Takahiro Niizuma

Detection of varicella-zoster virus DNA in peripheral mononuclear cells from patients with Ramsay Hunt syndrome or zoster sine herpete.

On the basis of alterations in varicella‐zoster virus (VZV) antibody titers, it appears that Bells palsy in some patients could be associated with VZV reactivation, that is, zoster sine herpete. To obtain stronger evidence of this association, polymerase chain reaction (PCR) was used to detect VZV DNA in auricular lesions or peripheral blood mononuclear cells (PBMCs) from Bells palsy or Ramsay Hunt syndrome patients. VZV DNA was detected in the auricular lesions of Ramsay Hunt syndrome, in PBMCs from 2 Ramsay Hunt syndrome patients, and in 4 of 17 samples from 16 Bells palsy patients. Three of these four positive patients were thought to have zoster sine herpete because of hearing difficulty, vertigo, and pain. VZV IgM antibodies were positive in 1 of the 2 patients with Ramsay Hunt syndrome, and in 2 of the 17 samples from the Bells palsy patients. VZV IgG antibody titers during the acute phase were significantly higher in the patients positive for the PCR or VZV IgM antibody than in those negative for them. These findings provide evidence that Bells palsy in some patients could be associated with VZV reactivation. J. Med. Virol. 56:359–363, 1998.

Bilateral facial nerve palsy associated with Epstein-Barr virus infection with a review of the literature

A case of bilateral simultaneous facial nerve palsy associated with an Epstein-Barr virus (EBV) infection in a 14-month-old girl is described. Diagnosis of the EBV infection was based on the presence of 7% atypical lymphocytes, EBV-DNA and seroconversion in the VCA-IgG antibody, an EBV-specific antibody. Although bilateral facial nerve palsy is very rare, approximately 40% of the EBV-associated facial nerve palsy cases reported have been bilateral.

Characteristics of facial nerve palsy during childhood in Japan: frequency of varicella–zoster virus association

Background: The aim of this study was to clarify the clinical characteristics of facial nerve palsy and the frequency of varicella–zoster virus association in Japanese children, retrospectively.

Gastric pneumatosis associated with duodenal stenosis and malrotation

Abstract. Pneumatosis intestinalis, which is linear or cystic gas within the bowel wall, is usually found in premature babies in association with necrotizing enterocolitis. Gastric pneumatosis defined as intramural gas of the stomach is a rare sign during infancy. We report an infant with Downs syndrome and a duodenal web with obvious gastric pneumatosis.

Responses of varicella zoster virus (VZV)-specific immunity in seropositive adults after inhalation of inactivated or live attenuated varicella vaccine.

To examine boostering of varicella zoster virus (VZV)-specific immunity in seropositive adults after nasal inhalation of heat-inactivated or live attenuated varicella vaccine, we determined specific cellular immunity, IgG antibody in sera and secretory IgA antibody in saliva before and after the inhalation. The mean titers in specific IgG antibody and skin test findings significantly increased following inhalation of both vaccines. However, the ratio of a two-fold or more increase in the levels of IgG antibody or skin test did not show significant difference after inhalation of the inactivated vaccine in comparison with those in the control. After inhalation of the live vaccine, the ratio showed significant difference but transmission of the live vaccine virus to others was suspected. No significant increase in VZV-secretory IgA antibody levels in saliva was noted following inhalation. The results of this study suggested that nasal inhalation of the live vaccine could increase specific immunity in adults. This method would be similar to the natural infection and simpler than subcutaneous injection.

Testing for rubella-specific IgG antibody in urine.

Background. In Japan rubella vaccination is generally done once during a lifetime, and the vaccination rate decreased after a revised vaccination law in 1995. History of rubella or vaccination may still be unreliable. Testing for rubella antibody is significant to prevent the occurrence of congenital rubella syndrome. However, the collection of blood samples to detect antibodies from young children is invasive and difficult. Methods. For this study we obtained 853 matched serum and urine samples from 904 healthy students 10 or 14 years of age in the Ibara and Yoshii districts of Okayama, Japan, for a comparison of antibodies for rubella in the matched samples. The serum and urine antibodies were measured with hemagglutination‐inhibition and enzyme‐linked immunosorbent assays, respectively, and with our urine‐based antibody test. Results. The sensitivity, specificity and concordance rates of this urine‐based antibody test were 96, 99 and 97% based on the serum antibody results of both assays. The coefficiency was 0.627 between the titers of the urinary and serum antibodies by the enzyme‐linked immunosorbent assay. The urinary antibodies were stable for at least 5 months at 4°C and 25°C. Conclusions. Urine‐based assay methods are helpful not only because they avoid the invasive approach of venipuncture but also because unprocessed urine specimens can be used and urinary antibody is stable for a long period. Therefore this test is suitable for screening. In addition protective amounts of rubella antibody in blood can be reliably assessed by means of urine samples.

Intrafamilial transmission of Salmonella oranienburg

Backgroud : There were diffuse outbreaks of Salmonella oranienburg in Japan since March 1999 which included 1505 patients. The outbreak was caused through ingestion of a dried squid snack contaminated with S. oranienburg. Such a large number of cases has not been previously recorded in Japan or other countries.

Elevated serum C-reactive protein in mumps orchitis.

A case of mumps orchitis with a high concentration of C-reactive protein (CRP) prompted us to evaluate the inflammatory response in mumps complications. We compared the CRP titers in mumps patients with orchitis and meningitis. The serum CRP titers were significantly higher in the patients with orchitis than in those with meningitis.

Low induction of varicella-zoster virus-specific secretory IgA antibody after vaccination

Breakthrough after varicella vaccination occurs in approximately 2.6%∼18.6% of immunocompetent children, but the reason has not been demonstrated clearly. As a first defense, specific secretory IgA antibody on the mucosa plays an important role in preventing invasion of microorganisms. To examine induction of varicella‐zoster virus (VZV) specific secretory IgA after natural infection and vaccination and its booster mechanisms, 143 salivary samples were tested by ELISA. The VZV‐secretory IgA values were significantly higher in the matched children after natural chickenpox than in those after vaccination, although the total secretory IgA did not differ between them. Two (7%) of the vaccinees lacked the sIgA antibody. In the elderly and in immunocompromised children, the VZV‐secretory IgA values were no lower than those in healthy children, and they did not lack VZV‐secretory IgA. The doctors and nurses taking care of patients with chickenpox had higher values than the other groups as did individuals who had had herpes zoster recently. VZV‐secretory IgA was thought to be stimulated by exogenous and reactivated endogenous VZV to neutralize VZV with weak activity. These results suggest that low or no induction of VZV‐secretory IgA antibody after vaccination may be one of the possible explanations for a breakthrough. J. Med. Virol. 62:46–51, 2000.

Recurrent meningitis with Mondini dysplasia after the operation and vaccination.

Several congenital diseases can cause recurrent meningitis, including immunodeficiency and cerebrospinal fluid (CSF) leakage. Mondini dysplasia, an inner ear malformation with cochlear dysplasia, can also be accompanied by CSF leakage, which occasionally causes recurrent meningitis via the auditory tube. We report the case of a girl with Mondini dysplasia who experienced three episodes of pneumococcal meningitis despite undergoing definitive operation and pneumococcal polysaccharide vaccination.