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Biomedical subjects

J McQuillin

Publications and source records attributed to J McQuillin.

At least 37 records · Page 2Linked to original sources
PubMed1976

Respiratory syncytial virus infection in north-east England.

During a period covering four winter epidemics 987 respiratory syncytial (RS) virus infections were identified in the children's wards that served a total population of about 875 000 in north-east England. The incidence of admission to hospital with RS virus infection tended to be twice as high among children in Tyneside as that among children from the rest of the catchment area. The risk of hospital admission with RS virus infection in the first year of life for city children was about 1 in 50. The risk tended to be increased when there was a high proportion of children in the population, overcrowded housing, and unemployment. There was no clear relation between climatic changes and the onset or progress of epidemics. Thirteen deaths associated with RS virus infection were identified, four of them sudden and unexpected at home, and nine of them in children with congenital or acquired abnormalities. Twelve children were admitted twice with distinct RS virus infections; the relative severity of their two illnesses depended on age. Hospital cross-infection accounted for 60 of the 987 illnesses. Large families and overcrowding among poorer families seem to lead to a higher incidence of RS virus infection, and measures to reduce overcrowding and improve housing should help to reduce the spread of infection. Breast-feeding also protects infants from infection, but further information is needed to pinpoint the infants at greater risk and how they may best be protected.

Child, Preschool↗
PubMed1975

Gastric 'flu influenza B causing abdominal symptons in children.

Influenza-B virus was identified in 102 children admitted to hospital during two epidemics in 1973 and 1974, enzbling the symptomatology of infection with this virus to be assessed in detail for the first time. Abdominal pain, often severe enough to require differentiation from acute appendicitis, emerged as a dominant symptom, especially in older children. Respiratory symptoms were often insignificant, although the lower respiratory tract was sometimes involved. Other symptoms in some children included convulsions and acute myalgia. The immunofluorescent method of virus diagnosis was found to be reliable for influenza B, except in a few cases ehere nasopharyngeal secretions were scanty, giving 97-5 percent copositivity with standard isolation techniques. The rapid result provided by immunofluorescence was helpful in clinical diagnosis and management and also in the control of hospital cross-infection.

Abdomen, Acute↗
PubMed1975

Role of respiratory viruses in childhood mortality.

Respiratory viruses have been identified at necropsy in the lungs of 13 out of 24 children who died with observed acute respiratory illness. The histological appearances of the lungs supported the association between virus and death in each of these 13 children and suggested an unidentified virus aetiology in a further five cases. Histological appearances compatible with bacterial infection were found in the lungs of only two of the 24 children. Similar virus and histological findings have been reported in about one-third of victims of the sudden infant death syndrome (cot deaths), indicating a rapid unobserved respiratory virus infection as the most likely mode of death in this group. Evidence that respiratory viruses may be involved in a larger proportion of sudden unexpected deaths, perhaps as antigens in a hypersensitivity reaction, is discussed. Respiratory viruses seem the major identifiable agents contributing to the maintenance of the postneonatal mortality rate since acute respiratory illness and the sudden infant death syndrome together account for about two-thirds of deaths at this age.

Acute Disease↗
PubMed1973

Sudden and unexpected deaths in infants: histology and virology.

The histological appearance of lungs of children whose death had been sudden and unexpected has been studied in relation with the viruses found at necropsy. Fifty-one children were investigated and in 33 the lungs had the histological appearance widely accepted as characteristic of the condition previously termed "cot death." Sixteen had the histological appearance of lymphocytic bronchiolitis, and it was from this group only that viruses were isolated. The viruses isolated were those associated with respiratory infections. Two patients showed the histological appearance of bacterial bronchopneumonia. Viruses are probably responsible for a substantial proportion of unexpected sudden deaths in infancy.

Bronchi↗
PubMed1971

Respiratory syncytial virus in hospital cross-infection.

During an epidemic of respiratory syncytial (R.S.) virus in Newcastle upon Tyne 13 children developed R.S. virus infections while in hospital with other conditions. R.S. virus infection was also noted in four members of the staff. In two of the hospital wards outbreaks developed. All children infected with R.S. virus developed symptoms. The symptoms varied with age; two children aged 2 months or less developed colds, as did five children over 1 year of age. One child of 15 months with Werdnig-Hoffman disease, though suffering from a cold, later developed pulmonary collapse. All five children aged 3 to 8 months developed bronchiolitis. The effectiveness of special nursing in cubicles was probably diminished because adults with mild colds were excreting virus. The dangers of R.S. virus infection to other children in the ward, especially those with congenital heart disease, is emphasized.

Arthritis↗
PubMed1971

Observations on clinical and immunofluorescent diagnosis of parainfluenza virus infections.

Immunofluorescent techniques have been applied to nasopharyngeal secretions for the rapid diagnosis of parainfluenza virus types 1, 2, and 3 infections. Seventy-five infections were found by isolation techniques; 55 of these had nasopharyngeal secretions taken and 53 were positive by direct examination. A comparison of the results of 60 neutralization tests with immunofluorescence applied to monkey kidney isolations showed complete agreement. Immunofluorescence appeared to be a satisfactory method for differentiating the various haemadsorption viruses. The importance of parainfluenza viruses and respiratory syncytial virus in croup was noted and the association of the parainfluenza viruses with acute respiratory virus infection was confirmed. The clinical relationship between respiratory syncytial virus and parainfluenza virus type 3 is discussed.

Carcinoma↗
PubMed1971

Rapid diagnosis of respiratory syncytial virus infection in children by the immunofluorescent technique.

The immunofluorescent examination of nasopharyngeal secretions has been compared with conventional cell culture for the diagnosis of respiratory syncytial (RS) virus infection in children under the age of 2 years in Newcastle upon Tyne and Manchester. Two hundred and sixty-eight identifications of RS virus were made by the fluorescent method, of which 258 (96%) were confirmed culturally. In 267 children from whom virus was isolated in cell culture a positive diagnosis was made by the fluorescent method in 258 (97%). In 238 infants with bronchiolitis a diagnosis of RS virus infection was made on the basis of the fluorescent test in 185 (78%) of which 180 (97%) were subsequently confirmed in cell culture. The reasons for false results are briefly discussed. It is concluded that the method is reliable for the early diagnosis of respiratory syncytial virus infection.

Bronchiolitis, Viral↗
PubMed1970

Respiratory syncytial virus infection of the newborn.

In an outbreak of respiratory syncytial (R.S.) virus infection in a maternity hospital the respiratory illness was of a mild nature and the virus was not found in infants without respiratory symptoms. This confirms the suggestion that R.S. virus can infect infants at a very early age. Rapid diagnosis was achieved by applying the direct fluorescent antibody technique to cells in nasal secretions. This proved to be more sensitive than culture techniques where there was delay between the onset of respiratory symptoms and submission of specimens to the laboratory.

Disease Outbreaks↗
PubMed1970

Speculation on pathogenesis in death from respiratory syncytial virus infection.

The lungs of three infants, two with bronchiolitis and one with pneumonia, were examined by fluorescent antibody techniques for the distribution of respiratory syncytial (R.S.) virus, and also for the presence of human globulin. In bronchiolitis the lungs contained little virus, whereas in pneumonia virus was abundant and widespread; and, paradoxically, while in bronchiolitis human globulin had the same scanty distribution as virus it was absent in pneumonia. It is suggested that the essential process in bronchiolitis is a widespread type 1 allergic reaction dependent on a second encounter with R.S. virus antigen, whereas in R.S. virus pneumonia the mucosal necrosis and alveolar and interstitial inflammation are the result of direct virus damage to the lungs. The alternative explanation put forward is that the process may be a type 3 allergic reaction.

Autopsy↗
PubMed1970

The use of cough-nasal swabs in the rapid diagnosis of respiratory syncytial virus infection by the fluorescent antibody technique.

Thirty-five consecutive infants admitted into hospital in Newcastle upon Tyne with acute respiratory disease had cough/nasal swabs and nasopharyngeal secretions taken. Both types of specimens were examined by the fluorescent antibody technique for respiratory syncytial virus; isolation techniques were also used. Twenty-eight specimens of nasopharyngeal secretion were positive, as were 26 of the corresponding cough/nasal swab preparations. Respiratory syncytial virus was isolated from all but one.Sixteen consecutive children who were only suitable for examination by cough/nasal swab preparations were also investigated by isolation and fluorescent antibody techniques for respiratory syncytial virus. Respiratory syncytial virus was isolated from eight, seven of whom were positive by the fluorescent antibody technique. The use of cough/nasal swab preparations stained by the fluorescent antibody technique, although not as efficient as nasopharyngeal secretions, may have a place in the rapid diagnosis of respiratory virus infection in older children and children in general practice. The importance of rapid diagnosis for respiratory virus infection in relationship to antiviral therapy was also discussed.

Bronchiolitis, Viral↗
PubMed1970

The late detection of respiratory syncytial virus in cells of respiratory tract by immunofluorescence.

Paired nasopharyngeal secretions were studied in 27 infants infected with respiratory syncytial virus, one taken at onset of illness and one about 7 days later. Both specimens were examined by immunofluorescence and tissue culture for respiratory syncytial virus. In 25 out of 27 (93%) specific fluorescence was still present in cells of the convalescent specimen but was much duller. Virus was difficult to isolate in convalescent specimens; only 8 out of 27 (26%) proved to be positive. Eight single secretions which were taken late in a respiratory illness were also shown to have this altered fluorescence with absence of virus isolation. Preliminary experiments using antihuman globulin suggest that the findings may be due to the attachment of local secretory antibody to the cells causing ;blocking' of staining reaction.

Antibodies↗
PubMed1970

Pathological changes in virus infections of the lower respiratory tract in children.

The pathological changes are described in 22 children with proven or suspected virus infection of the lower respiratory tract. Two main patterns of disease were found: acute bronchiolitis and interstitial pneumonia. Particular viruses were not specifically associated with particular histological changes. The prime importance of the respiratory syncytial virus (RSV) as a cause of disease and death in young infants is again shown. Structural lesions and clinical dysfunction correlate fairly well; in acute bronchiolitis the main lesion is epithelial necrosis when a dense plug is formed in the bronchiolar lumen leading to trapping air and other mechanical interference with ventilation: in interstitial pneumonia there is widespread inflammation and necrosis of lung parenchyma, and severe lesions of the bronchial and bronchiolar mucosa as well. The implications of these structural changes for clinical management are discussed. The possibility of a hypersensitivity reaction in the cot death syndrome is raised, mediated by a serum antibody-antigen-complement reaction.

Adenoviridae↗