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The Neurologic Disorders in Film
Published in Eelco F. M. Wijdicks, Neurocinema—The Sequel, 2022
Two films show a scene with a missed diagnosis of meningitis. In The Men (1950) , one of the traumatic spine injury patients develops fever. It shows testing for neck stiffness, a lumbar puncture, and the surgeon in charge going bonkers after the patient dies. The movie Barbara (2012) also shows a missed diagnosis of meningitis. Barbara (played by Nina Hoss) is a physician sent to a small sea town in northeast Germany close to the Baltic Sea. A girl is admitted, confused, and belligerent. The physician prepares a sedative because this patient had been admitted many times with fake diseases. (It is later revealed that she is in a hard-labor camp and tries to escape using fake medical illness as an excuse.) Barbara discovers neck stiffness and proceeds with a lumbar puncture. Apparently, the girl had hidden in the woods while attempting to escape and contracted tick-borne meningoencephalitis. It realistically shows meningoencephalitis presenting with behavioral problems. The patient recovers after she is treated with “serum.” This is quite timely, particularly because tick-borne encephalitis is prevalent in Eastern Europe and Russia—in the summer. Most cases occur in Germany and the areas formerly known as Czechoslovakia and the USSR. The median incubation time is eight days after a tick bite. The mentioned “serum treatment” is unexplained because there is no specific treatment for tick-borne encephalitis, only prevention by active immunization.88
Determination of Antiviral Activity
Published in Adorjan Aszalos, Modern Analysis of Antibiotics, 2020
A generalized statement can be made regarding essentially all the group A and B arboviruses, and that is that they will induce a fatal encephalitis in a variety of laboratory animals, but especially the mouse when injected intracerebrally. Younger mice are usually more susceptible than the adult animal. Peripheral exposure, including intranasal instillation, will often also produce a CNS-associated illness. With several of the viruses (such as yellow fever virus), some adaptation to the animal is required before reproducible infections occur. This adaptation is accomplished by successive passage of the virus through the brain of the animal [277]. Examples of chemotherapy experiments with these viruses include reports by Odelola [278] using West Nile virus in mice, Stephen et al. [256] using Chikungunya virus infections in monkeys and yellow fever virus and Venezuelan equine encephalitis virus infections of mice, Bauer and Sadler [279] with Semliki Forest, dengue, and less known arboviruses in mice, Mizuma et al. [280] using Japanese encephalitis in mice, Kramer et al. [281] using St. Louis encephalitis in mice, and Gresikova et al. [282] with tick-borne encephalitis in mice.
Arthropod-borne virus encephalitis
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
Although Japanese encephalitis is undoubtedly the most widespread destructive arbovirus encephalitis, afflicting tens of thousands of people annually in Asia, this section will start with Venezuelan equine encephalitis which can also afflict tens of thousands of people as well as horses in South and Central America and Mexico. Outbreaks of Venezuelan equine encephalitis are typically separated by several years or decades. A very large number of people are afflicted by the Central European, or milder, form of tick-borne encephalitis, and an unknown number in the former Soviet Union by the severe Far Eastern form of Russian spring–summer tick-borne encephalitis. Other arboviral encephalitides discussed in this section are Murray Valley encephalitis of Australia and Rift Valley fever, which, in the past two decades, has become a broader geographic threat than simply east Africa.
Role of environmental factors in multiple sclerosis
Published in Expert Review of Neurotherapeutics, 2021
Amin Zarghami, Ying Li, Suzi B. Claflin, Ingrid van der Mei, Bruce V. Taylor
Interestingly, there is some evidence to suggest that some vaccinations may be protective against MS onset. A 2019 case-control study (12,262 MS cases/79,185 controls) demonstrated that HBV vaccination was associated with a reduced MS onset risk (OR:0.84; 95%CI: 0.72–0.97) [220]. Similarly, a 2011 meta-analysis (n = 3 studies on diphtheria vaccination; n = 8 studies on tetanus vaccination) suggested that the diphtheria and tetanus vaccines may be associated with decreased risk of MS onset (Table 1) [218]. A 2006 meta-analysis (n = 9) found that getting a tetanus vaccination in the 5 years before the first MS symptom was protective against MS onset and dose-responsive [221]. Finally, a 2019 case-control study (12,262 MS cases) found that tick-borne encephalitis (TBE) vaccination in the 5 years before diagnosis was associated with a decreased risk of MS onset (OR:0.90; 95%CI:0.84–0.96) [220].
Low prevalence of tick-borne encephalitis virus antibodies in Norwegian blood donors
Published in Infectious Diseases, 2021
Åshild Marvik, Yngvar Tveten, Anne-Berit Pedersen, Karin Stiasny, Åshild Kristine Andreassen, Nils Grude
Tick-borne encephalitis (TBE) is one of the most important tick-borne diseases in Europe and Asia [1–4]. The causative agent, tick-borne encephalitis virus (TBEV), is neurotropic and consists of three subtypes described according to their main distribution area: European (TBEV-Eu), Far-Eastern (TBEV-FE) and Siberian subtype (TBEV-Sib) [5]. Three other subtypes of TBEV, TBEV Baikalian (TBEV 886-84), TBEV 178-179 and TBEV Himalayan have also been suggested [6–9]. TBE is a zoonotic disease and transmission to humans is mainly due to tick bites and only a minor extent due to the alimentary route through infected dairy products [1,4,10]. Ticks and small rodents constitute the reservoirs for TBEV. Ixodes ricinus is the principal vector for TBEV-Eu and occurs in large parts of Europe. Ixodes persulcatus, the vector for the Far-Eastern and Siberian subtypes, occurs in Eastern Europe, Siberia and far east including Japan [2]. Thus, in Europe, human disease caused by TBEV-Eu predominates [2,3,11].
Post-exposure prophylactic vaccine candidates for the treatment of human Risk Group 4 pathogen infections
Published in Expert Review of Vaccines, 2020
James Logue, Ian Crozier, Peter B Jahrling, Jens H Kuhn
Finally, tick-borne encephalitis virus (TBEV; Flaviviridae: Flavivirus) is generally transmitted by ixodid ticks in Western (Ixodes ricinus) and Eastern (Ixodes persulcatus) Europe. The virus is maintained by over 100 species of wild animals, including voles, deer, and domestic animals such as sheep [122–124]. Although patients infected with TBEV normally only present with an initial, nonspecific febrile phase, 20–30% of patients progress to a second stage of disease with CNS signs (meningitis, encephalitis, or both). Lethality is generally 1–2%, but 30–60% of patients develop chronic neuropsychiatric sequelae [125,126]. Three different vaccines for pre-exposure disease prevention (IPVE, FSME-IMMUN, and Encepur) are generally available in endemic regions [127]. However, fears over the potential of antibody-dependent disease enhancement or increased viral infectivity caused by ‘sub-optimal’ concentrations of virus-specific antibodies have hampered further vaccine development [128]. For this reason and the potential of other adverse effects [129], none of these vaccines are licensed by the US FDA. Vaccine use is neither recommended by the US Centers for Disease Control and Prevention (CDC) nor the WHO except for high-risk individuals, such as laboratory workers or workers with high exposure to potentially infected host ticks [130,131]. Multiple studies into the use of antibody treatments as PEP have produced promising results in laboratory mice with no disease enhancement [132,133].