OT: ALS/Seronegative TBE (several articles in one) Important for EVERYONE...

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1: Int J Med Microbiol. 2006 May;296 Suppl 40:54-8. Epub 2006 Mar 20. Links

Analysis of the long-term dynamics of tick-borne encephalitis (TBE) and

ixodid tick-borne borrelioses (ITBB) morbidity in Russia.

Korenberg E, Likhacheva T.

Gamaleya Research Institute of Epidemiology and Microbiology, Russian

Academy

of Medical Sciences, Gamaleya Str. 18, Moscow, 123098 Russia.

focus

 

As early as in the 1960s, Professor M.P. Chumakov suggested that primary

tick-borne encephalitis (TBE) diagnoses made by practicing physicians should

be

verified by serological or virological methods. Verification showed that

Ixodid

tick-borne borrelioses (ITBBs), or infections of the Lyme borreliosis group,

which proved to be sympatric to TBE in Russia accounted for an even higher

morbidity in past years. Some other tick-borne diseases were still unknown

at that

time. We analyzed 1062 case histories of patients with febrile diseases

acquired through tick bites in the Udmurt Republic, Russia (one of the most

hazardous regions with respect to TBE morbidity), recorded from 1965 to

1968, and

1509 similar cases recorded from 1983 to 1988. In the first period, 97 out

of 684

cases (14.2%) included in the official statistics of TBE morbidity could be

classified as ITBB according to modern case criteria. In the second period,

464

out of 1509 cases recorded as TBE (30.7%) were retrospectively diagnosed as

ITBB. No specific diagnosis could be made in 7-17% of the total number of

cases

interpreted as 'tick-borne' diseases. A similar situation existed in other

regions of Russia before 1996 and, as a consequence, the official parameters

of

annual TBE morbidity in different periods were overestimated by a factor of

1.2-1.6. Here, the long-term dynamics of TBE morbidity in Russia are

presented

as they appear according to official data and after correction with regard

to

estimations.

 

PMID: 16545980 [PubMed - indexed for MEDLINE]

 

1: J Neurol. 1975 Dec 2;211(1):11-23. Links

An uncommon case of amyotrophic lateral sclerosis with isolation of a virus

from the CSF.

Muller WK, Hilgenstock F.

An atypical case of amyotrophic lateral sclerosis (ALS) is described,

characterized by early manifestation, a long lasting course with asymmetry

of the

lesions, absence of bulbar symptoms in the presence of an otherwise very

advanced

symptomatology, and constant signs of an inflammatory reaction in the CSF

which was the reason to initiate extensive virological studies, including

procedures for virus isolation. A virus belonging to the TbE complex of

arbovirus

group B (tick-borne flavivures), was finally isolated from the CSF. About

70% of

the ALS cases in Hamburg/W. Germany, examined for antibodies, apparently had

contact with this virus. The antibody pattern found made it possible to

explain

this exceptional case.

: J Neurol Neurosurg Psychiatry. 2006 Jun 5; [Epub ahead of print]

Links

Clinical features of double infection with encephalitis (TBE) and lyme

borreliosis (LB) transmitted by tick bite.

Logina I, Krumina A, Karelis G, Elsone L, Viksna L, Rozentale B,

Donaghy MJ.

Stradin's University Hospital, Latvia.

 

BACKGROUND: In Latvia and other endemic regions a single tick bite has

the potential to transmit both tick-borne encephalitis (TBE) and Lyme

Borreliosis (LB). OBJECTIVE: This retrospective study analyses both the

clinical features, and differential diagnosis in 51 patients with

serological evidence of combined tick-borne infection with TBE and LB.

67% had exposure to ticks. RESULTS: Biphasic fever suggestive of TBE

occurred in 55%. Meningitis occurred in 92% with painful radicular

symptoms in 39%. Muscle weakness occurred in 41%, in 29% the flaccid

paralysis compatible with either TBE. Only two presented with the

bulbar palsy typical of TBE. Typical LB facial palsy occurred in 2.

Typical TBE oculomotor disturbances occurred in 3. Other features

typical of LB were detected in our PATIENTS: distal peripheral

neuropathy in 4; arthralgia in 9; local erythema 1 to 12 days after

tick bite in 7; erythema chronicum migrans in 1. ECG abnormalities

occurred in 15. CONCLUSIONS: Patients with double infection with TBE

and LB fell in 3 main clinical groups: febrile illness - 3 (6%);

meningitis - 15 (30%); central or peripheral neurological deficit

(meningoencephalitis, meningomyelitis, meningoradiculitis,

polyradiculoneuritis) - 33 (65%). Systemic features pointing to LB were

found in 25 (49%); IgM antibodies to Borreliosis were resent in 18 of

them. The clinical occurrence of both LB and TBE vary after exposure

via tick bite, and the neurological manifestations of each disorder

vary widely, with considerable overlap. This observational study

provides no evidence that co-infection produces unusual manifestations

due to unpredicted interaction between the two diseases. Patients with

tick exposure presenting with acute neurological symptoms in areas

endemic for both LB and TBE should be investigated for both conditions.

The threshold for simultaneous treatment of both conditions should be

low given the possibility of co-occurrence and the difficulty in

ascribing individual neurological manifestations to one condition or

the other.

 

 

PMID: 16754695 [PubMed - as supplied by publisher]

 

TITLE: [The phenomenon of antigenic defectiveness in naturally

circulating strains of the tick-borne encephalitis virus and its

possible connection to seronegative forms of the disease]

VERNACULAR TITLE: Iavlenie antigennoi defektnosti u

tsirkuliruiushchikh v prirode shtammov virusa kleshchevogo

entsefalita i ego vozmozhnaia sviaz' s seronegativnymi formami

zabolevaniia.

AUTHORS: Pogodina VV; Bochkova NG; Dzhivanian TI; Levina LS;

Karganova GG; Riasova RA; Sergeeva VA; Lashkevich VA

SOURCE: Vopr Virusol 1992 Mar-Apr;37(2):103-7

CITATION IDS: PMID: 1441427 UI: 93070214

ABSTRACT: Ten strains of tick-borne encephalitis (TBE) virus

isolated from single specimens of I. persulcatus ticks were

studied. The strains were divided into antigenically complete (AC)

and antigenically defective (AD), depending on the presence or

absence of some virusantigens in concentrated virus preparations,

characteristics in rocket immune electrophoresis (RIEP), rate and

intensity of humoral immune response in monkeys and rabbits, and

plaque size in SPEV cell culture. The AC-strain markers include high

activities of precipitating, hemagglutinating (HA), and complement-

fixing (CF) antigens, formation of precipitates moving in rocket

shape towards anode and cathode in RIEP, rapid development of

antihemagglutinins and virus-neutralizing antibodies, large

plaques (3-5 mm). The AD variants are characterized by the

lack of HA and precipitating activity, low titres of CF antigen,

slow and poor immune response, the lack of cathode precipitate

" rocket " , very small plaques. The antigenic defectiveness is

transitory and shows in early passages; after 10-11 passages in

SPEV cell cultures or in white mice, transformation AD----AC

occurs. A transformed strain is neutralized, like standard TBE

strains, by blood sera of a typical patient with poliomyelitis-

like form of TBE. Examinations of blood sera from the population

of an endemic zone (Yaroslavl Province) and 67 TBE patients (Kurgan

Province) demonstrated the association of AC and AD variants with

the formation of immune portion of the population and TBE etiology.

Cases of the disease confirmed by seroconversion in HI with

commercial diagnosticum are associated with AC variants,

whereas AD variants are associated with those TBE cases which are

difficult to diagnose using the commercial diagnosticum.

 

MAIN MESH

 

1: Vopr Virusol. 1982 Jul-Aug;27(4):473-9. Links

[Characteristics of long-term persisting strains of tick-borne encephalitis

virus in different forms of the chronic process in animals]

[Article in Russian]

Frolova TV, Pogodina VV, Frolova MP, Karmysheva VIa.

The properties of the Vasilchenko strain of tick-borne encephalitis (TBE)

virus and its 3 variants isolated at various stages of persistent infection

(383,

453, and 535 days) in Macaca rhesus monkeys and Syrian hamsters with

different forms of the chronic TBE were studied. The process characterized

by chronic

focal inflammatory-degenerative changes in the brains of hamsters without

the

disturbance of motor functions was associated with persistence of different

kinds of virus-specific antigens without virulent virus production. Brain

explants of this group of hamsters yielded a virus with cytopathogenic

properties

but not pathogenic for mice. In a chronic disease developing without the

initial

acute period, a virus was recovered from hamsters which proved to be

virulent

for mice and to possess the hemagglutinating and high invasive activity. The

most virulent strain was isolated from monkeys with continuously progressive

chronic encephalitis with steady paralysis of the extremities. This isolate

differed from the parental Vasilchenko strain by a high pathogenicity for

hamsters by intracerebral and subcutaneous routes, and thermostability at 50

degrees

C.

 

PMID: 6753337 [PubMed - indexed for MEDLINE]

 

1: Zh Nevrol Psikhiatr Im S S Korsakova 2001;101(4):10-5 Related Articles,

Books

[Clinical pathogenic peculiarities of chronic Russian tick-born

encephalitis]

[Article in Russian]

 

Nadezhdina MV.

 

 

Clinical, serologic, epidemiological and neurological studies were carried

out

in 23 patients (18 men, 5 women) aged 15-69 years who had chronic Russian

tick-borne encephalitis (RTE). With permanent stable humoral immunity the

fact

that these forms might develop was confirmed in 73.9% of the cases. In 26.1%

of

the patients were found to have incomplete vaccination and vaccine therapy

combined with RTE viral infection. The following conditions underlay

chronization were observed in all forms of acute RTE: fever in 4.3%,

meningitis

in 30.4%, focal lesion in 43.5% (the encephalitic syndrome in 8.7%,

poliomyelitis in 8.7%, encephalopoliomyelitis in 26.1%). Initially

progressive

course was found in 21.7% of the cases. There was a primary rise of the

hyperkinetic syndrome after the meningeal and focal forms of RTE with the

encephalitic syndrome; while development of the amyotrophic syndrome (ATS)

was

found after the focal form with the poliomyelitic and encephalopoliomyelitic

syndrome. The amyotrophic lateral sclerosis (ALS) syndrome occurs as both

primary progressive RTE and ATS transformation independently of the initial

RTE

form. Latent periods of development of ATS and ALS syndrome were virtually

equal (mean 1.4 years) and did not depend on the initial form of acute RTE.

The

duration of development of latent chronic forms makes it necessary to follow

up

RTE patients for at least 3 years.

 

 

PMID: 11490426 [PubMed - indexed for MEDLINE]

 

 

 

1: Zh Nevropatol Psikhiatr Im S S Korsakova. 1987;87(2):170-8. Links

[Pathogenesis of persistent and chronic forms of tick-borne encephalitis

(experimental study)]

[Article in Russian]

Frolova TV, Frolova MP, Pogodona VV, Sobolev SG, Karmysheva VIa.

A long-term experiment was conducted to study various aspects of the

pathogenesis of persistent and chronic tick-borne encephalitis (TBE).

Virological,

serological, pathomorphological, electron microscopic and immunofluorescent

techniques have been utilized in this study. Persistent TBE infection of

Syrian

hamsters examined over the period from 40 days to 2 years was characterized

by

the presence of virus-specific antigens in the organs and of specific

antibodies

in the blood serum. The persisting TBE virus was found to be predominantly

localized in the central nervous system and spleen. Nerve cells underwent

ultrastructural changes which were characteristic of flavivirus infection

and

related to the morphogenesis of viral particles. The authors have developed

an

experimental model of a primary progressive form of TBE with early and late

manifestations of clinical symptoms of the disease.

 

PMID: 3033955 [PubMed - indexed for MEDLINE]

 

 

1: J Neurol Neurosurg Psychiatry. 2006 Jun 5; [Epub ahead of print] Links

Clinical features of double infection with encephalitis (TBE) and lyme

borreliosis (LB) transmitted by tick bite.

Logina I, Krumina A, Karelis G, Elsone L, Viksna L, Rozentale B, Donaghy MJ.

Stradin's University Hospital, Latvia.

 

BACKGROUND: In Latvia and other endemic regions a single tick bite has the

potential to transmit both tick-borne encephalitis (TBE) and Lyme

Borreliosis

(LB). OBJECTIVE: This retrospective study analyses both the clinical

features,

and differential diagnosis in 51 patients with serological evidence of

combined

tick-borne infection with TBE and LB. 67% had exposure to ticks. RESULTS:

Biphasic fever suggestive of TBE occurred in 55%. Meningitis occurred in 92%

with

painful radicular symptoms in 39%. Muscle weakness occurred in 41%, in 29%

the flaccid paralysis compatible with either TBE. Only two presented with

the

bulbar palsy typical of TBE. Typical LB facial palsy occurred in 2. Typical

TBE

oculomotor disturbances occurred in 3. Other features typical of LB were

detected in our PATIENTS: distal peripheral neuropathy in 4; arthralgia in

9; local

erythema 1 to 12 days after tick bite in 7; erythema chronicum migrans in 1.

ECG abnormalities occurred in 15. CONCLUSIONS: Patients with double

infection

with TBE and LB fell in 3 main clinical groups: febrile illness - 3 (6%);

meningitis - 15 (30%); central or peripheral neurological deficit

(meningoencephalitis, meningomyelitis, meningoradiculitis,

polyradiculoneuritis) - 33 (65%).

Systemic features pointing to LB were found in 25 (49%); IgM antibodies to

Borreliosis were resent in 18 of them. The clinical occurrence of both LB

and TBE

vary after exposure via tick bite, and the neurological manifestations of

each

disorder vary widely, with considerable overlap. This observational study

provides no evidence that co-infection produces unusual manifestations due

to

unpredicted interaction between the two diseases. Patients with tick

exposure

presenting with acute neurological symptoms in areas endemic for both LB and

TBE

should be investigated for both conditions. The threshold for simultaneous

treatment of both conditions should be low given the possibility of

co-occurrence

and the difficulty in ascribing individual neurological manifestations to

one

condition or the other.

 

PMID: 16754695 [PubMed - as supplied by publisher]

1: Nervenarzt. 2002 Dec;73(12):1191-4. Links

[Problems of differential diagnosis in tick-borne encephalitis-induced

polyradiculitis]

[Article in German]

Kollmeier M, Hagemann G, Kunze A, Willig V, Straube E, Witte OW.

Neurologische Klinik der Friedrich-Schiller-Universitat Jena.

 

In about 10% of cases, tick-borne encephalitis (TBE) presents with

additional

myeloradiculitic features mimicking acute poliomyelitis, which can rarely

appear as the sole symptom. We report on a 59-year-old man infected with TBE

in

Thuringia,Germany, who developed polyradiculitis with rapidly progressive,

predominantly proximal tetraparesis and respiratory failure. We discuss the

differential diagnosis and the epidemiological relevance in conjunction with

a

second typical case of TBE acquired in the same region and time period.

 

PMID: 12486571 [PubMed - indexed for MEDLINE]

1: Zh Nevrol Psikhiatr Im S S Korsakova. 2003;103(6):4-6. Links

[The study of adaptation syndrome in mixed-infection of tick-borne

encephalitis and borreliosis in children]

[Article in Russian]

Subbotin AV, Poponnikova TV, Zinchuk SF.

Twenty two children with mixed-infection of tick-borne encephalitis (TBE)

and

ixodic tick borreliosis (ITB) were studied. Blood hydrocortisone level was

changed in 94.5% of the cases. The most significant activation of

hydrocortisone

secretion in combination with the most pronounced and prolonged general

brain

manifestations, was detected in infants. Blood hydrocortisone level

correlated with clinical symptoms of combined TBE and ITB infections. Along

with higher

hydrocortisone level, down-regulation of production of antibodies both to B.

burgdorferi and to TBE virus was specific for all children studied.

 

PMID: 12872617 [PubMed - indexed for MEDLINE]