Polio-like motor paralysis associated with acute hemorrhagic conjunctivitis in an outbreak in 1981 in Bombay, India: clinical and serologic studies

High and rising neutralizing antibody titers (NATs) to enterovirus type 70 (EV70) were detected in the serum and cerebrospinal fluid (CSF) of patients with polio-like motor paralysis accompanying acute hemorrhagic conjunctivitis (AHC) in an outbreak of AHC in 1981 in Bombay, India. Fifty-four (88.5%) of 61 patients with AHC with or without neurologic disease had serum NATs of ≥ 1:16, and some paired sera from these patients showed significant increases in NAT. Serum from noninfected control subjects had no significant neutralizing antibody to EV70. Thirty-six (94.7%) of 38 CSF specimens from 30 patients with spinal or a combination of spinal and cranial motor paralysis associated with AHC had NATs ranging from 1:2 to 1:256. No neutralizing antibody was found in CSF specimens from patients with AHC alone or in those from non-infected control subjects, and a reduced ratio of serum NAT to CSF NAT was detected in patients with neurologic disease. Therefore, it is highly likely that intrathecal synthesis of antibody occurred in response to direct invasion of the central nervous system by EV70. The results represent strong laboratory evidence of the neurovirulence of EV70

Real-time near-body drug screening during autopsy I:use of the Randox biochip drugs of abuse DOA I and DOA II immunoassays

Screening for drugs of abuse is widely employed as part of forensic toxicology investigations. The nature of specimens collected at autopsy varies depending on local customs, the case circumstances, and the condition of the cadaver. It is generally accepted that wherever possible specimens of peripheral blood, liver, stomach contents, vitreous humor, and muscle can be useful for toxicological analysis. In some countries, legislation or religious custom may mitigate against the removal of postmortem tissue unless shown to be necessary. The availability of a sensitive and broad ranging near-body screening test may provide a useful tool to assist pathologists in making decisions regarding the retention of tissues for toxicology analysis. We describe the performance of the Randox drugs-of-abuse (DOA) arrays, DOA I and DOA II, for near-body screening using whole blood, urine, vitreous humor, liver, and psoas major muscle. Samples were obtained from 106 autopsies and screened for the presence of amphetamine, barbiturates, benzodiazepines, benzoylecgonine, buprenorphine, cannabinoids, fentanyl, ketamine, lysergic acid diethylamide, methadone, methamphetamine, methaqualone, methylenedioxymethylamphetamine (Ecstasy), opiates, oxycodone, phencyclidine, and propoxyphene in the mortuary whilst the postmortem was being performed. Blood from each case underwent confirmatory analysis using either gas chromatography-mass spectrometry, liquid chromatography with tandem mass spectrometry or diode array detection. Excellent agreement between the near-body screening tests on a variety of tissues and confirmatory analyses in blood was obtaine