Directigen FluA؉B (BD Diagnostic Systems, Sparks, Md.), a new rapid test for the detection of influenza virus types A and B, was evaluated with nasopharyngeal aspirate specimens collected from 250 patients in comparison with culture and direct fluorescent antigen (DFA) detection tests. The patients studied were predominantly children, 80% being <6 years old. Specimens negative by culture but positive by the Directigen FluA؉B or DFA tests were analyzed by reverse transcription-PCR to resolve the discrepant results. The resolved sensitivity, specificity, and positive and negative predictive values of the Directigen FluA؉B test for influenza virus type A were 96%, 99.6%, 96%, and 99.6%, respectively, and for influenza virus type B they were 87.5%, 96.8%, 80%, and 98%, respectively. Storage of nasopharyngeal aspirates in virus transport medium at 2 to 8°C for 48 h had little adverse effect on the detection of influenza virus type A, but diagnosis of influenza virus type B is best carried out with fresh specimens. The test detected a range of human and animal influenza virus A subtypes, including the H5N1 and H9N2 viruses that recently caused human disease in Hong Kong.

Important features of this disease are its high morbidity and mortality within a flock or herd, rapid local spread and its role as an occupational, health and safety risk to farm workers and their families.

SUMMARY Eleven infants with neonatal onset of intractable epilepsy are described, who showed the clinical and electroencepahlographic features of Ohtahara syndrome. With time, transition to West and Lennox‐Gastaut syndromes occurred. No cause could be found in eight cases. All nine survivors are severely mentally and physically handicapped and continue to have seizures. Early infantile epileptic encephalopathy represents the earliest of the age‐dependent epileptic encephalopathies. RÉSUMÉ Encéphalopathie épileptogène infantile précoce avec bouffée suppressive (syndrome d'Ohtahara) L'article décrit 11 nourrissons avec un début néonatal d'épilepsie incurable présentant les caractéristiques cliniques et électroencéphalographiques du syndrome d'Ohtahara. Avec le temps, une transition survint vers les syndromes de West et de Lennox‐Gastaut. Aucune cause ne fut retrouvée dans huit cas. Les neuf survivants sont tous gravement handicapés sur les plans mental et physique et continuent à avoir des crises. L'encéphalopathie épileptogene infantile précoce représente la plus précoce des encéphalopathies épileptogènes reliées a l'âge. ZUSAMMENFASSUNG Infantile epileptische Encephalopathie mit burst suppression Muster (Ohtahara Syndrom) Es werden 11 Kinder mit einer im Neugeborenenalter beginnenden, unbeeinflußbaren Epilepsie beschrieben, die klinische und elektroencephalographische Merkmale des Ohtahara Syndroms aufwiesen. Im Verlauf traten Übergänge zu den West‐ und Lennox‐Gastaut Syndromen auf. In acht Fällen konnte keine Ürsache gefunden werden. Alle neun Überlebenden sind geistig und körperlich schwer behindert und haben weiterhin Anfälle. Die frühinfantile epileptische Encephalopathie ist die am frühsten auftretende altersabhängige epileptische Encephalopathie. RESUMEN Encefalopatia epileptica infantile precoz con accesos de supresión (sindrome de Ohtahara) Se describen once lactantes con epilepsia intratable de inicio neonatal, que mostraron las carasteristicas clinicas y EEG del sindrome de Ohtahara. Con el tiempo tuvo lugar su paso al sindrome de West y de Lennox‐Gastaut. No se halló ninguna etiologia en ocho casos. Todos los neuve supervivientes eran gravemente minusválidos, tanto mental como fisicamente y continuaron teniendo ataques. La encefalopatia epiléptica infantil precoz representa la más temprana de las encefalopatias epilépticas dependientes de la edad.

No abstract

Haemorrhagic septicaemia was excluded as a cause of disease from the three farms, however P. multocida was the primary agent in the affected calves. It is possible the agent has been present in New Zealand for some time but not reported, as there had been no transfer of animals between affected farms. Emergence of the syndrome could potentially be a result of factors other than just the presence of the organism, such as changing management. The syndrome described may be of increasing importance in the future.