need for a modified approach to initial antibiotic treatment bearing in mind the multiple antibiotic-resistant strains that are frequently encountered (AU)

Immunoglobulin and C3 levels in normal human amniotic fluid

Forty-one amniotic fluid samples were tested by single radial immunodiffusion, using Hyland plates for the demonstration of IgG, IgA, IgD, IgM and C3. All of the immunoglobulins except IgM could be detected throughout gestation. There was a tendency to increase during mid-pregnancy and thereafter to decrease toward term. IgM was detected in only 5 samples (12.2 percent) obtained at term. The literature is reviewed with particular emphasis on IgD, IgM and C3 in amniotic fluid (AU)