NEW DISEASE REPORTED

Taihape Daily Times, 24 May 1919, Page 6

NEW DISEASE REPORTED

AFFECTION OF THE BRAIN.

SEVERAL AUCKLAND CASES

DESCRIPTION OF SYMPTOMS

A new disease, chiefly affecting the "brain, has made its appearance in Auckland, and several cases are reported to have occurred. Its technical name is lethargic encephalitis. The illness was present in England in epidemic form from February to June. 191 S. and the suggestion was made when the earliest cases were reported that they were examples of botulism, and gave no support to the association of the outbreak of infection from food.

The epidemic in England never attained large proportions, and at present tscre is not a groat deal of evidence available dealing with the. disease. V From the experience gained in England, it is recognised to be an acute affection, due to a specific \iius, which probably finds its way through the nose like acute anterior poliomyelitis —infantile paralysis —and which, like it, has a special affinity for the nervous system, though for different areas and ailments. It is stated that Professor Marinesco, of Bucharest, who more than ten years ago studied and described bothlism, is of the opinion that

symptoms accompanying lethargic encephalitis present a striking resemblance to those of sleeping sickness.

CASES IN AUCKLAND HOSPITAL Girving evidence at an inquest, on Tuesday, Dr. C. E. Macguire, medical superintendent of the Auckland Hospital, said the patient, a married man, 38 years of age. was suffering from lethargic encephalitis. Several such cases had been treated in the Auckland Hospital. The disease appeared in epidemics, was was not in itself epidemic. In the case under investigation, the case itself occurred while the patient was under an anaesthetic, administered to permit a minor operation necessary to dedicate the diagnosis, and also as a means of treatment. The actual cause of death was

respiratory failure. Another case has been reported by

a private practitioner. SYMPTOMS OF THE DISEASE. Lethargic encephalitis lias been described as a general infectious disease, characterised by manifestations originating in the central nervous system, of which the most frequent are progressive lethargy and stupor. Usually the first symptom is simple cattarhal conjunctivitis. In a smaller number of cases of those which occurred in England, tonsilitis, sore throat, and bronchial catarrh were observed, but the most salient symptom was progressive lethargy. It might bo ushered in by fainting attack, but the onset is

more often gradual. The patronf generally becomes dazed or stupid, is inclined to sleep a great deal, and to bo drowsy by day. In marked cases the lethargy is accompanied, by heaviness of the eyelids, pain in the eyes, and blurred vision. Headache is common, and giddiness is a highly characteristic symptom. The patient may exhibit a highly emotional state, and symptoms which may be labelled hysterical. In other instances ; the mental depression is so great that melancholia might- be The severerest cases lie like a log in; bed, in a state of catalepsy. Delirium, usually soeturial, is not uncommon.

During the time of the epidemic i:: England, among KSS cases. 37 death" were recorded.

QUESTION OF AFTER-EFFECTS. » -There is little evidence regarding ; after-effects, but among certain epidemic cases in England certain manifestations persisted after the expiration of three months from the date cf onset. Among these were an alteration of the mental condition, persistent cranial nerve palsy, and the appearance of paralysis, apparently of spinal origin. The resemblance between encephalitis and the rare eases of the cerebal form of infantile paralysis is very close, and it seems probable that some of the cases reported in England and elsewhere in the past as cercbro-spinal-poliomyelitis may have been cases of the new disease. There are clinical indications that in the epidemic in England last year both polomyelitis and lethargic encephalitis occurred, but ricn in association with each other. It is believed that convalescence will last for six months after the beginning of an illness.

Lethargic encephalitis was made a notifiable disease by the Local Government Board in England. The advantages of notification as the fundamental step in- elucidation of the prob. lems of infectious disease in general appear now to have been fully recognised. and with- information of the occurrence of cases at their disposal, the authorities will be able to co-ordinate in research, and the discovery of the cause ,of the disease wall bo advanced. In New Zealand lethargic encephalitis is not a notifiable infectious disease, but it is the opinion among medical mon that it should bo included in the liat of diseases under the Public Health Act, especially in view of the fact that several cases have already oecuried.